Forensic Psychiatric Assessment Research Articles

Forensic Psychiatric Assessment with the Claim of Incitement, Solicitation, Assistance to Suicide, and Reinforcement of Suicide Decision: A Case Report

Although the act of suicide is not considered a crime in Turkish Criminal Law, any contribution (incitement, solicitation, assistance and reinforcement of suicide decision) to the commitment of suicide is a crime according to the 84th item. However, the number of cases opened with respect to this item as well as request for forensic psychiatric expertise is very rare. In these cases, forensic psychiatric expertise depends on the psychiatric evaluation of the individual that committed suicide and the analysis of his/her relationship with the person that incited the suicide. If the suicide is completed, then the psychiatric process gains the qualification of a "psychological autopsy". In this paper, we examined a reporting process prepared for an individual that died as a result of suicide and the person accused of inciting him to suicide.Evidence and forensic aspects are discussed.

The effect of gender on the outcome of forensic psychiatric assessment in Sweden: A case vignette study.

Previous research suggests that female violent offenders at risk of a prison sentence are more likely than their male counterparts to be assessed as having mental health problems of a nature or degree that would lead to a court requirement for hospital treatment. To test the hypothesis that there is bias towards hospital disposal of female compared with male violent offenders with mental disorder. In Sweden, the National Board of Forensic Medicine oversees all assessments of mental disorder for the criminal courts. Twenty-six Board appointed forensic psychiatrists, psychologists and social workers each independently assessed six case vignettes for fit with criteria for 'severe mental disorder', a prerequisite for hospital disposal from court. Each gender neutral vignette described a person who had been convicted of serious assault and had a major mental disorder. A gender was then assigned to each offender randomly within a block design, thus varying between sets. Participants were blind to the main aim of the study and the gender variation. There was no significant association between gender of the person assessed and judgement that s/he had a 'severe mental disorder'. An offender depicted as having mental retardation was more likely to be assessed as at high risk of criminal recidivism if portrayed as female, regardless of the sex, place of work or level of experience of the assessor. We found no evidence of gender bias in determining appropriateness of a hospital disposal of an offender with mental disorder. The difference in assessment of recidivism according to sex of the patient was only in relation to mental retardation; further research would be needed to able to interpret this. As researchers in other countries have reported gender bias in disposals from court, our findings may provide support for a centralised forensic psychiatric assessment board and formal, on-going training. Copyright © 2015 John Wiley & Sons, Ltd.

The Analysis of Complex Forensic Psychiatry and Psychology Expert Assessments in Estonia

Every year, several hundred forensic psychiatry and psychology expert assessments are conducted, on persons about whom an examination ruling has been issued by the body conducting proceedings. However, it remains unclear how frequent the cases are wherein the assessment identifies the presence of a mental or behavioural disorder. Therefore, 55 forensic psychiatric and psychological complex examination assessments, from 2011 and 2012, were examined. It was found that in nine cases there were conditions suggesting mental incapability according to the Penal Code’s Article 34, sections 1 to 5. The wording of questions in examination rulings demonstrates that direct guidelines would be needed for specifying how the questions should be formulated.

Critique of the use of neuroscience in forensic psychiatric assessments: The issue of criminal responsibility

ObjectivesThis paper sets out to examine the way in which neuroscientific knowledge and techniques have been used in some European courts, in order to assess their impact on the assessment of criminal responsibility and to anticipate potential misuse of neuroscience in the courts. MethodWe conducted a case-law search and examined two European cases in which neuroscientific techniques were used in order to prove the diminished responsibility or irresponsibility of the accused. ResultsAfter reviewing these cases we concluded that there were significant difficulties and limitations of technical/scientific, conceptual and legal nature, concerning the use of neuroscience for the assessment of responsibility. DiscussionNeuroscientific data, no matter how accurate and reliable may become, will only make sense in the quest for the assessment of criminal responsibility if they are contextualized and supplemented with data collected from other levels of analysis. ConclusionDespite the importance of the contribution of neuroscience to forensic assessments for a more refined understanding of the complex interaction between the brain, mental states and behaviour, the use of neuroscientific evidence in legal contexts will not dispense with the need to define the limits of responsibility and irresponsibility of the accused. It is a social, moral, political and, ultimately, legal question.

Divergences dans l’expertise de responsabilité des personnes schizophrènes accusées d’homicide volontaire : enquête auprès des experts de la cour d’appel d’Aix-en-Provence

In France, forensic psychiatric assessment plays a central role in the relationship between psychiatry and justice. The psychiatric expert is commissioned to determine whether or not the accused has a mental disorder and to specify whether or not it affected discernment at the time of offense. Nowadays, psychiatric expertise is coming under more and more criticism, particularly regarding divergences between experts. Our objectives were to find points of divergence between experts, try to understand causes and suggest ways to try to reduce them. For this we conducted a study, between July 2012and January 2013, with psychiatric experts of the Court of Appeal of Aix-en-Provence through semi-structured interviews. We focused on a limited context: psychiatric expertise of responsibility for schizophrenic persons accused of murder. We questioned the experts about the issue of criminal liability of a person with schizophrenia in general but also in clinical situations we thought particularly involved in disagreements. We recruited a population of 17psychiatrists, mostly males of average age of 58years, working mostly in the department of adult psychiatry of a hospital. We highlighted the differences between the experts, first with regards to the issue of liability in general. Experts divided seemed to keep in majority (52.9%) the alternative between abolition and alteration of discernment when faced with a schizophrenic person accused of murder. The differences were even more pronounced in specific contexts. Thus, the fact that the person had suffered from delirium at the time of the offense led half of the experts (47.1%) to conclude a systematic abolition of discernment, while the other half made such a conclusion when the delirium was directly linked to the facts. Discontinuation of neuroleptic treatment, drug abuse or existence of premeditation changed the conclusions of the experts in half the cases, more in the sense of an increased accountability in the cases of drug abuse or premeditation, and in the direction of a reduction of liability in case of cessation of treatment. The denial of facts by the accused caused fewer disagreements between experts. Among experts, 76.5% had already observed differences, which, according to them, were based primarily on schools of thought, or personal views (64.7%), which could distort clinical evaluation and especially forensic interpretation of the relationship between pathology and facts. The experts thought it was possible and desirable to reduce differences and proposed different solutions for this, especially the return to dual expertise and colleges of experts. Our results were consistent with those in the literature. Based on proposals from experts and data from the literature, we identified five perspectives likely to reduce differences: first it would be useful to put in place a better specific training in forensic psychiatry and expertise, not only theoretical but also in terms of practical training through tutoring. We would identify a jurisprudence in forensic psychiatric assessment and identify consensual points. It would be good to allow experts to acquire sufficient experience not just through tutorials but also by statutory changes. Moments of exchange between experts -including a return to dual expertise and the organization of work meeting- could also reduce differences. Finally, we propose legislative changes: not only to rewrite the paragraph 2of Article 122-1of the French Penal Code, but also to give priority to the expertise of responsibility on the expertise of dangerousness. We showed that there were differences between the experts mainly concerned with the forensic interpretation, and that they seemed linked to schools of thought or to personal views of each expert. To reduce the differences, we discussed five perspectives.

The Role of Culture in Temporal Lobe Epilepsy and Criminality: A Case Series from Malaysia

Culture still plays an important role in the understanding of epilepsy among non-western developing nations. As a result, many patients are left undiagnosed and untreated until a serious incident such as an accident or a crime occurs, leading to medical attention. This case series gives two examples of patients who were sent for forensic psychiatric assessment after allegedly committing a crime in Malaysia. Both had temporal lobe epilepsy but diagnoses were delayed because of cultural beliefs, and ultimately they were acquitted using insanity as a defence. Implications from these cases include the need for improving public awareness of temporal lobe epilepsy as a treatable medical condition in view of the prevalent cultural belief of ‘possession states’, and the need for more streamlined and precise forensic services that would include an automatism defence.

Les soins pénalement ordonnés : analyse d’une pratique complexe à travers une revue de la littérature

In France, there are two main types of court-ordered treatment (COT) as far as mental health is concerned: obligations of treatment and injunctions of treatment. Obligations of treatment date back from 1958whereas the law implementing injunctions of treatment is fairly recent as it was passed in 1998. Obligations and injunctions of treatment are two different types of COT that differ in terms of proceedings (obligations of treatment require no preliminary forensic psychiatric assessment; as for injunctions of treatment, they require the appointment of a coordinating medical doctor) and that are applied for different offences. However, both are psychiatric commitment procedures connecting the judicial, medical and social fields and their overall numbers have been on the rise. These common psychiatric practices have seldom been assessed and no review of the literature on the subject has ever been published. Better knowledge of such forensic practices is essential to their improvement and even to adjust the legal framework of these measures that are enjoying a boom. The purpose of this literature review is to define the prevalence of COT as well as the sociodemographic, criminal and psychiatric characteristics of those concerned by such measures. A review of the French medical literature on COT was carried out using Science Direct up to December 2013. The results of seven studies were included and analysed. This was completed with a review of the articles listed in social sciences and law databases (Cairn and Dalloz). It has become increasingly frequent to rely on psychiatric teams to implement COT while at the same time public mental health services have to face a surge in activity with restricted financial means. Obligations of treatment are far more common (about 20,000court orders a year) than injunctions of treatment (about 4000measures are currently being enforced). However the latter have showed an increase of 506% over the 2000decade. Both measures mainly concern men (83-99%) who are rather low on the social scale. In about half of these men, no mental disorder was found, however the prevalence of personality disorders ranged from 22to 65% while that of psychotic disorders was low. Injunctions of treatment concerned sex offenders (90% of cases) whereas obligations of treatment concern non-sexual abusers (40-70%) rather than sex offenders (20-30%). Psychiatric research on COT is still thin on the ground and its methodology does not allow rigorous evaluation though the use of such measures is growing. When confronted with people who have not sought any care or treatment, healthcare professionals are at a loss. In France, training in forensic psychiatry is inadequate and specialised healthcare (particularly for sex offenders) need improving to reach the level of those found in many other European countries. The purpose of psychiatric treatment differs from that of lawmakers whose aim is to prevent recidivism. However, better treatment consistency requires setting up partnerships between justice, health and social services. To improve connections, there are various avenues of work such as, for instance, the creation of coordinating medical doctors for injunctions of treatment in France or European experiments using a multidisciplinary approach to prevent recidivism in sex offenders. The framework of such a partnership remains to be created as it is part and parcel of COT but has not been provided for in the law. Healthcare jurisdictions as defined in the 2009French National Health Law might provide an appropriate framework for mental health and law professionals to collaborate.

Divergences dans l’expertise psychiatrique de responsabilité : bilan et premières hypothèses à travers une revue de la littérature

Forensic psychiatric assessment regarding liability ensures a balance between justice and psychiatry. In France, criminal assessment is not contradictory. The psychiatric expert is commissioned by judges to determine whether or not the accused has a mental disorder and specify whether it affects discernment and control of actions at the time of offense. Its mission focuses on the mental element required to constitute an offense, and is structured around Article 122-1 of the Criminal Code. This article, composed of two paragraphs, distinguishes the framework of the abolition of discernment — a cause of non-imputability and therefore of a statement of lack of criminal responsibility due to mental disorder — and the framework of the alteration of discernment. Nowadays expertise seems to meet discomfort, with criticism focusing on possible differences among psychiatric experts, without specific studies having been conducted to confirm it. Our objective was to identify the main points of disagreement between psychiatric experts and to propose explicative hypotheses. For this, we carried out a literature review on PubMed, Science Direct and Cairn, and studied the report of the 2007 public hearing on forensic psychiatric assessment with contributions from different authors. The keywords were: forensic psychiatry, psychiatric court report, psychiatric expertise, differences among experts, legal responsibility, and discernment. We defined differences as disagreements between experts, or as a mismatch in conclusions and approaches of experts. The differences among experts concerned mainly forensic interpretation, i.e. the discussion of the relationship between pathology and offense, particularly in contexts that involve a larger forensic discussion, including interruption of medication, use of drugs, association with antisocial personality, premeditation, denial of facts, especially when the accused suffers from a mental illness (especially schizophrenia). For a finding of abolition of discernment, an expert must consider two requirements, one temporal (the mental disease must be active during offense) and the other causal that involves seeking a direct and exclusive relationship between the offence and the mental state, according to expert jurisprudence. Some experts do not comply with these two requirements or this jurisprudence, whence differences. There were also diagnostic differences and disputes relating to the concept of "alteration of discernment". Disagreements appeared to be related primarily to personal ideologies or different schools of thought that influenced interpretations and conclusions of experts, e.g. accountability as a therapeutic response for the psychotic person. Then, the lack of clarity of expert mission regarding necessary causal relationship — between any disease and crime — to demonstrate to conclude an abolition of discernment, could also contribute to differences. Moreover, time available to achieve the mission is too short and the expert would not devote enough time to an expert examination, which could lead to less good expertise and differences; especially as observed clinical examination in expertise is sometimes difficult, misleading, due to pathological reticence of accused mentally ill but also sometimes due to possible simulations. Finally, the low quality of some expert reports — due in part to the less well-trained experts, but also the particular conditions of achievement of expertise, especially in prisons — were mentioned by some authors as causes of differences. It appears from this review of literature that differences mainly concern forensic interpretation and are mainly explained by ideologies. This synthesis is a preliminary work prior to a study among psychiatric experts.

Classification of Mental Disorders of Late Age

Aging is accompanied by the rise of mental health problems and dementia. Their number by 2050 could reach 120 million people. The absens of classification of mental disorders of late age prevents from their correct diagnosis, forensic psychiatric assessment, promotes ageism. Kraepelin (1900) placed them in the category 'Interior body disease processes', and subdivided into 'arteriosclerotic', 'presenile psychosis of the age reverse development' and 'senile mental disorders'. Bleuler (1920) attributed them to 'Acquired psychosis with gross brain disorders. Organic syndrome'. Sternberg (1977) distinguished functional, vascular and atrophic forms. Shakhmatov (1996) believed that the classification of mental disorders of late age should basically be determined by the presence or absence of dementia. In ICD-9, ICD-10, DSM-5 there is no special section on mental disorders of aging. As a result there is a loss of such unique and specific syndromes of involution, as pseudoparalytic, frontal, paraphrenic disoders, acute and chronic Wernicke presbyophrenia, 'functional', delirium (involutional paranoid) and hallucinatory (Akboma dermatozoic delusion) psychosis of later age. ICD-10 consides a state of R54 'Old Age', but without pairing with category 'Mental disorders'. In the DSM-Y there is no section on mental disorders of old age, the only innovation is ontogenetic approach in the description of mental disorders, depending on different age periods and renaming of dementia into neurocognitive disorders, aimed at destigmatization of patients. The pilot version of the section 'Mental disorder' in the ICD-11 presents the category of 'Old age'. We believe that it is reasonable to classify 'Behavioral and mental disorders of late age' in this variant.

Police National Computer Record Checks in Referrals to a Medium Secure Unit

Introduction The forensic history is a vital part of the assessment in patients referred to forensic services. It influences decisions made about risk and the link between illness and offending behaviour. Doctors should view the police national computer, (PNC) record in all assessments of referrals. Objectives To establish whether PNC records are available to doctors conducting forensic psychiatric assessments of new referrals at a medium secure unit (MSU). Aims Establish what proportion of patients referred to a MSU in London had a PNC record present at the time the assessment report was presented to the admissions panel. Methods The admissions panel of a MSU in London has kept data on all assessments carried out since 2011. All of this data was reviewed to see what proportion of patients had a PNC record present at the time the assessment report was presented to the admissions panel. Results In total there were 186 patients. 21 of these were women. 165 of these were men. 59% of the assessments had a PNC record present. In 19% of assessments a PNC was not requested. In 18% it was requested but not available. In 4% it was deemed not necessary. Conclusions A PNC record was not available in 41% of forensic assessments carried out by a large forensic service in London. In 19% of these cases a PNC had not been requested. Suggested recommendations are that the PNC is requested at the time that the referral is received by the trust.

Neonaticide and Infanticide - a Case Series From One Forensic Unit in Croatia

Introduction Neonaticide denotesmurder of a child during the first 24 hours oflife; infanticide is the murder of achild under the twelve months of age. Neonaticide is statistical rare delictand is defined as a „privileged murder' according to the Croatian Criminal LawAct. Objective To describe thecases of six women who faced criminal charges for neonaticide and infanticide. Aftera forensic psychiatric assessment of their level of criminal responsibility, thesepatients were considered guilty byreason of reduced sanity and some committed to penale institution and others toambulantory forensic treatment at the Forensic Unit of University Psychiatry ClinicVrapce, Zagreb. Aim To report some riskfactors for neonaticide and infanticide based on psychiatric diagnosis, age ofperpertrator and socio-cultural background. Methods These reports wereanalysed based on content of medical histories and court reports. Results Borderlinepersonality disorder, acute stress reaction, low intelectual capacity, level of education, poverty, younger age and disturbed family relationswere most common among presented neonaticide and infanticide perpetrators atthe Forensic Unit of the University Psychiatry Clinic Vrapce. Conclusion The investigationinto cases of neonaticide and infanticide may offer an insight into the factorsthat may be of relevance in understanding how a mother may come to commitdescribed delicts and enhance the odds for effective prevention. Identifyingrisk factors for neonaticide requires better psychiatric care for the parturient women in maternal wards and further nationwide research andcoordination.

A forensic-psychiatric study of sexual offenders in Rio de Janeiro, Brazil

Sexual violence is defined as any sexual act forced upon a person who did not give his or her consent. Our objective is to investigate the socio-demographic features, clinical correlates, criminal behaviour characteristics, and the level of penal responsibility of sexual offenders who were referred to forensic psychiatric assessment in the city of Rio de Janeiro, Brazil. This is a cross-sectional descriptive study. All written reports made in the year of 2008 by court-appointed psychiatric experts on individuals charged with having committed sexual crimes and referred to the main forensic hospital in the State of Rio de Janeiro, Brazil, for assessment were reviewed. Forty-four expert reports were identified. All alleged offenders were male. Nineteen (43.2%) offenders did not receive any psychiatric diagnostic. Nine offenders (20.4%) were diagnosed with mental retardation. In 16 cases (36.4%), some form of mental or neurological disorder was diagnosed. Thirty-one (70.4%) offenders were considered fully responsible, eight (18.2%) partially responsible, and five (11.4%) not responsible by reason of insanity. The sexual crimes allegedly perpetrated by the offenders were rape (n=14, 32%), attempted rape (n=4, 9%), indecent assault (n=26, 59%), and indecent exposure (n=5, 11.4%). In 10 cases (22.7%), the offender was under alcohol influence at the moment of the crime. The profile of Brazilian sex offenders subject to forensic psychiatric assessment were male, caucasian, single, working part time, with no mental disorder, who perpetrated indecent assault.

Analyse qualitative de rapports d’expertise psychiatrique concernant des faits de pornographie infantile

ObjectivesThere are different forms of sexual assault against minors. Child pornography is the realization of deviant fantasies. It has very specific characteristics with regard to its realization and use, and hence to the political actions taken to deal with it. A child pornographer is defined as an adult who uses the sexual depiction of a child for his own interests or for the commercialization of the images. Confusion can be made between child pornographers and online offenders. The online offender is a person who uses the Internet to feed his sexual fantasies virtually, or to groom a child in order to provoke actual contact. Most often, online offenders are child pornographers, because they use child pornography to facilitate contact with the victim. It is important to understand the psychopathological aspects of child pornographers in order to provide appropriate treatment. Understanding the phenomenon of child pornography is complex, because it is sometimes a matter of deviance without leading to actual abuse, and it is this virtual aspect that appears to be encouraged by the Internet. It has probably increased certain deviant behaviours that were previously limited by inhibition. Psychiatric assessments are carried out at the request of the law courts. Forensic psychiatrists have to give psycho-criminological information to explain the offense and to allow the prosecutor to make appropriate decisions. The characteristics of child pornographers are varied. In this study, we analysed forensic assessments in child pornography cases to provide guidelines based on the characteristics of child pornographers described in the literature. Material and methodsWe analyzed the data of 69 forensic reports. We had previously identified items which are traditionally evaluated in general psychiatric assessments and specific items relating to the characteristics of child pornographers reported in the literature. Using this performance measurement matrix and the 69 forensic reports, we identify the items which appeared in under 10% of the forensic reports. ResultsWe noted 20 items found in under 10% of the forensic reports. In this paper, we describe 11 of these items which appeared to us to be the most important: diagnosis hypothesis, risk of reoffending, time between the offense and the assessment, fantasies, inconsistency when talking about the offense, sense of virtuality, difficulty talking about sexuality, biographical data, addiction to images, information given by the prosecutor to the forensic psychiatrists, currently receiving psychotherapy. ConclusionsIt is important to carry out qualitative analyses of forensic assessments. Forensic psychiatrists can find a considerable amount of information in the scientific literature to help in their assessments, because they do not always know everything about all deviant behaviours. Standardization is required in the field of forensic psychiatry. In France, forensic psychiatric assessments are made without supervision. There is also interpersonal variation in the assessments. Knowledge about deviance has developed, revealing more specific characteristics about each specific behaviour. The importance of the legal consequences makes this standardization essential. The aim of this qualitative analysis is to produce guidelines to help forensic psychiatrists assess child pornographers. Moreover, it is important to pursue this research in order to improve knowledge about the psychopathological and socio-demographic aspects of offenders. It is also important that the data used for research are as complete as possible. Most often, the only possibility to study deviant behaviour is to use forensic material.

Area of specialty preferences of forensic authorities in forensic psychiatric evaluation requests: a university hospital experience

Area of specialty preferences of forensic authorities in forensic psychiatric evaluation requests: a university hospital experience Objective: In this study, we aimed to find the relevant factors of forensic medicine, child and adolescent psychiatry, and psychiatry fields’ preferences in the forensic psychiatric assessment requests of forensic authorities. Method: Case records which are consulted to Erzurum Ataturk University Faculty of Medicine, Forensic Medicine, Child and Adolescent Psychiatry, and Psychiatry Departments between 01.01.2010 and 31.12.2010 were assessed retrospectively. Results: Of the 330 cases who were assessed, 54.2% (n=179) were male, 45.8% (n=151) were female, 54.8% were (n=181) child and adolescent, and 45.2% (n=149) were adult. In the light of our results, forensic authorities noticed the difference of choice between forensic medicine and child and adolescent psychiatry when consulting child and adolescent cases. Besides there was no difference for the choice between forensic medicine and psychiatry in the forensic psychiatric evaluation of adult cases. Discussion: It is thought that interdisciplinary approach which was formed by developing law practices of specialty area choice in the forensic psychiatric evaluation requests of forensic authorities is an important step for achieving accurate results. Conclusion: Evaluations in the area of forensic psychiatry should be made with cooperation of related disciplines.

Forensic mental health assessment in France: Recommendations for quality improvement

The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called “experts” in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

Evaluación objetiva del procesamiento de las emociones. Estudio de un caso forense

IntroductionThe main objective of the emotions is to ensure the homeostasis, the survival and the well-being of the organism. ObjectiveTo demonstrate the usefulness of performing neurophysiological and neuropsychological assessments in patients, in order to demonstrate the significant role of the emotions in the execution of certain behaviours. MethodsA forensic psychiatric interview was conducted. EEG in vigil state was registered, the generators of current density to theta band were calculated, and the emotions recognition test was performed. ResultsThe results of the psychiatric interview demonstrated that fear was an important element in acting impulsively, and lack of foresight of the accused. A substantial decrease was demonstrated in the ability to understand the scope of the acts and the direction of the behaviour during the time the crime occurred. The EEG showed alterations in frontal regions, and the generators of current density were located in frontal-temporal regions and occipital associative areas. ConclusionsIt is recommended to associate these studies with the forensic psychiatric assessment, in order to increase the objectivity of the diagnoses formulated by medical experts.

EPA-0132 – Criminal responsibility for murder among remand prisoners sent for forensic psychiatric assessment in sri lanka

There is lack of research on criminal responsibility among offenders with mental illness in Sri Lanka. ‘Unsound mind’, defined in penal code of Sri Lanka, excludes persons from responsibility for acts of crime. Psychiatric diagnosis does not always exclude those from criminal responsibility. A forensic psychiatric assessment is used to judge responsibility for a crime. Psychiatrists are requested by courts to give opinions on such matters. Describe proportions of those who were deemed to not responsible for the crime of murder due to insanity. Retrospective study, where hospital records and court reports of persons charged with ‘murder’, and were admitted for psychiatric assessment in year 2011, maintained by the forensic psychiatry unit at the National Institute of Mental Health, were analyzed. 42 were admitted (38 males, 4 females). 37 (88%) of them had a mental illness. Out them 13(35%) were deemed to be having an ‘unsound mind’ at the time of the alleged offence. 12 (32%), were found to be of ‘sound mind’ thus responsible for the charge of murder, despite having identified mental illnesses. In 13(31%) the mental state could not be reconstructed due to lack of information. Most common diagnosis was schizophrenia.

The “Bestie di Satana” Murders

In recent years, satanic groups have been responsible for various types and degrees of crimes. We report the case of a number of murders committed in Italy by a group of young people calling themselves the "Bestie di Satana". Forensic psychiatric assessment of the members of a satanic sect charged with the crime revealed that all the young people had a fragile, immature personality, a very low level of education and were socially disadvantaged. The trial of the members of the "Bestie di Satana" sect was concluded with the verdict of deliberate murder, and all the members were given long jail sentences. This report should lead us to explore social and cultural responses to juvenile satanism, statistically shown to be a relatively rare phenomenon but with a high criminal potential.

The Infanticide: Some Forensic and Ethical Issues

Forensic investigation and clinical treatment of infanticide mother is an occasion to reflect about the social stigma associated with this crime. The forensic-psychiatric assessment must be anchored on an authentic and meaningful clinical relationship to criminal mother, without misinterpretation and countertransferal dynamics, such as emotional reactions of mistrust and stigmatization of the offender.

Innocence, déni, aveu, culpabilité : conclusion de la journée

The author reviews the various papers presented during this meeting. He concludes that forensic psychiatric assessment has to become more scientific and forensic psychiatry must be necessarily taught to judges and psychiatrists.