Forensic psychiatry

Strictly speaking, 'forensic' psychiatry could refer to any aspect of psychiatry with a legal dimension. In practice, however, the term 'forensic psychiatry' applies mainly to the interface between psychiatry and offending (criminal) behaviour.

For convenience, risk assessment and report writing, both of which are relevant to all of psychiatry, are discussed in this chapter.

Forensic psychiatrists are psychiatrists (mostly general adult but some child and adolescent as well) with special knowledge of offending behaviour among the mentally disordered, and the law relating to this. Their role includes:

• assessment and care of patients in prisons, Medium Secure Units, and Special Hospitals

• psychiatric reports on criminal matters for courts and lawyers

• court diversion schemes for mentally disordered offenders (MDOs)

• supervision of patients in the community, such as those on restriction orders (s37)

• consultation service to general psychiatrists.

Considerable political and media interest in forensic psychiatry has followed a succession of well-publicized individual 'scandals'; for example, crimes by MDOs have led to calls for them to be detained permanently in psychiatric hospitals. Measures such as the Supervision Register and Care Programme Approach have been introduced, in part in response to such pressures, although the Supervision Register was soon abolished again.

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