Forensic Psychiatry In Civil Law

[Enkidu]

To what extent are forensic psychiatrists involved in things like custody disputes during a divorce in which one spouse is mentally ill? Is this something that psychiatrists are involved in, or is this a situation where the patients medical records are simply subpoenaed and no further psychiatric evaluation is needed?

Also, are forensic psychiatrists involved in questions about competence to enter into certain contracts or to make changes to wills? If a party to a lawsuit wanted to say that their grandmother couldn't change her will due to her mental health, would a forensic psychiatrist be called in to evaluate her, or is there some other method?

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[nitemagi]

You're asking about sub-subspecialties, within forensic psychiatry, namely civil and say geriatric forensic psychiatry. I did not do a fellowship, but my understanding is that most fellowships train heavily in criminal and less in civil. Psychiatrists can get involved in custody disputes, though I'd be cautious. I used to think about getting into child forensic psychiatry, but was told by a child psychiatrist this is actually a really dangerous field (parents have been known to KILL the evaluating psychiatrist), because there's little that's as threatening as being a part of taking away someone's children.

Competency evals and geriatric forensics is a legitimate niche, though the only people who I happen to know that practice in that area didn't do fellowships but got grandfathered in.

So in short, both areas are legitimate for psychiatric involvement and consultation, but I don't know anyone that does that exclusively.

 

[whopper]

To what extent are forensic psychiatrists involved in things like custody disputes during a divorce in which one spouse is mentally ill?

It all depends if the Court or one of the people involved (mother or father or other party) want an evaluation. While one would expect such an evaluation to be common, it's not easy to find evaluators.

I know several forensic mental health professionals that will not touch such cases with a ten-foot pole. Custody evaluations will usually force the evaluator to recommend the mother or father to take custody, and at leaste one party will be very upset over the results.

I've known several people who've done evaluations and told me very bad things happened to them during the process such as mothers claiming the evaluator tried to rape them, the father harassing the evaluator if the recommendation didn't go his way...etc.

Is this something that psychiatrists are involved in, or is this a situation where the patients medical records are simply subpoenaed and no further psychiatric evaluation is needed?

Either or, depending on whims of the court and the participants involved.

Lawyers often times battle these details out and will only get mental health professionals involved if it can somehow be made advantageous to their side, and they can pay for it. Their pay comes from their client. So if the client doesn't have much money or the lawyer is a public defender working on a paltry pay, they might not ask for a mental health evaluation. In some courts, the court will demand the evalutor, in which case it's the court that pays, not the lawyers (and thus the parties involved in the legal case).

Also, are forensic psychiatrists involved in questions about competence to enter into certain contracts or to make changes to wills?

Yes. Same as above, it all depends if the Court or a lawyer asks for a psychiatrist to get one involved.

If a party to a lawsuit wanted to say that their grandmother couldn't change her will due to her mental health, would a forensic psychiatrist be called in to evaluate her, or is there some other method?

Yes---if someone such as the court or a lawyer wanted such a person involved.

Word of advice if you're not a forensic psychiatrist, don't get involved in things like this if they ask you to do this. You're not supposed to do things like this as a clinical psychiatrist. E.g. if the Court asks you do to a competency evaluation for a will on one of your patients, you can write a letter to the court saying this is outside your expertise and it's actually an ethical conflict-of-interest. I do know some clinical psychiatrists that do forensic work either because they have enough forensic experience and can competently do it, or they are foolish enough to venture into this without knowing what they are doing.

If a psychiatrist were in the latter category, and the opposing side had a forensic psychiatrist working for them, they'd be easily able to point out the weaknesses of a non-forensic psychaitrist doing forensic evaluations. It could be a very embaressing situation to be on a witness stand and have the lawyer from the opposing side ask the psychaitrist to admit they dont' know WTF they were talking about in their evaulation....during a cross examination that could literally last for hours.

I've seen video footage of situations like this. No, the opposing lawyer sometimes won't make this quick and ask for the psychiatrist's testimony and reports to be thrown out. They might drag this out for hours, if not days, while asking the psychiatrist very exposing and embaressing questions.

Lawyer: According to professional guidelines, you sir were not supposed to do a competency evaluation on your own patient?

Doctor: Umm.....

Lawyer: Answer the question!

Doctor: Umm

Lawyer: Your honor, I demand you force the good doctor to answer the question unless he wants to plead the fifth

Judge: Doctor, you must answer the question unless you plead the fifth.

Doctor: I plead the fifth

Lawyer: Doctor, do you commonly do things outside your specialty while charging money for it and posing as an expert in forensic psychiatry without training in this field?

Doctor: Umm....