Forensic Psychiatry

One is reminded of an ancient tale of 10 blind men sent by a king to describe an elephant. Whichever piece of the beast each blind man touched, so ran his faulty description. At one time or another the FBI, Army, and Hasan’s superiors each touched a piece of Nidal Hasan. Tragically, no one was able to assemble the entire frightful picture, and head him off at the pass.

Army psychiatrist MAJ Nidal Hasan sought to get out of the service, but the Army, which had poured hundreds of thousands of dollars into his military and medical training, offered him no legal exit.

Ideology is much less important than common sense solutions. The mentally ill have many unmet needs and suffer from great and undeserved coercion.

Lack of communication is often a key factor in mass murder, according Phillip Resnick, MD. Although HIPAA is important, the safety of the individual and the public should outweigh privacy issues, and “risk to human life always trumps confidentiality.”

Some attorneys have argued that SSRIs cause serious adverse events, capable of compelling defendants to engage in strikingly complex criminal behavior. On close examination, however, these phenomena may be clearly distinguished from criminal behavior.

What is truth? In the end, it is not a forensic psychiatrist's place to judge. He or she is a cog in a bigger machine that is supposed to treat psychiatric illness.

Many patients with serious mental illness become entangled with the justice system. Extending our notions of interdisciplinary teams to include parole and probation officers provides us with options and opportunities not typically available otherwise in support of our patients.

Some criminal activity can be eliminated by pharmacotherapy for ADHD. Should this information influence clinical practice? The short answer is an un­equivocal “yes.”

A resident describes her experience in dealing with a potentially agitated patient.

Dr Osheroff played a significant role for psychiatric practice in the 1980s. For many, his situation personified the changes that swept psychiatry at that critical juncture.

A therapeutic alliance can serve to build a trusting relationship between clinician and patient and increase the patient’s feelings of agency and autonomy.

When our jails become our largest public mental health facilities, we definitely have a problem-a problem we created-in how we respond to serious mental illness.

The rise in suicides and lethal overdoses of opioid analgesics is probably not coincidental. In most overdose deaths, we have no way of knowing with any degree of certainty whether they were accidental deaths or intentional suicides.

A panel of experts at the APA Annual Meeting discussed how changes in DSM-5 may affect clinical practice. Highlights here.

The Sandy Hook Promise . . “To do everything in our power to be remembered--not as the town filled with grief and victims; but as the place where real change began.”

This article explains and demonstrates the importance of psychiatric advance directives and the benefits and obstacles involved in implementing them.

American psychiatrists might be able to sympathize in the wake of recent mass tragedies leading to new, hastily conceived laws that directly impinge on psychiatric practice, confidentiality, and duty to protect third parties.

On December 18, 2012, French psychiatrist Daniele Canarelli, age 58, received a 1-year suspended prison sentence by the Criminal Court of Marseille after one of her patients killed someone.

Both clinicians and weather forecasters employ the same general process of information gathering, analysis, and reaching a conclusion.

The humanities are a variety of academic disciplines that focus on the human condition with analytic and sometimes speculative methods. This is in contrast to the empirical methods of the natural sciences.

Bringing the arts and humanities to psychiatry requires bringing these areas of study into our education, our research and our practice models.

Shakespeare's understanding of the human condition miraculously transcends his culture, time, and place.

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.

Diagnosing rape as mental disorder is an improper use of psychiatric diagnosis and promotes the abuse of psychiatric commitment to further what would otherwise be an unconstitutional form of preventive detention.

The news media has always been in the business of searching for "the right sort of madness" to capture the public's imagination.

Newtown’s loss has finally forced us to look more deeply at violence and the treatment of mental health within our society.

Mental health professionals, state-run forensic services, and law enforcement agencies need to come together and discuss the most efficient and safe models when confronting psychiatric emergencies to improve and expand these practices across America.

What we know for sure is that for all the young children and adults who were killed in Newtown, their world ended a week ago. Soon after the tragedy, one of the fathers of a child killed tearfully pleaded for society to learn from what happened in order to prevent future mass murders. Here, recommendations from a psychiatrist.

The number of medical diseases that can present with psychotic symptoms (ie, delusions, hallucinations) is legion. A thorough differential diagnosis of possible medical and toxic causes of psychosis is necessary to avoid the mistaken attribution of psychosis to a psychiatric disorder.

Can patient care still be your greatest concern, given today’s litigious landscape? Does patient-focused care need to take a back seat against protecting yourself from malpractice?