Talk:Forensic psychiatry

Two distinct

Forensic Psychiatry and Forensic Psychology are two related but distinct subjects. Psychiatrists are Medical doctors who specialise in Psychiatry and then superspecialise in Forensic Psychiatry. (Similar to a doctor who may first specialise in Medicine and then superspecialise in Cardiology). Forensic psychiatrists specialise in the assessment and treatment of mentally disordered offenders. They often work at the interface of Psychiatry and the Legal profession, functioning as expert witnesses in court room settings.

Forensic Psychology is practiced by Forensic Psychologists. Psychologists are not medical doctors in the United States, and unlike medical doctors, they can only diagnose medical conditions within the scope of their practice. Generally these diagnoses must be for medical conditions listed in the "Diagnostic and Statistical Manual of Mental Disorders".. Also unlike medical doctors, most psychologists in the U.S. cannot prescribe medication. In recent years, both New Mexico(in 2002) and Louisiana(in 2004) enacted laws allowing some psychologists to prescribe medications for psychological conditions. To obtain prescriptive privileges, psychologists in these states must obtain a post-doctoral masters degree or equivalent in psychopharmacology, pass a licensing exam related to the prescription of psychoactive medications, and meet other requirements. Psychologists in the U.S. military are also allowed to prescribe with the proper training. Psychologists commonly employ therapy to treat psychological conditions, whereas psychiatrists are more likely to focus on treatment via the use of medication or other medical solutions. Forensic Psychologists are specialists in assessing personality and making predictions of risk among offenders (predominantly mentally disordered offenders) They also provide therapies such as the Sex Offenders Treatment Program (SOTP), Enhanced Thinking Skills (ETS) to offender populations.

Cremice (talk) 06:25, 6 February 2014 (UTC)

References

Accuracy

I am not sure if any private sector "medium secure units" exist in Britain. I work in this sector and I am aware of several but all are NHS owned and run. —The preceding unsigned comment was added by Ianmurray5 (talk • contribs) 11:04, 12 December 2006 (UTC).

Katrina R. Moss's book, Medium Secure Psychiatric Provision in the Private Sector (Aldershot: Ashgate 1998 ISBN 1-84014-310-X) is largely about a comparison between two NHS units and Stockton Hall, a psychiatric hospital owned by Partnerships in Care, an organisation previously known as AMI and earlier still as American Medical International. Medium secure units are also run by Care Principles (e.g. Linden House in Yorkshire and Rowan House in Norfolk) and Castlebeck Care. They all have web sites. NRPanikker 03:48, 20 October 2007 (UTC)

There are loads of them. Westminster Healthcare, The Priory, St Andrews Hospital, Partnerships in Care... —Preceding unsigned comment added by 86.142.156.123 (talk) 22:22, 13 January 2010 (UTC)

Quality

this article needs some work. the grammar in the opening paragraph is atrocious and not suitable for wikipedia content.

For those looking to help clean this article up, a good amount of content and over 100 good references can be found in this article, The Rebirth of Forensic Psychiatry in Light of Recent Historical Trends in Criminal Responsibility

Canada

The section on forensic psychiatry in Canada reads like a poorly written editorial in a poorly-edited college newspaper (you know, the kind with glaring grammatical and spelling errors in the headlines). I started working on cleaning it up until I saw that it just went on and on and on. I was tempted to outright delete the whole thing as I had done with a couple of paragraphs already. Maybe each paragraph could be summarized as a sentence that also contains the opposing argument, as per NPOV policy. Even aside from the low quality and high bias of the writing (nothing personal to the author, just looking to improve the article), there's way too much text for the section; for pete's sake, the section is almost longer than the whole rest of the article.. anyway, if nobody else comes to the rescue here, I will probably delete the entire section and simply start over -- seems like that might be the best course of action in any case. I wish to give the author(s) the courtesy of the chance to improve their content rather than find it erased and paved over, so to speak. Mr0t1633 (talk) 08:56, 12 November 2009 (UTC)

Significant controversies

Per WP:MOS (lede) - "summarize the most important points—including any prominent controversies". I added such material to the lede, and a construction tag. I will develop the material in a section of the body. Please discuss, add more reliable sources, and suggest similar material to add to the article body. ParkSehJik (talk) 00:10, 27 November 2012 (UTC)

Yes, "summarize". The paragraph you added does not summarize anything in the article. Also, most of it is not even relevant to forensic psychiatry. And on top of that most of it is undue weight to minority positions. Tagging various things in the first paragraph as either "citation needed" or as "dubius" seems to be about trying to make a point. --Harizotoh9 (talk) 01:07, 28 November 2012 (UTC)

• 1. Three sentences is a short summary. Content will be added to the article and expanded beyond these three sentences.
• 2. What is your source that this is a "minority" position? I would not be surprised if any survey done did not show it was a majority position.
• 3. Even if you find a source that it is a minority position , the primier journals in the field repeatedly devote articles to these same points, indicating it is a significant minority position, no matter what the size of the minority. What is your means of weighing that trumps the editors of those jounrals finding the positions significant enought to devote mutiple journal articles to it? (There are hundreds more MEDRS articles I will select from for material in the article body. ParkSehJik (talk) 02:37, 28 November 2012 (UTC)

I've removed it as being hopeless WP:POV, WP:BATTLE, and more general WP:NOT violations. --Ronz (talk) 17:42, 28 November 2012 (UTC)

What do you mean by "hopeless" POV? These are mainstream RS and MEDRS sources stating peer reviewed facts about this article topic. The sources are mainstream surces, the top journals on the topic in the world.

• 10% of legal opinions (re forensic psychiatry) termed or compared expert witnesses to “hired guns”, “whores”, or “prostitutes”. (source - Journal of the American Academy of Psychiatry and the Law, 27:414 –25, 1999 – 2). Prosecutors made the plurality of the comments. This is not just a review of usage on the street, this is a review of legal opinions. 10% of legal opinions, the majority of which are by prosecutors, is significant per MOS (lede), and is in no way UNDUE. And that is just a citation of what is in the legal record, so it the very most conservative number on prevalence of opinion in the legal profession.

• There is also RS that such usage has a rational basis in the way the profession is currently practiced, of which I am compiling. Here are four of many RS on the topic - (1. “Hired guns,” “whores,” and “prostitutes”: case law references to clinicians of ill repute, D. Mossman, Journal of the American Academy of Psychiatry and the Law, 27:414 –25, 1999 – 2. Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice, Hagen MA, New York: HarperCollins, 1997 – 3. Reel Forensic Experts: Forensic Psychiatrists as Portrayed on Screen, Susan Hatters Friedman, MD, Cathleen A. Cerny, MD, Sherif Soliman, MD, and Sara G. West, MD, J Am Acad Psychiatry Law 39:412–17, 2011.

• Hagan criticized the methods of clinical assessment and psychological testing (in an evidence based and very reasoned and manner) and argued that mental health testimony is business rather than science, which is only a small part of the many bases of my placement of the Dubious tag on “medicine” re forensic psychiatry, and thereby on "all of psychiatry" being medicine. I was ridiculed as not being worthy of responding to re my arguments to keep the content I put in with MEDRS, with no sourcing for the ridicule, and simply because I put a dubious tag per the MEDRS and RS. This is not a good way to treat editors, nor is it a good basis for editing andarguing on talk, citing "common knowledge" to trump MEDRS sourced info.

• Samuel Gross (a Michigan Law School prof) writes “The contempt of lawyers and judges for experts is famous. They regularly describe expert witnesses as prostitutes.” This is RS for the use of “famous”, in addition to the source I provided describing “frequent” use of the expression. No wiki editor critical of my edits is citing any sources to base their opinions. The New York Times published similar remarks re being partisans rather than science based medical practitioners (In U.S., expert witnesses are partisan, Liptak A, New York Times. August 12, 2008, p A1).

• This is not just a “minority” “opinion”, and my recitation of what is in highly MEDRS and RS sources is not POV. It is citing sources. Deletions based on editors (likely as yet uninformed) opinions are not justified. I expect that in the end, these editors, likely deleting in good faith, will read the RS and MEDRS literature, and the material will gradually go into the article. In the meantime, editors should stop attacking me because they are uninformed as to what is in the MEDRS and RS sources, and is a prevalent, if not dominant, view in the legal, medical, and scientific community. ParkSehJik (talk) 19:10, 28 November 2012 (UTC)

The pov is inherently unencyclopedic. --Ronz (talk) 20:18, 28 November 2012 (UTC)

There is no POV. These are mainstream RS and MEDRS, for the most poart reporting facts and statistics from objective studies. What does "inherently unencyclopedic pov" mean, and what are the ojective criteria for establishing it? ParkSehJik (talk) 05:50, 29 November 2012 (UTC)

"There is no POV." Sorry, but that sentence makes no sense from the perspective of WP:NPOV.

The material is unsuitable for this article as was proposed, and most likely any other article, violating multiple policies, especially WP:NOT. You've brought up the same points again and again across multiple talk pages. I suggest carefully reading and responding to [1] and [2]. --Ronz (talk) 06:22, 29 November 2012 (UTC)

I will read as you suggest, but you are not responding to my questions re your edits. What does "inherently unencyclopedic pov" mean, and what are the ojective criteria for establishing it? How does WP:NOT apply, when I am only regurgitating controversy content from RS? ParkSehJik (talk) 07:02, 29 November 2012 (UTC)

I suggest you respond to those comments first so we can get beyond statements like "There is no POV." --Ronz (talk) 18:07, 29 November 2012 (UTC)

• The opinions held by judges and attorneys of members of a profession does not aid in explaining the profession, nor are accurately measured opinions indicative of the actual reliability of members of that profession. An accurate statistic of how common an opinion is has no bearing on the validity of the opinion itself. In an article about accountants, there is no reason to provide a statistic indicating that 50% of bankers are of the opinion that accountants are liars, even if it's an accurate statistic. It doesn't prove they're liars and it doesn't further understanding on the subject of accountants. It's not even an opinion, but a statistic based on an opinion.Cremice (talk) 07:09, 6 February 2014 (UTC)

Should the psychiatry, forensic psychiatry, and related articles be held to a lower MEDRS standard than alternative medicine and its related articles?

Discussion re uniform application of MEDRS standards to all WP articles is here[3].

Following discussion re MEDRS, ontologic status of psychiatric categories, and controversy re the scientific methodologies for attaching the term "disease", "disorder", and :lifetime" to the categories (if they really exist, e.g., Penis envy), in the psychiatry, forensic psychiatry, Bipolar disorder, and related article talk pages, FiachraByrne correctly wrote (bolfaced added by me for emphasis of most relevant part, and whose comment I may have distorted by excerpting just a part of it in order to raise the following issue) -

"Psychiatry is one of the oldest medical specialisms. It's designation as medical practice is a disciplinary/professional attribute that has little to do with the actual content of psychiatric knowledge or the nature of psychiatric practice. To establish this it is unnecessary to evaluate whether in any or all instances psychiatry adheres to the so-called 'scientific method'."

However, the designation of psychatry always being medicine, and not just some parts of it, with the associated implications of established efficacy in healing real diseases, at Wikipedia, is a WP:MEDRS issue, not just a matter of determining the common usage on the street. The part of FiachraByrne's comment quoted above raises issues being glossed over by other editors at those multiple talk pages, where it is declared to be "common knowledge" that psychiatry is for the most part evidence and science based, that its designated categories (eg., penis envy and bipolar disorder) are real, that the DSM designation of their being "disorders" estabishes with MEDRS that they are, and that they are lifetime, and questioning this violated WP:COMMONSENSE, and is WP:BATTLE because it is unquestionable, even with MEDRS and RS saying otherwise, all because Diagnostic and Statistical Manual of Mental Disorders (DSM), the self-proclaimed "bible" for practitioners, is always unque3stionably MEDRS. Furthermore, RS and MEDRS content is being totally deleted from any WP:MOS (lede) "controversy" paragraph as being UNDUE, by simply citing the declarations in DSM, even when contradicted by other MEDRS sources.

The same WP:MEDRS standards should be applied to psychiatry as to alternative medicine articles. Traditional Chinese Medicine (TCM) is also one of the oldest "medical" practices. There is rigorous enforcement by WP:MEDRS hawks (of which I am one) that assertions re TCM being healing "medicine", as defined in that article and by MEDRS standards. The only allowable edits are that TCM practitioners "claim" to heal. TCM uses supernatural etiological objects ("qi" flow blockage causing qi, not the heart, to propel the blood inadequately), and outright false statements about anatomies, developed without the "cutting" of the "tom" in "anatomy" (Greek "tom" means "cut", as in "a-tom" – meaning not further able to be cut, as atoms were thought to be), has also historically been designated "medicine". MEDRS has different standards than accepted common usage, and for good reasons well argued in setting up the policy.

• Should the psychiatry, forensic psychiatry, Bipolar disorder, and related articles be held to a lower WP:MEDRS standard than alternative medicine and its related articles, as to its designation as a healing "medicine", with implications to claims of efficacy and intent of all areas of its practice (e.g., forensic psychiatry, or psychiatry practiced under the color of being "medicine" at Guantanamo), when there are substantial MEDRS sourced content that at, least part of psychiatry, is not based on science at all, and other parts are not intended to heal anything?

• Should Diagnostic and Statistical Manual of Mental Disorders V be continued to be unquestioned as MEDRS, and citec as "common knowledge" which, if questioned with MEDRS or RS, is claimed to be WP:BATTLE and violate WP:COMMON SENSE, as was DSM IV, especially in light of comments such as that of Allen Frances, chair of the DSM-IV Task Force - "DSM 5 will accept diagnoses that achieve reliabilities as unbelievably low as 0.2-0.4 (barely beating the level of chance agreement two monkeys could achieve throwing darts at a diagnostic board"[4].

Discussion is here[5].

ParkSehJik (talk) 19:44, 29 November 2012 (UTC)

Note, discussion was moved to MEDRS per this exchange -

This is not a proper venue for such comments. See WP:TALK, WP:DR, and WP:CANVAS. --Ronz (talk) 17:57, 29 November 2012 (UTC)

Where do you suggest moving the discussion to? I will read what you suggest more fully. WP:Canvas cannot apply since I have yet to form an opinion as to the answer to my own question. I am noticing editors to get a full discussion and as many perspectives as possible. I expect my views on the answer to my own question will fluctuate as different reasoned views and RS supporting them are made by others. ParkSehJik (talk) 18:11, 29 November 2012 (UTC)

Criticism of Forensic Psychiatry

I have included this section with perfectly valid points (some of which, reasonably, ought NOT to require citations). Also, if you think that the assertions made do not meet verifiability standards, I think that (after the forthcoming citations are provided) there is an obligation upon whoever wishes to revert the page edit to justify their position. If given a reasonable time period, I will provide citations. ASavantDude (talk) 21:51, 18 July 2016 (UTC)

You start with adding with citations to reliable sources, not stating that no one can revert because you may or may not add sources at some point in the future. Yobol (talk) 22:36, 18 July 2016 (UTC)

Agreed. Please review WP:MEDRS regarding any health-related claims. --Ronz (talk) 22:42, 18 July 2016 (UTC)

A Broad View of Forensic Psychiatry

To many who contribute to the topic of Forensic Psychiatry, the field defined by Wikipedia ignores other important medical-legal categories within forensic psychiatry. The emphasis of the existing Wikipedia definition is almost entirely on the application of psychiatry within the criminal justice system. While criminal cases represent a central element for the use of forensic psychiatrists, it is by no means the entire focus of this subspecialty of psychiatry. I attribute this inattention to other important applications of psychiatry to disputed legal matters to the training in forensic fellowships and the emphasis placed upon criminology at professional meetings of forensic psychiatrists, and also forensic psychologists.

Forensic psychiatrists are used in family law matters involving child custody and assisting the court with what is in the best interest of the child. Just as psychiatric testimony is considered about a criminal defendant’s competency to stand trial or participate in his/her defense, psychiatric opinions are commonly considered regarding a person’s competence to create or amend a will or trust. Psychiatry is essential in determining the extent of disability or impairment in workers' compensation, Social Security, and long-term disability systems. There need be no criminal dispute in cases of malpractice and licensing of physicians, yet psychiatrists are again relied upon by juries, judges and licensing boards. This Wikipedia definition of forensic psychiatry ignores personal injury and other civil proceedings where psychiatrists, and psychologists, provide opinions regarding allegations of emotional distress and damages that are crucial to those type of cases.

I am a clinical professor of psychiatry at a major medical center and school of medicine. I avoid criminal cases for several reasons. I have not studied the precedent criminal cases which my colleagues better understand. I have had enough exposure to locked facilities and the patients or inmates who reside in such institutions. It’s not my cup of tea, so to speak, just as I might say is the case for child psychiatry or other fields of medicine such as general surgery. That being the case, I consider myself a forensic psychiatrist. I am also an occupational psychiatrist. I routinely am relied upon in disputed cases of work-related injury, both physical and mental. I provide opinions about fitness for duty, most notably dealing with police-involved shootings. There are cases in which psychiatric testimony is needed to make a determination of industrial versus non-industrial retirement benefits. Claims of sexual and other forms of harassment without a doubt rely upon the opinions of psychiatric and psychological experts.

Intertwined with work-related injury claims are third-party lawsuits, and occasionally assessments of workplace safety, that make use of a psychiatrist’s formulation. If the issue of malingering must be considered by the court in certain criminal cases, the veracity of the claimant is also an issue in most occupational and other civil disputes. Should it not be the role of a highly trained forensic psychiatrist to determine whether somatization, symptom exaggeration, a factitious disorder, &/or malingering account for the clinical presentation in these type of injury claims?

I could go on, but my point is that a significant portion of legal cases that make use of forensic psychiatric testimony have nothing to do with the criminal justice system. I am asking for a response from my fellow forensic psychiatrists. I could have listed citations to support my premise. Rather, I chose to keep my point simple. The Wikipedia definition of Forensic Psychiatry should be amended to include the many other applications of this subspecialty of psychiatry beyond the intersection of psychiatry and criminology. After all, the premier professional association of forensic psychiatry is entitled “The American Academy of Psychiatry and the Law,” of which I am a member. It is not named, “The American Academy of Psychiatry and Criminal Law.” If there is a consensus that the existing definition should be broadened, I am willing to put forth a draft, with citations, of an amendment to the definition as a new section within Forensic Psychiatry. The goal is enhance the current definition and in no way remove what is already present.WorkingMansShrink (talk) 17:47, 19 March 2021 (UTC)

American Spelling

A user recently converted something that I put in a long time ago about specialised Forensic Psychiatric units for learning disabled in-patients to American spelling. As this was in a section dealing with practice in the UK, I thought it was appropriate to revert from colonial to British spelling. NRPanikker (talk) 17:51, 9 April 2022 (UTC)

Wiki Education assignment: Brain Tips

This article was the subject of a Wiki Education Foundation-supported course assignment, between 17 January 2024 and 24 April 2024. Further details are available on the course page. Student editor(s): Kenna.quattro (article contribs).

— Assignment last updated by Kenna.quattro (talk) 18:00, 5 March 2024 (UTC)

@Kenna.quattro. Your edits to this article were pretty good. Thanks for making them. You can see a couple things I changed by clicking here. Please be careful of a tone that is too persuasive / stating opinions as fact, and please try to add at least one citation per paragraph. Oh also, one of your citations was just a link to the PubMed homepage, I think you forgot to put the paper title/PMID. Please fix at your convenience. Happy editing. –Novem Linguae (talk) 23:51, 16 April 2024 (UTC)