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Psychiatry and Criminal Responsibility

What Does A Psychiatrist Need To Assess “Not Criminally Responsible” Issue:

  1. Crowns file including police reports, witness and victim statements
  2. Previous psychiatric records
  3. Autopsy report
  4. Clinical interview with accused
  5. Mental status examination of accused
  6. Direct questioning of accused regarding knowledge of wrongfulness
  7. Detailed account from accused about circumstances of offense
  8. Possible psychological testing
  9. Possible neurological examination(s)

Patterns of Criminality and Mental Disorder

  1. Crime was a response to psychotic symptoms, such as delusions and hallucinations many will be NCR
  2. Crime motivated by compulsive urges, such as paraphilias or disorders of impulse control most not NCR
  3. Crime the result of a personality disorder
  4. Coincidental mental disorder not related to crime
  5. Mental disorder results from the crime dissociation, depression
  6. Malingered mental disorder to avoid responsibility

Factors To Be Considered In Assessing Criminal Responsibility

  1. Evidence of mental disorder currently, in the past and at time of offense
    presence of delusions, mood disorder
  2. Motive for offense
    – if no apparent motive other than psychotic, suggests valid mental disorder
    – if rational motive also present, such as profit, suspect malingering or coincidental mental disorder
  3. Consider planning and preparation for crime
  4. Evidence of impaired functioning within a few days of the crime
  5. Detailed understanding of accuseds thinking and behaviour before, during and after crime
    – evidence of bizarre behaviour
    – attempt to escape or avoid detection
  6. Consider criminal record and personality disorder
  7. Consider previous psychiatric history
  8. Do previous hospital records describe delusions or hallucinations that relate to current offense
  9. If accused did not know the act was wrong, was this due to mental disorder?