Fitness to be interviewed assessments: are specialist trainees fit enough?

Jonathan Green,John Kent,Suraj Shenoy

doi:10.1192/pb.bp.111.036293

Abstract

Aims and methodThe law allows courts to exclude evidence from police interviews if it is obtained unfairly or would have an adverse effect on the fairness of proceedings. The assessment of a detainee's fitness to be interviewed is therefore of paramount importance. We surveyed 70 psychiatrists in higher training within the Yorkshire and Humber Deanery to ascertain their current understanding of this clinically important task. The psychiatrists' level of training received and awareness of local employee guidance in relation to their responsibilities in this field was investigated. We then piloted an interactive teaching session aimed at improving knowledge in this area and gained feedback from attending higher trainees.ResultsThere was a 64% response rate to the survey before implementation of the teaching session. The survey found that half of all respondents had been asked to carry out a fitness to be interviewed assessment at some point in their higher training. Only a third of the respondents had attended formal teaching in this area, and only a fifth were aware of local employee guidance. All the trainees who attended the pilot teaching session felt it was beneficial to their future clinical practice.Clinical implicationsIt is imperative that all the higher training schemes in the country incorporate training in this field to help satisfy the Royal College of Psychiatrists' intended specialist trainee learning outcomes and, more significantly, to avoid potential miscarriages of justice.

Highlights

We discovered that uncertainties about the role of trainee psychiatrists in this area continued and formal training was lacking
Our survey has revealed that formal training in this area continues to be poor, there has been almost a sevenfold increase in the number of trainees receiving such training, from 5% in the earlier survey to 33% in our survey
Our survey has highlighted that awareness of the available literature in this area among psychiatric trainees is good. That this is no substitute for formal training

Summary

Results

We received a total of 45 replies (64%). Almost half of these replies were from middle-grade doctors on the general adult training rotation, a fifth were from doctors on the old age training rotation, and the rest were from trainees on other rotations (learning disability, child and adolescent, psychotherapy, dual trainees). More than half of the 45 middle-grade doctors (n = 26) had been asked to assess a detainee’s fitness to be interviewed by the police at some point in their higher training. The PACE Codes of Practice state that ‘a detainee shall not be interviewed if there is a risk of significant harm to the detainee’s physical or mental state’.3 This concept was considered vague by trainees, who felt uncomfortable about making this judgement with no prior knowledge of the detainee. Consistent with findings from our earlier survey, many trainees questioned whether or not on-call psychiatrists employed by the National Health Service are contractually obliged to carry out fitness to be interviewed assessments for the police. It was concluded that local service-level agreements and trust policies will determine whether trainees and local psychiatrists will perform fitness to be interviewed assessments in police stations

Method

Discussion