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Forensic Psychiatric Assessment


being mindful of potential diagnoses, whether made by reference to ICD-10 or DSM-IV, will likely want to explore for related symptoms, and for evidence for and against disorders.


Ensure that you have asked any necessary questions at the interface between the clinical assessment and the legal questions to which you know the information will be applied.


Some interviews are more difficult than others. Disturbed patients often benefit from being given time, space and reassurance as to the interviewer’s interest in them. However, don’t be afraid to terminate an interview; if a defendant is aroused, it is unlikely they will be able to provide a worthwhile history, and further attempts to elicit information might simply escalate the risk.


At the conclusion of an interview, it should be explained to the defendant what happens next, with approximate timescales for the production of a report if possible. It is never appropriate to tell the defendant your conclusions. Aside from taking proper time to read all available information and to think, your opinion and its implications have to be taken into the context of all the evidence in the case as a whole, and legal opinion on the totality of the evidence, of which yours is only one part, even if it is an important part. Hence, information to the defendant about your opinion should come from his lawyer, whether you have been instructed by the defence or prosecution.


Interpreters


Many interviews in death penalty cases will need to be conducted with the help of an interpreter, if not in terms of language per se, then in terms of culture (if the doctor comes from a different culture). Te choice of interpreter is important, but in practice might be limited.


Tere are clear difficulties with using family members in this role, although it might be felt expedient in certain situations; not least in regard to confidentiality, the difficulty for defendants in speaking about unpleasant events in the family, or the shame that a defendant might feel in reporting symptoms of mental illness or details of an offence in front of a family member.


A professional interpreter who has some experience of psychiatric interviews is to be preferred, particularly for death penalty work. Tey should not be known to the defendant, and preferably belong to an organisation that offers


should training. It is especially important that the


interpreter is able to maintain confidentiality. Sometimes these quite basic requirements are hard to meet in practice.


Note taking


Clinicians will have their own ways of taking notes, their own idiosyncratic notations and abbreviations. Note taking should not interrupt the flow of what ideally will appear like a natural conversation. However, notes are a matter of legal record. Tey need to be understandable at least to you accurate, and full enough for you to later prepare a report.


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