Table of Contents

How to write a Psychiatric Court Report ?

Guidelines on how to write a "court report" on offender patients for Magistrates, Crown and Civil Courts.

Requests usually originate from the magistrates' Bench, a Judge, the Crown Prosecution Service, defence solicitors, Probation or Social Services.

The medico-legal document should contain a comprehensive summary of the individual. The report should be unbiased, not be drawn into the adversarial arena. Medical experts give opinions, and the courts of law decide the outcome.

The author may be cross-examined on the content of the report and accuracy of the document. Reports are prepared when an individual is found guilty but is pending sentencing.

Sometimes a report is requested at the pre-hearing stage and concern is expressed about the patient's "fitness to plead": The Courts here only require an answer to the question: whether the individual * understands the nature of the charge, * is able to instruct a solicitor, * and follow the proceedings of Court.

Patients are also assessed at the pre-trial stage when pleading not guilty to charges. The assessor should beware of falling into the trap of acting as judge and jury, and making recommendations to the Court as if found guilty.

Reports should be carefully worded, a secondary report containing recommendations for sentencing be submitted to the Court after innocence or guilt is proven.

General principles in the interviewing

  • Inform the patient that normal confidentiality does not exist, notes will be taken in order to ensure accurate data for later report compilation.
  • Information gathering should be from a variety of sources, the patient himself, the police evidence, an informant relative source, and liaison with any other professionals involved with his case.
  • Adequate time should be allowed for assessment with repeated interviews if necessary.
  • Assessors should not be bullied into meeting Court deadlines, but courteously inform the Courts of the time necessary to provide an adequate, accurate report and request a further remand.
  • Wording in the report should clearly indicate the difference between information based on factual sources and opinions derived from fact.

GENERAL PRINCIPLES

  • CONFIDENTIALITY ALTERED
  • ACCURACY OF DATA
  • TIME
  • CONSIDERED OPINION

You are writing for a non-medical reader: avoid jargon or medical terms. Medical terms should be explained in layman's terms.

Use succinct English with numbered points rather than rambling prose. The report should be easily readable, with headings to guide the reader and draw attention to important facts.

The report should answer following questions:-

  • type of birth
  • developmental milestones, and overall period of infancy
  • education, type of schools
  • pattern of socialisation, interaction with peers and staff
  • any behavioural or learning difficulties, and whether ever suspended or expelled
  • any qualifications or illiteracy.
  • Work history in chronological account gives details of duration of employment
  • relationship with co-workers and superiors, any work difficulties and reasons for leaving employment, training courses
  • the individuals use of time during long periods of unemployment
  • the individual's socialisation in adulthood
  • close relationship history and psychosexual history
  • When giving history of use of alcohol and substance abuse:
  • age of onset
  • patterns of use
  • any physical or psychological features of dependence
  • consequences of abuse, and summary of professional involvement.
  • The subject's hobbies and interests.

PERSONAL HISTORY

  • DEVELOPMENTAL
  • BIRTH
  • MILESTONES
  • EDUCATION
  • WORK
  • SOCIALISATION
  • RELATIONSHIP HISTORY
  • PSYCHOSEXUAL HISTORY
  • DRUGS AND ALCOHOL
  • HOBBIES AND INTERESTS

Family History

Summary of the family pedigree, family environment and relationships, and presence or absence of a psychiatric, criminal or substance abuse history in family.

FAMILY HISTORY * PEDIGREE * PSYCHIATRIC HISTORY * CRIMINAL HISTORY * SUBSTANCE ABUSE HISTORY * ASSESSMENT OF FAMILY ENVIRONMENT

Past Medical History

in a chronological numbered form gives both the date of events and the age of the patient on each occasion.

Past Psychiatric History

in a chronological numbered form with dates of events, age of the patient, treatment venue and outcome, and the relevance to the offending history discussed.

Past Criminal History

A chronological, numbered summary with dates and patient's age, the nature of the offence, offence antecedents, attitude of the individual to his offending behaviour and the victim, and subsequent disposal by the court.

Previous offences

of a similar nature to the current charge. Whether the nature of offences is escalating in seriousness, or whether the frequency of offending is increasing.

Where the patient has been made subject to a Hospital Order, Probation Order with a condition of treatment, or any other Order in the past.

Present Alleged Offence

The individual's description of events, in comparison with the information provided in the depositions.

External and internal antecedent factors, such as substance abuse or an abnormal mental state.

The patients' attitudes to their offence behaviour, the effect on their victims, and their future risks should be elicited.

PRESENT ALLEGED OFFENCE

  • PATIENTS DESCRIPTION
  • DEPOSITIONS
  • ANTECEDENT FACTORS
  • ATTITUDE

Informant History

A relative or close friend is interviewed. Who the informant is, his relationship to the accused, and how long he has known them if a friend is reported. The assessor judge the reliability of the informant source, and record the informant's formulation of the defendant's problems.

Mental State at Time of Interview

A clear, concise description of the patient's mental state and personality attributes when appropriate.

Mental State at Time of Offence

A description of the individual compiled from the various informant sources. It should describe how the mental state would have affected the person's criminal responsibility at that time, both in their capacity to form intent, and to be accountable for their actions. If offending is a consequence of passivity, or acting upon delusional ideas or hallucinations this should be explained.

Opinion

numbered in sections. 1. The patient is under disability or not. 2. The Mental Health Act 1983 is applicable to them or not. 3. The individual's life-history, highlighting relevant factors pertaining to the offence, an account of the offence with an explanation where possible, and future risk predictions. 4. Recommendation to the Court.

to state "No medical recommendation" when there is not a specific medical intervention in the case. You must liaise with the probation service to support non custodial disposals to the Court.

If making a medical recommendation for hospital admission, identify a bed for the patient and supply the requisite Section recommendation forms.

Report on whether Hospital Order is recommended and the offence is of a serious nature, whether a Restriction Order would be appropriate.

When recommending a Probation Order with a condition of psychiatric treatment, the doctor should include a summary of the proposed treatment plan.

The report ends with the author has Section 12 approval and contain the author's qualifications and title.

References

  • The Psychiatric Court Report: Professor R. S. Bluglass. Med. Sci. and Law 1979, Vol.19, No.2 April.
  • "The Psychiatric Court Report", Bluglass 1979 - gives historical and legal aspects, and the assessment process.
  • Preparing Psychiatric Court Report. Gibbens T.C.N. 1974. Br. J. Hosp. Med. 12, 278-284.