Psychiatry Explained

Forensic Psychiatry (for Adults and Children)

Forensic psychiatrists most commonly provide treatment in a secure hospital environment, but may deliver services to prisons or deliver specialist community services. Generally, their patients are subject to legal restrictions.
Forensic psychiatrists need expertise in assessing and limiting further harm to the patient or others and also need highly developed multidisciplinary clinical and inter-agency skills.
Knowledge of relevant legislation and criminal, civil and case law is central to the work which means working with criminal justice agencies and the courts.
An important part of the work is assessment of risk of harm to others as well as to the patient themselves.
Forensic psychiatrists also provide specialist advice to the courts, the probation service, the prison service and other psychiatric colleagues.

Adolescent forensic psychiatry is a developing subspecialty that sits between adult forensic psychiatry and child and adolescent psychiatry.

Most Young Offenders Institutions/Young Persons' Prisons or local authority secure children's homes (LASCH) now receive specialist in-reach from CAMHS teams. In the UK, the sub-speciality has largely developed its base in the NHS adolescent secure units.

Psychiatry and Immigration (source: rcpsych)

It is the duty of Psychiatric experts to help the court/tribunal on matters within their expertise. This duty overrides any obligation to the person from whom experts have received instructions or by whom they are paid (Ministry of Justice, 2012a). The following general requirements for expert evidence are stated:

Expert evidence should be the independent product of the expert uninfluenced by the pressures of litigation.

Experts should assist the court by providing objective, unbiased opinions on matters within their expertise, and should not assume the role of an advocate.

Experts should consider all material facts, including those which might detract from their opinions.

Experts should make it clear –

when a question or issue falls outside their expertise; and

when they are not able to reach a definite opinion, for example because they have insufficient information.

If, after producing a report, an expert’s view changes on any material matter, such change of view should be communicated to all the parties without delay, and when appropriate to the court.

Depending on the course of the interview, however, they should not limit themselves to those questions or tools considered in advance.

A key consideration both before the interview takes place and during its progress is whether the inter- view might have a re-traumatising effect.