
Psychiatry
Lecture 26: Forensic Psychiatry
Overview
Forensic psychiatry is defined as "a subspecialty of psychiatry in which scientific and clinical
expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional or
legislative matters" (American Academy of Psychiatry and the Law 1989, 1991).
Just few of the major areas in which forensic psychiatrists evaluate cases and provide
testimony include:
-
malpractice litigation
- will contests
personal injury litigation
-
- competency determinations (both civil and criminal)
criminal responsibility
-
- presentencing hearings
What is the M’Naghten rule?
Also known as the right-wrong test, the M’Naghten rule is based on the 1843 English case in
which Mr. M’Naghten, a gentleman with persecutory delusions, in an attempt to kill Sir
Robert Peel, mistakenly murdered Edward Drummond, Sir Peel’s secretary.
if a defect in reasoning existed
not guilty by reason of insanity
The state that a person is
at the time of the act to the extent that the person didn’t know the nature, quality, and/or
consequences of the act, or if that the person was incapable of recognizing that the act was
wrong.
What is the irresistible impulse rule?
d to revise the M’Naghten rule. The rule, also
In 1922, a group of English jurists decide
, states that a person is not criminally responsible
“police at the elbow rule”
known as the
for his acts, if he is unable to resist performing the act because of mental disease.
What does the term "mens rea" mean and how does it apply?

Mens rea literally means “evil thing” in Latin. In forensics, mens rea is the rational intent to
do harm or “evil” to another.
For a person to be legally culpable, they must be capable of forming this intent. If they are
incapable of rational thought due to their mental disease or defect, they can not be held
legally responsible for their act.
Who is David Bazelon and what did he say in the Durham case?
Judge David Bazelon, in the 1954 case of
Durham v. US, enunciated the product rule of
criminal responsibility.
A person is not criminally responsible for his/her act if the act is the product of a mental
disease or defect.
The purpose of the decision was to obtain good, complete psychiatric testimony.
In 1972, sitting as an appellate judge , he overruled his own case in
US v. Brawner, because
confusion had developed over the definitions of “product”, “disease”, and “defect”.
Subsequently, American courts have adopted the recommendations of the American Law
Institute regarding criminal responsibility.
garding
What are the recommendations of the American Law Institute re
criminal responsibility?
The American Law Institute, in its model penal code regarding criminal responsibility,
ot responsible for crimes committed, if at the time of the
persons are n
recommends that
act, because of mental disease or defect, they lacked the capacity to appreciate the
criminality of their act, or could not conform their behavior to the requirement of the law.
Additionally, repeated antisocial or criminal behavior is not taken to be evidence of a
“mental disease or defect”.
Responsibility
Key issue of responsibility is whether the accused had the mental capacity to form intention
or whether mental disorder might have affected that capacity.
In children; the age of the accused affect their capacity to form the intent to commit crime.
Children under 10 are excluded from criminal prosecution (cannot form intent;
doli
incapax). Ten to fourteen years old may be convicted if there is evidence of mens rea and
knew that the offence was legally or morally wrong.

Criminal Responsibility
According to criminal law, committing an act that is socially harmful is not the sole criterion
of whether a crime has been committed. Instead, the objectionable act must have two
components:
1. voluntary conduct (actus reus) and
2. Evil intent (mens rea).
An evil intent cannot exist when an offender's mental status is so deficient, so abnormal, or
so diseased to have deprived the offender of the capacity for rational intent.
Diminished Responsibility
An individual’s blame worthiness may be reduced by his having a mental illness. It’s only
available in relation to the charge of murder and is defined as:
Where a person kills or a party to killing of another he shall not be convicted of murder if
he was suffering from such abnormality of mind as substantially impaired his mental
responsibility for his acts and omissions in doing or being party of the killing.
Intention (mens rea)
Most jurisdictions require evidence of guilty intention for an offender to be convicted
Mens rea is a technical term of intention
Intention: person perceives and intends that his act will produce unlawful
consequences
Other forms of intent
Recklessness: deliberate taking of an unjustifiable risk
Negligence: bring about a consequence which a ‘reasonable and prudent‘ person
would never foresee and avoided
Accident: blameless inadvertence.
Absence of intention (automatism)
Defendant lacked intention for an offence. The example is acts committed while sleep
walking. It is hard to determine retrospectively
Patients who abuse alcohol and drug and intoxicated had no intention to commit a crime.

to stand trial
Competency
In English Law, the issue is called ‘fitness to plead’. The defendants must be in a fit
condition to defend themselves. A person may be suffering from sever mental disorder but
still be fit to stand trial.
etermine how far
sychiatrist should d
In order to determine competency to stand trial the p
the defendant can:
- Understand the nature of the charge
Understand the difference between pleading guilty and non guilty
-
- Instruct counsel
Challenge jurors
-
Follow the evidence presented in court.
-
If not fit to plead----court will hold a
trial of facts to determine whether the individual
carried the offence.
If the offence is not serious----the court direct the offender to treatment, may be out patient.
If serious----the court direct the offender to be detained in hospital
If fit to plead----return to the court for trial.
's Criminal Justice Mental Health Standards stated in 1994
American Bar Association
The
that the issue of a defendant's current mental incompetence is the single most important
in the criminal mental health field, noting that an estimated 24,000 to 60,000 forensic
issue
were performed every year
competency to stand trial
evaluations of a criminal defendant's
in the United States.
(not guilty by the reason of insanity)
Legal insanity
Defendant lacked
mens rea for the charge because they were legally insane
It’s defined in different way in different jurisdictions
It results in a defendant admitted to treatment in hospital as opposed to being sent to
prison. It result in more lenient sentencing
Fitness to be punished
In jurisdictions which have corporal or capital punishment, psychiatrists are asked to
assess offenders to determine whether they are mentally well enough to be punished. They
may be asked to treat offender in order to make them fit to be punished or executed.
Some have argued that it is unethical for psychiatrists to be involved in such procedures.

False confessions
There are three types;
Voluntary: may arise from morbid desire to notoriety, from difficulty to distinguish
fact from fantasy, wish to expiate guilt feelings, or desire to protect another person
Coerced-complaint: Forceful interrogation and are usually retracted subsequently.
Coerced-internalized: Techniques of interrogation undermines suspect’s own
memories and recollections so that come to believe that they may have been
responsible for the crime.
It increases in: history of substance abuse, head trauma, a bereavement, current anxiety, or
guilt.
False accusations
Individual who claim to be the victims of a crime that has not occurred.
Examples are accusations of rape or stalking.
Frequently seen in sever personality disorder.
Crime
A crime is an act that is capable of being followed by criminal proceedings. It is a man-made
concept defined by the rules of the state and modified by legislation, therefore there are
differences between countries and across time in the same country.
sification of crime
Clas
Crimes against the person (offences of interpersonal violence): minor assault, homicide;
sexual offences: indecent exposure, rape; robbery.
Crimes of dishonesty: Burglary; theft and handling stolen goods; fraud and forgery
Criminal damage : Property damage; arson(fire setting)
Drug crime : Use, possession, supplying
Homicide
Homicide is the killing of a person by another.
Legal classification:
Lawful: Justifiable (e.g. on behalf of State); excusable (e.g. accident).
Unlawful: Murder; manslaughter; infanticide (sentencing as for manslaughter).

The traditional psychiatric classification:
no psychiatric disorder
there is
Normal homicides:
psychiatric disorder
there is
Abnormal homicides:
Legal aspects of homicide
1.Murder
Offender of sound mind and discretion, and had malice aforethought (intent to cause
death or grievous bodily harm).
2.Manslaughter
Homicide unlawful, but circumstances do not meet full criteria for murder or there are
certain mitigating factors, such as:
immediate severe provocation
-
-abnormality of mind (diminished responsibility)
3.Infanticide:
It is the killing of a baby aged under 12 months by its mother, the balance of
whose mind is disturbed at the time by the effects of childbirth. Some result from a
psychiatric disorder such as depression, and rarely a psychotic illness, while others seem to
follow a loss of temper by the mother in relation to an aspect of the baby's behavior.
The end