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Handbook of Forensic Psychiatric Practice in Capital Cases


Should you write down the questions asked (with the responses)?


Tis has merits. A very full account of the interview is then available to the court, and particularly of how symptoms of mental disorder emerged during the interview. However, it is laborious and can spoil the flow of both interview and report. In practice it is probably best to write notes in summary form, and in the third person, but to ensure that topics that may be legally crucial are recorded verbatim, with answers recorded in the first person, as they are spoken by the defendant.


Should the defendant be seen more than once?


Seeing a defendant twice allows the information elicited at the first interview to be checked. Any contradictions or discrepancies that arise from having checked the defendant’s account with other material can be put to him or her. Also, the mental state of the defendant can be observed on two separate occasions, with noting of any changes or inconsistencies between the two interviews. Tis is likely to be especially important in cases of suspected personality disorder.


Collateral information


Obtaining a collateral history is important in any forensic assessment. Tere are a variety of potential sources for this. Friends or family members could be interviewed, for example, although often this is not possible. As well as case papers and medical records, other potential written sources of information include school and social services records (see above); all should be matched against the patient’s account. Such a process of triangulation, presuming that the information obtained is consistent, allows the clinician to express an opinion with a greater degree of certainty than would otherwise be the case. Gathering information from others may be subject to special rules if they are also witnesses, requiring consent from the prosecution (there is usually no difficulty in questioning defence witnesses if you are instructed by that side).


Physical examination and investigations


Mental disorders can have an organic cause. If such a cause is established, it can not only have significant clinical effects, but it can also have important legal consequences, ultimately even in terms of legal automatism. Notwithstanding its importance, it can be practically difficult to conduct a physical examination, particularly in prison because of a lack of privacy and a lack of equipment (see above). Te examiner is also placing himself in close contact with the defendant and could possibly expose himself or herself to an enhanced risk of violence. However, such examination may be necessary.


Specialist investigations such as EEG, MRI brain and CT head scans are now commonplace in clinical practice in Western Europe and the USA. Tere is far less often no access to such technologies in practice for those detained in prison in parts of Africa. Such investigations are also often difficult to access for prisoners in the Caribbean.


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