Expert Witness Journal Dec 24 - Journal - Page 80
psychological interventions rather than medical
treatments. This distinction can be crucial in legal
cases, where it is vital to instruct an expert who has the
appropriate qualifications for the specific issues at
hand.
In another case, Mr Jiggly had a long history of
mental illness and drug misuse. At the time of his
offence, a serious assault, he was off his prescribed
medication and was consuming street drugs, which
aggravated his condition. When Dr McAllister
interviewed him in prison, Mr Jiggly initially appeared
calm and cooperative. However, when asked about his
nickname, he became enraged and abruptly ended
the interview, making it difficult to assess his fitness to
plead. This case highlighted the challenges forensic
psychiatrists face when trying to extract meaningful
insights from individuals who may not be in a stable
mental state.
In recent years, cases have highlighted the need for
courts to ensure they are appointing experts with the
right mix of practical and academic experience. As
Dr McAllister points out, the difference between
psychologists who are experienced practitioners
and those who are primarily researchers can have
significant implications in court. Legal professionals
must instruct experts who combine academic
knowledge with real-world experience as well as
continued professional development in both their
clinical practice and their role as an expert witness.
In both instances, the expertise of the forensic
psychiatrist was critical in providing the court with a
thorough understanding of the defendant's mental
health. These assessments informed not only whether
the individuals were fit to stand trial but also whether
they required compulsory treatment under the
Mental Health Act.
Selecting the Right Forensic Expert
Instructing the correct expert is not always straightforward, especially within the complex and specialised
field of forensic psychiatry. Psychiatry, like medicine, has
multiple subspecialties, each addressing different areas
of mental health. For example, forensic psychiatrists
may specialise in areas such as child and adolescent
psychiatry, learning disabilities, or addiction, and
choosing an expert outside their specialty could
weaken the integrity of their opinion in court.
The Importance of Clear Instruction
Clear communication between legal professionals and
forensic experts is essential. Dr McAllister stresses the
importance of specifying in the letter of instruction
whether the psychiatric assessment should be
conducted in person or remotely. Miscommunication
about this can lead to delays in court proceedings, as
Dr McAllister recounts in an example where a
misunderstanding about the location of an assessment
caused an unnecessary delay.
Dr McAllister draws an analogy to medical practice:
just as you wouldn’t consult a hand surgeon for a
hearing loss case, legal professionals must ensure they
are instructing the right type of forensic psychiatrist.
The expertise of forensic psychiatrists extends beyond
diagnosis and treatment. Their unique role in the
criminal justice system allows them to recommend
compulsory assessment and treatment within a legal
framework, providing courts with crucial advice on
cases involving mental illness.
This issue is becoming more relevant as remote
assessments have become more common since the
COVID-19 pandemic. While remote assessments offer
convenience, they may not always be appropriate,
particularly for complex cases where face-to-face
interaction may provide more reliable insights into the
defendant's mental state.
A common task for forensic psychiatrists is assessing
whether a defendant is mentally fit to stand trial.
Fitness to plead encompasses several factors, including
whether the defendant can understand the proceedings, instruct their defence, and participate meaningfully in the trial. A failure to assess this accurately can
lead to miscarriages of justice, making the role of the
forensic psychiatrist indispensable.
Legal professionals must also ensure that the
instruction provided to the expert are as detailed and
clear as possible. This enables the forensic psychiatrist
to tailor their assessment to the specific needs of the
case and, if necessary, refer the case to a colleague with
more relevant expertise.
The Future of Forensic Psychiatry: Changes in
Mental Health Law
As the legal landscape evolves, so does the practice
of forensic psychiatry. Dr McAllister touches on
significant changes on the horizon, particularly
reforms to the Mental Health Act. A governmentcommissioned independent review led by Sir Simon
Wessely has proposed several changes that could have
a profound impact on forensic psychiatry.
Case Studies: Understanding the Work of Forensic
Psychiatrists
Dr McAllister shared several anonymised case studies
that illustrate the complexities forensic psychiatrists
navigate when working as an expert witness.
One case involved Mr Trumpton, a defendant who
claimed that a conspiracy involving the media proved
his mental illness. During his psychiatric assessment,
Mr Trumpton referenced articles in a newspaper as
evidence of his delusional beliefs. While his behaviour
was odd, he remained calm and coherent throughout
the interview, raising questions about whether his
presentation was authentic, or a performance
designed to mislead the court. Dr McAllister noted
that truly unwell individuals often display confusion
or an inability to maintain coherence during
questioning-traits Mr Trumpton did not exhibit.
EXPERT WITNESS JOURNAL
One of the key recommendations is that magistrates’
courts should have similar powers to Crown Courts,
such as the ability to demand psychiatric assessments
without conviction. Additionally, there are calls for
statutory time limits to be introduced for the transfer
of individuals from prison to psychiatric hospitals,
ensuring that mentally ill individuals receive timely
treatment.
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DECEMBER 2024
