fpamed News

Forensic assessment of somatoform and functional neurological disorders

Functional neurological disorders (FND) and somatization are common in clinical practice and medicolegal settings. These conditions are frequently disabling and, if arising following an accident, may lead to claims for legal compensation or occupational disability (such as social security disability insurance). However, distinguishing FND and somatization from symptoms that are intentionally produced (i.e., malingered or factitious) may pose a major forensic psychiatric challenge. In this article, we describe how somatoform disorders and FND lie along a spectrum of abnormal illness‐related behaviors, including factitious disorder, compensation neurosis, and malingering. We provide a systematic approach to the forensic assessment of FND and conclude by describing common litigation scenarios in which FND may be at issue. Forensic testimony may play an important role in the resolution of such cases.

The Role of the Child Psychiatrist in Court Cases Involving Child Victims of Sexual Assault

Many jails and prisons in the United States do not have enough mental health professionals (MHPs) to meet the mental health needs of the people incarcerated in these facilities. This article examines strategies used to address MHP shortages in U.S. jails and prisons, including compensation incentives, telemental health services, interdisciplinary health care, flexible work schedules, and training rotations in correctional settings. These measures may help alleviate some of the shortages of MHPs in correctional facilities; however, these shortages will likely persist without broader policy reforms that decrease the size of U.S. correctional pop- ulations or increase the number of MHPs across the country.

Addressing Shortages of Mental Health Professionals in U.S. Jails and Prisons

Many jails and prisons in the United States do not have enough mental health professionals (MHPs) to meet the mental health needs of the people incarcerated in these facilities. This article examines strategies used to address MHP shortages in U.S. jails and prisons, including compensation incentives, telemental health services, interdisciplinary health care, flexible work schedules, and training rotations in correctional settings. These measures may help alleviate some of the shortages of MHPs in correctional facilities; however, these shortages will likely persist without broader policy reforms that decrease the size of U.S. correctional pop- ulations or increase the number of MHPs across the country.

Pittsburgh’s Freedom House Ambulance Service: The Origins of Emergency Medical Services and the Politics of Race and Health

This manuscript explores the history of the Freedom House Enterprises Ambulance Service, a social and medical experiment that trained “unemployable” black citizens during the late 1960s and early 1970s to provide then state of the art prehospital care. Through archives, newspapers, personal correspondence, university memoranda, and the medical literature, this paper explores the comparable, yet different roles of the program’s two leaders, Drs. Peter Safar and Nancy Caroline. Despite its success in demonstrating national standards for paramedic training and equipment, the program ended abruptly in 1975. And though Pittsburgh’s city administration cited economic constraints for its fledgling support of Freedom House, black and majority newspapers and citizens alike understood the city’s diminishing support of the program in racial terms. The paper discusses Safar and Caroline’s well-intentioned efforts in developing this novel program, while confronting the racial, social, and structural constraints on the program and the limits of racial liberalism.

Gut Feelings: A Commentary on Recent Findings Involving Biomarkers and Their Relationship to Mental Illness

By Mark I. Levy, MD, DLFAPA fpamed Forensic Psychiatrist Not everyone with Major Depressive Disorder (MDD) responds to antidepressant medication. Researchers are increasingly asking “Why?” and coming up with novel understandings. The most common antidepressants prescribed these days are close to a dozen different SSRIs (selective serotonin reuptake inhibitors, e.g., the Prozac family of drugs). […]

Determining Competence to Stand Trial: A Brief Breakdown by a Forensic Psychiatric Expert

By Steven H. Berger, MD fpamed Forensic Psychiatrist A person who is incompetent to stand trial cannot have a fair trial.  That is a basic tenet of our American justice system.  What is competence to stand trial?  How is it determined?  What happens if a person is found incompetent? In general, to be competent to […]

Considerations for the Forensic Evaluation of the LGBTQ+-identified Person

Even LGBTQ+-identified youth and adults in the San Francisco Bay Area bubble experience stress associated with being a sexual or gender minority. Please read about Dr. Paul Elizondo’s experience serving LGBTQ+-identified youth and adults in his psychiatric practices in outpatient, residential treatment program, and incarcerated settings.

Cyberbullying and Adolescent Suicide

Today’s youth are exposed to the Internet through the ubiquitous presence of smartphones, social networking, and messaging, carrying a simultaneous devaluation of face-to-face and telephone communication. This rapid expansion of online socialization has introduced new complications to old problems, including the progression of bullying into cyberbullying and cyberbullicide.

Perceived Gender Bias and the Expert Witness

By Nancy Hoffman, PsyD fpamed Forensic Psychologist The power I exert on the court depends on the power of my arguments, not on my gender. – Justice Sandra Day O’Connor Historically, medicine and the law have been typically dominated by men, creating the possibility of gender bias in the courtroom. Therefore, women’s presentation style is […]

The Benefits of Using the “Team Approach” When Assessing Emotional Damages in Mass Tort Litigation 

By Dr. Mark I. Levy, MD, DLFAPA fpamed Forensic Psychiatrist Catastrophic events, or other situations such as toxic torts and product liability claims, often lead to litigation where a large number of claimants report severe emotional damages. While multi-plaintiff litigation requires an expert to contrast and compare vulnerabilities and resiliency factors within members of the […]

A New Study Confirms Old Knowledge: Psychotherapy Works for Post-Traumatic Stress Disorder

By James Armontrout, MD fpamed Forensic Psychiatrist When people think about psychotherapy often the image of years of weekly meetings with slow-paced and hard-won improvements comes to mind. While this can be the case for some conditions, many newer psychotherapies for Post-Traumatic Stress Disorder can often achieve remarkable results in a time-limited fashion. For example, […]

Six Tips for Making the Best Use of an Emotional Damages Expert

by Tyler Durns, MD fpamed Forensic Psychiatrist First, one must understand what emotional damages claims entail. Such declarations might be founded in a variety of outcomes and antecedents. Emotional damage claims may result from duress relating to routine employment, workplace discrimination and harassment, emotional harm from defamation and libel, intentional or negligent infliction of emotional […]

How Forensic Psychiatrists Evaluate Individuals with Traumatic Brain Injury

By Octavio Choi, MD, PhD fpamed Forensic Psychiatrist Traumatic brain injury (TBI) is a type of injury that is caused by a sudden and violent blow or jolt to the head. It can result in a wide range of organic/cognitive/emotional injuries and behavioral symptoms, depending on the severity of the head trauma. One area where […]

When should you retain a forensic neuropsychiatrist as an expert witness?

By Nicole Brooks, MD fpamed Forensic Psychiatrist A forensic neuropsychiatrist is a medical professional who specializes in the interaction of neurology (i.e. brain, spinal cord, and nerve structure and function), psychiatry (mental, emotional, and behavioral disorders), and the law. This type of expert witness may be uniquely valuable in a variety of legal cases to […]

What is the Value of a Forensic Psychologist?

By Howard J. Friedman, PhD, ABPP fpamed Forensic Neuropsychologist Forensic psychology is the intersection of psychology and the legal system. Forensic psychologists apply their knowledge of psychology to legal issues and often work with criminal cases. They can play a valuable role in the legal process by providing insights into the mental states of individuals […]

Six Tips for Choosing the Right Forensic Psychiatric Expert

When it comes to choosing a forensic psychiatric expert, it’s important to select someone who has the right qualifications and experience. This type of expert is typically called upon to provide psychological or psychiatric evaluations, testimony, and reports in legal proceedings, including criminal and civil cases. Here are some key factors to consider when selecting […]

Family Murderers: Clinical and Forensic Perspectives on the Insanity Defense

By Ambarin S. Faizi, DO fpamed Forensic Psychiatry Associate Navy veteran Robert Fisher killed his wife, his son, and daughter in their Scottsdale, Arizona home, before setting it on fire in April 2001. Authorities believe he committed the murders because he thought his wife was planning to leave him, and he did not want to […]

A “What, When, Who, Where, Why, and How” Guide to Forensic Psychiatric Consultation in Criminal Mitigation

Mentally ill and emotionally disturbed offenders comprise a significant group of those whose criminal conduct has brought them into the criminal justice system. This is a worldwide phenomenon. However, it may be even more pronounced in the United States Criminal Justice System.

Criminal Responsibility and Legal Insanity

Chapter 15 from Forensic Psychology: Crime, Justice, law, Interventions, Fourth Edition explores the history and caselaw as well as describes the forensic mental health assessment of criminal responsibility, and in particular – the not guilty by reason of insanity defence in criminal cases. Particularly, the mental illness defence is explored through examination of case law and case studies from the United States in which the author, John Matthew Fabian, has been involved.

Opioids and Litigation: 10 Bullet Points Every Trial Attorney Needs to Know

Opioids refers to the universe of opioid-type medications. Opiates refer to the naturally occurring analogues (e.g. Opioid, morphine, and codeine). Opioids include the naturally occurring analogues as well as synthetics such as fentanyl. Opioids are medically indicated for short-term acute pain. Post surgical or acute injury Opioids have limited medical indication for Chronic Non-Cancer Pain […]

A Review of Statutes and the Role of the Forensic Psychiatrist in Cyberstalking Involving Youth

Adolescents are increasingly exposed to Internet-facilitated crime as they spend more time online. The mental health risks and legal consequences for youth involved in cyberstalking are growing areas of concern. The nature of online stalking presents several challenges regarding investigation, fair adjudication, fact-finding, and legislation. Laws governing online stalking behaviors inconsistently reference the age of a victim or perpetrator as a factor for consideration in case disposition. During adjudication, the forensic psychiatrist may be asked to evaluate the victim or perpetrator involved in cyberstalking. This article focuses on the current legal landscape governing cyberstalking behavior involving adolescents, the roles a forensic psychiatrist may assume in this context, and the opportunity to bring a developmental perspective to these cases. Paul Elizondo, DO, Dale E. McNiel, PhD, and Rene´e Binder, MD

Response of US psychiatric programs to the COVID-19 pandemic and the impact on trainees

Since the start of the COVID-19 pandemic, trainees have experienced a variety of changes to trainee program policies and guidelines. Overall, poor communication and trainee dissatisfaction with departmental response correlated with concern of infection and anxiety/burnout. Insights garnered from this study could provide scaffolding for the best practices to reduce trainee physician anxiety/burnout for the […]

What Neuroscience Can and Cannot Answer in the Courtroom

Octavio Choi, MD, PhD presents for UCSF Department of Psychiatry and Behavioral Sciences Grand Rounds series. Click title above or Read more link below to watch on YouTube.

Pharaohs, philosophers, and Freud—Tracing bias in modern correlates of hysteria.

‘Hysteria’ is a historical term that encompasses several modern-day neuropsychiatric conditions. The chronicle of this illness is fraught with prejudice from the time of its inception through subsequent adaptations. Relics of cultural misconceptions have been carried forward into contemporary correlates of the illness. The consequences of these follies in present-day are best understood through a […]

Do no harm in due process – a historical analysis of social determinates of institutionalization in the USA

Involuntary hospitalization has been a fundamental function of psychiatric care for mentally ill persons in the USA for centuries. Procedural and judicial practices of inpatient psychiatric treatment and civil commitment in the USA have served as a by-product of socio-political pressures that demanded constant reform throughout history. The origin of modern commitment laws can best […]