AAPL practice guideline for forensic psychiatric evaluation of defendants raising the insanity defense. American Academy of Psychiatry and the Law.
ABSTRACT The insanity defense is a legal construct that excuses certain mentally ill defendants from legal responsibility for criminal behavior. This practice guideline has delineated the forensic psychiatric evaluation of defendants raising the insanity defense. The document describes acceptable forensic psychiatric practices. Where possible, standards of practice and ethical guidelines have been specified. And where appropriate, the practice guideline has emphasized the importance of analyzing the individual case, the jurisdictional case law and the state (or federal) statute. This practice guideline is limited by the evolving case law, statutory language and legal literature. The authors have emphasized the statutory language of current legal standards, as well as the state or federal courts' interpretation of those standards because the same statutory language has been interpreted differently in different jurisdictions. Similarly, this practice guideline has reviewed the state and federal trends that determine which diagnoses meet the criteria for mental disease or defect. These trends yield to jurisdictional court interpretations. Finally, the authors hope this practice guideline has begun the dialogue about formulating a forensic psychiatric opinion by surveying the various approaches used to analyze case data. The forensic psychiatrist's opinion in each case requires an understanding of the current jurisdictional legal standard and its application, as well as a thorough analysis of the individual case. The psychiatrist's analysis and opinion should be clearly stated in the forensic psychiatric report. It should be noted that the role of a psychiatric expert witness in the criminal justice system is predicated on the law's interest in individualizing the criteria of mitigation and exculpation. Forensic psychiatric analyses and formulations of opinions are, therefore, subject to change as the legal guidance changes.
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ABSTRACT: This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was "fair" using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and "fair" inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.International Journal of Law and Psychiatry 12/2013; 37(3). DOI:10.1016/j.ijlp.2013.11.020 · 1.19 Impact Factor
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ABSTRACT: Maryland's test for a finding of legal insanity (not criminally responsible [NCR]) allows a defendant to be found legally insane due to either a lack of appreciation of wrongfulness (cognitive impairment [CI]) or lack of ability to refrain from illegal behavior (volitional impairment [VI]). During a four-year period, 1,446 defendants underwent in-depth (post screening) evaluations for the NCR plea at Maryland state hospitals. Of the 416 defendants assessed as NCR by the hospitals' court-appointed evaluators, 44 (11%) were assessed as NCR due to VI alone. Diagnostically, the VI and CI groups were similar. Criminal charges were also similar, but the VI group was more likely to have been charged with murder. Many of the forensic evaluators concluded that the VI group was unable to refrain from illegal conduct based on considering a number of factors, including psychiatric symptoms and the defendant's behavior as related to the offense. Some evaluators' reports offered an opinion, but did not adequately explain what data they used to arrive at their conclusion. This paper examines the history of and rationale for a volitional test of insanity and how it is assessed by forensic evaluators.Psychiatry 04/2008; 5(3):58-66.
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ABSTRACT: Why do the courts let so many dangerous, violent people off on the insanity defense? If they kill somebody, shouldn't they pay like anyone else? Is the insanity defense really necessary? Every big case on television and in the papers ends up as a battle of the shrinks, and some axe murderer goes to a cushy hospital instead of the Graybar Hilton he deserves. --J. Q. Public Contrary to popular belief, the insanity defense is rarely used; it is tough to win; the Constitution probably requires that it be available to qualified defendants, and defendants found not guilty by reason of insanity (NGRI, NGI, NRRI) may spend more time in mental hospitals than they would have spent incarcerated had they been found guilty. The purpose of the insanity defense is related to a very old, well-tested requirement for finding defendants guilty: the prosecution must prove not only that the alleged act was committed, but that the act was committed in a criminal way. "Taking" is not the same as "stealing"; "killing" is not the same as "murder." In general, for a crime to be committed, the actor must intend to commit a crime.