Handbook of Forensic Psychiatric Practice in Capital Cases


Clinical mental health services provided to offenders may be offered by general psychiatrists, rehabilitation psychiatrists, substance misuse services or those psychiatrists (often forensic psychiatrists) working in secure settings. For some time, the term ‘forensic’ was only applied to those services that managed offenders and/or ‘risky’ patients, but it is now expected that many other services will also manage such patients.


Mental health services in prison


Since 2006, in the UK the NHS has provided inreach services to prisons, usually consisting of community psychiatric nurses, and some psychiatric/psychological consultancy, often with a dedicated health care centre. Tese personnel may be general adult practitioners, or sometimes forensic practitioners. In addition to the psychiatric services into prisons, the prison service also retains its own psychology service, primarily staffed by forensic psychologists.


In less developed economies such services are often more patchy and less integrated.


Secure psychiatric services Te ‘forensic’ professionals who work in secure mental health services in the UK include the same range of professionals expected in any mental health service. Tus there will be psychiatrists, psychologists, art psychotherapists, medical psychotherapists, nurses, health care assistants, occupational therapists, social workers and pharmacists. Confusingly, some secure services will also employ forensic psychologists because of their expertise in offender management programmes. Generally, however, the distinguishing feature of any ‘forensic’ mental health professional is that they have experience of working with very disordered men and women, usually with long and/or significant histories of violence, and often in long- stay residential care.


Again, in less developed economies such services may well be absent as specialist services per se, with reliance necessarily being placed upon general services to provide forensic care.


Specific staff groups


Forensic psychiatrists are psychiatrists, medically qualified initially, who have further training in the sub- specialty of forensic psychiatry.


Clinical psychologists working in forensic settings have undertaken a general training in clinical psychology to doctorate level. Tey are almost always members of a multidisciplinary team, but will generally be especially responsible for the co-ordination and delivery of psychological assessment and interventions of a variety of types. Increasingly they are specialists within clinical psychology (as are forensic psychiatrists within psychiatry).


Forensic psychologists are, by training, quite distinct from clinical psychologists, and typically have a master’s degree in their subject. Tey usually directly address offending behaviour, often not in the context


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