Handbook of Forensic Psychiatric Practice in Capital Cases


good sense of the flow of the interview, as well as clues, perhaps, as to the presence of formal thought disorder, the preoccupations of the defendant and how he responded to challenge. Alternatively, the defendant’s account can be summarised and re-arranged to fit the structure preferred by the author. However, whichever approach is adopted, it is important to quote verbatim things said by him that could be of major legal relevance.


Whatever method is chosen, it is important to make clear what the defendant volunteered and what information was elicited by way of direct questioning.


Writing in terms ‘Mr A said….Mr A told me…’ makes it clear that it is his account that is being reported. However, this approach runs the risk of making the report stilted and difficult to read. And the use of direct quotes from an interview can bring the patient to life for the reader, allowing the voice of the patient to emerge.


Recording the questions asked with the defendant’s responses can provide a real insight into how he reacted within the interview. However, recording both question and answer accurately is difficult during an interview, unless the interviewer is skilled at some form of shorthand, and what a defendant says sometimes makes little sense on paper in the absence of body language and intonation (although this can be described alongside the quote). Tat said, again it may be particularly important to record verbatim questions and answers relating to legally important matters.


Te patient’s emotional responses should be noted; for example, the observation that they became tearful when talking about their dead dog but not their dying mother might be of significance. Again, though, there is a danger that this extra information will hinder the flow of the account. A solution is to place the emotional reaction of the defendant in brackets next to the point of the interview where it was witnessed.


Mental state examination


Te length of the mental state examination that is recorded varies between authors, from a few lines to many paragraphs. Some include only positive findings. However, there is a need to report important negatives too, for example the absence of psychotic signs. Tis said, it might not be necessary to list every typical schizophrenic sign that is not present; it is only the absence of signs that one might have suspected could have been present that should be noted.


Te detail in which the cognitive examination is recorded will vary from case to case. In most, it will probably suffice to report that there were no gross abnormalities, and to give some indication of the defendant’s general level of intelligence. Where cognition is at issue, the account will be detailed.


Information from other sources


Where medical or psychological investigations – including those described in reports provided to lawyers or the court – have been carried out on the defendant other than by the doctor reporting, the findings relevant to the opinion expressed by the doctor should be summarised. Tis is necessary


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