PSYCHIATRIC ASSESSMENT FOR
LEGAL PURPOSES
The VIEW FROM BOTH SIDES
Society
Law Psychiatry
Families
LOSER!
“Win-win” means I win twice, doesn’t it?
Lawyers
Family Court
Experts
Child
Parent
Court
Custody
Evaluator
Parent
Agency
Topics
 Law
& Psychiatry
 Clinical vs. Forensic Psychiatry
 Child Custody Determination
 Special Issue
Law
&
Psychiatry
Old
History
Young
Free Will
Philosophy
Determinism
Client Rights
Objective
Patient Needs
Cases & Codes
Education
Clinic & Lab
Adversarial
Approach
Consensus
Sources of Conflict
Differences in background,
Professional education, and training.
Experiences at the interface: legal
Inter-Professional regulation of psychiatric practice &
psychiatric input into legal decisions.
Pre-existing personal issues.
Personal Prior negative contacts with “them.”
Overcoming Conflict
Practice within expertise. Prepare
Professional
well. Answer the questions.
Educate each other. Practice good
Inter-Professional
conflict resolution technique.
Get real! Psychiatrist not opponent.
Personal
Lawyer not narcissistic threat.
Clinical Psychiatry
Forensic Psychiatry
Ends are medical.
Ends are legal.
- Doctor-patient relationship.
- Focus is on diagnosis and
treatment.
- No doctor-patient relationship.
- Focus is on applying psychiatric
expertise to legal questions in legal
contexts.
Ethical principles
Ethical principles
- Do no harm.
- Best interests
- Truth-telling
- Respect for person
Role of Forensic Psychiatry
Assist administration of justice by
Goal applying psychiatric expertise to
legal questions in legal contexts.
Produce targeted medical-legal
Objective evaluation, report, and testimony.
Apply ethics & practice guidelines of
Standard of Care forensic psychiatry.
Bias. Speculation. Conflicts of
Caveat interest. Expert for own patient.
Guidelines of Forensic Psychiatry
Not treatment. Limited confidentiality.
Full Disclosure Need for informed consent.
Address all evidence. Challenge own
Honesty findings. Expose limits of certainty.
Clinical, scientific, & forensic expertise.
Competence Report writing and courtroom skills
Identify legal question, legal rules,
Framework relevant data, and reasoning process.
Child Custody Determination
History
 Best Interest of Child
 Role of Child Custody Evaluator
 Uniform Standards
 Sexual Abuse & Sexual Abuse Allegations

History
Parental rights.
 Parens patriae.
 Family privacy.
Mental Health Input
 Tender years doctrine.
 Best interest of the child.

“Best Interest”
Legal Standard or Psychological Premise?
Toddler is kidnapped. Kidnapper marries. New couple
becomes good psychological parents. Child does well. A
decade later, child is discovered. By this time, biological
parents are angry, depressed, drink too much and live on
fringes of society but they want their child back as a
matter of right.
Best Interest of the Child
Child’s Needs



Loving, nurturing, safe, permanent home.
Education, health care, spiritual/ethical training.
Guidance in interpersonal development.
Parent’s Skills





View child as distinct being with its own needs.
Refrain from using child for self-gratification.
Respond to daily needs & protect from harm.
Set appropriate limits for welfare of child.
Promote relationship to non custodial parent.
Role of Custody Evaluator
Assist Court resolve custody disputes
Goal and protect children from future harm.
Produce targeted medical-legal custody
Objective evaluation, report, and testimony.
Apply forensic and practice guidelines
Standard of Care applicable to custody determinations.
Bias. Speculation. Conflict of interest.
Caveat Serving as expert for own patient.
Uniform Standards
Legal


Case Law
California Codes
Psychiatric

Clinical, scientific, forensic,
specific additional areas of
training and experience.
Fam. Code 3110, 3011, 3118

Rules of Court
Rules 1257.3, 1257.4, 1257.7
Competence

Standard of Care
Practice Parameters for Child
Custody Evaluation of
American Academy of Child &
Adolescent Psychiatry
Sexual Abuse & Abuse Allegations
Sexual Abuse




Clinical impact
Legal impact
Factor in custody/visitation determination
Tactic in custody/visitation dispute
Abuse Allegations

Overview
Forensic assessment
Reporting duty

Consequences of false allegations


The Special Issue
Do you think a 40-hour week is a vacation?
Do you think going to jail is a good way to relax?
Does your blood pressure equal your hourly rate?
When your mate asks how you feel, do you say…
STOP INTERROGATING ME !
and is this the response you get?
Attorney Stress
Burnout
 Secondary Traumatic Stress
 Impact on Practice
 Prevention
 Treatment

People v. Arno
90 Cal App. 3d 505, FN 2
“We feel compelled by the nature of the attack in
the dissenting opinion to spell out a response:
1. Some answer is required to the dissent’s charges.
2. Certainly we do not endorse “victimless crime.”
3. How that question is involved escapes us.
4. Moreover, the constitutional issue is significant.
5. Ultimately, it must be addressed in light of precedent.
6. Certainly the course of precedent is clear.
7. Knowing that, our result is compelled…”
Summary

Custody evaluation is a medical legal activity of
utmost value to society.

Experts need clinical expertise, familiarity with
applicable law, and be able to perform consistent
with the principles and practices of forensic
mental health assessment.

Manage stress before stress manages you!