What is Forensic Psychiatry?

Forensic psychiatry is the sub specialty of psychiatry dealing with the interface between psychiatry and the law. Forensic psychiatrists serve as consultants and expert witnesses for civil and criminal attorneys, the judiciary, government and non-government agencies, and corporations. Some are involved in treating individuals in correctional institutions or in mandated treatment settings.

As a consultant or expert witness, a forensic psychiatrist is retained when mental health concerns intersect with legal matters. Such areas include criminal responsibility (the “insanity defense”), competencies in both criminal and civil matters, child custody, fitness for duty, dangerousness risk assessment and personal injury including assessment of emotional trauma. The forensic psychiatrist is presented with questions that involve the application of psychiatric medicine, technique and information to legal matters sometimes derived from statute or case law. Ethically, a forensic psychiatric evaluation is  always necessary when addressing diagnostic issues.

A forensic psychiatric evaluation employs in depth interview techniques of clinical psychiatry, but also relies upon collateral sources of information, addresses more prominently the possibility of malingered (feigned) psychiatric illness, and attempts to answer specific medical-legal (psychiatric) questions. The evaluation is not treatment: indeed, the  need for objectivity demands that it be performed outside of a treatment relationship.

In the United States, the practice of forensic psychiatry is governed by a strict code of ethics, derived from the Principles of Medical Ethics as codified by the American Medical Association and as applied to psychiatric practice by the American Psychiatric Association and further modified by the American Academy of Psychiatry and the Law (“AAPL”), the most prominent professional organization for Forensic Psychiatry. AAPL is a subsidiary organization of the American Psychiatric Association.

Forensic Psychiatric training is available within a limited number of medical school psychiatry departments as a twelve month, full-time post graduate  fellowship  program for physicians who have already completed four years of residency training, including at least three years in the field of Psychiatry. Following completion of a Forensic Psychiatric Fellowship and passing a comprehensive written examination, the board certification “With Added Qualifications in Forensic Psychiatry” is given to  psychiatrists who are already Diplomates of the American Board of Psychiatry and Neurology.