Forensic Psychiatry is law related psychiatry, associated with the management and treatment of mentally abnormal offenders, the assistance and support of the Court and related agencies. It is also revolved around the prediction and (if possible) the amelioration of dangerousness, psychiatric ethics and the psychiatric contribution to criminology and penology.

An offense is a behaviour against the law. A crime is therefore not a symptom of a psychiatric disorder, so a Forensic Psychiatrist does not treat crime but treats mental disorders amongst criminals.

Roles of the Forensic Psychiatrist

  • Advice to the Courts and related agencies.
  • Advice to other Psychiatrists and General Practitioners.
  • Provision of psychiatric treatments for mentally abnormal offenders.
  • Provision of psychiatric treatments for mentally abnormal people whose behaviour is likely to lead them to offend.
  •  Assessment and management of risk arising in association with mental disorder.

The Psychiatric Assessment of the Mentally Abnormal Offender

A psychiatric assessment of a mentally abnormal offender is carried out and illustrated in the form of a Psychiatric Court Report which can be requested by Magistrates and Crown Courts, the Director of Public Prosecutions or the Crown Prosecution Service, the Probation Service and Defence Solicitors.

Reports are routinely requested in cases such as:

  • Sexual offences
  • Homicide
  • Arson

Other requests can be for bizarre circumstances of an offence such as:

  • Offence out of character.
  • Repeated offending.
  • First offence at a late age.
  • History of psychiatric treatment or illness.
  • Unusual behaviour in the Courts.
  • Known alcohol abuse.
  • Known drug abuse.
  • Incomprehensible offender.

Our Psychiatry Experts consider the needs of the Court, the needs of the patient and the safety of the community.

  Special attention is given to:

  • Mental state of client at the time of the offence – criminal responsibility.
  • Mental state of client at the time of the trial – fitness to appear in Court and fitness to plead factors in mitigation.
  • Need for psychiatric treatment.
  • Other matters such as false confessions, general comments on sentencing and dangerousness.

Criminal Responsibility

Crimes generally are dissected into two elements; the fact (Actus Reus), and the mental element (Mens Rea) which usually involves intent and recklessness.

  • The Special Verdict

‘Not Guilty by Reason of Insanity’ – Criminal Procedure (Insanity) Act 1964.

‘To establish a defence on the grounds of insanity it must be clearly proved that at the time of the committing of the act the party accused was behaving under such a defect of reason, from disease of the mind as not to know the nature and quality of the act he was doing, or if he did not know what he was doing was wrong’.

If the offender Is not guilty (by reason of insanity) he may still be made the subject of a Hospital Order, with or without a Restriction Order, a Supervision Order, or an Absolute Discharge.

  • Diminished Responsibility

The law recognises that responsibility might be eroded but not completely abolished by mental disorder, in the case of the murder.

Section 2 of the Homicide Act 1957 states: ‘Where a person kills or is a party to the killing of another, he shall not be convicted of murder if he was suffering from such abnormality of mind … as substantially impaired his mental responsibility for his acts or omissions in doing or being a party to the killing … a person who but for this action would be liable … to be convicted of murder shall be liable instead to be convicted of manslaughter’.

  • Abnormality of mind is a broader term than ‘insanity’, and includes the ‘irresistible impulse’.
  • Substantial means ‘more than trivial’.
  • Mental responsibility remains undefined.

The verdict would be ‘not guilty of murder but guilty of manslaughter on the grounds of diminished responsibility’. The judge, who can only give a life sentence for murder, then has full discretion when pronouncing a sentence.

  • Infanticide Act 1938

This Act states: ‘when a woman caused the death of a child under the age of twelve months, but at the time the balance of her mind was disturbed by reason of her not having fully recovered from the effects of child birth or lactation, consequent upon the birth of the child, she shall be guilty not of murder but of infanticide’.

This is a type of manslaughter which allows the Judge discretion when sentencing. The commonest disposal is a Probation Order with or without a condition of treatment.

  • Automatism

The carrying out of apparently purposeful or semi-purposeful behaviour without the awareness of its subject. In this rare occurrence, the mental element of the crime is missing.

If automatism arises from a disease of the mind and is likely to recur, it is deemed insane automatism and a special verdict is made (not guilty by reason of insanity).

If the automatism is caused by an external agent, e.g. the injection of insulin, and is unlikely to recur, it is then non-insane automatism and the defendant is acquitted.

  • Intoxication

Intoxication by alcohol or drugs is no defence in law, unless the offender is rendered incapable of forming an intent.

  • Absentmindedness

Is a common defence, particularly for cases of shoplifting.

Disability in Relation to the Trial

An offender may be unfit to appear in Court due to physical or mental illness, the term ‘under disability’, or ‘unfit to plead’ refers to his/her ability to defend him/herself in Court. This is established by a jury trial if the offender is unable to:

  • Know the difference between guilty and not guilty.
  • Instruct Counsel.
  • Follow the evidence in Court.
  • Challenge a juror.

If found fit to please a separate trial is begun to establish guilt.

If found unfit to plead the defendant is subject to a Hospital Order with or without a Restriction Order, Supervision Order, or an Absolute Discharge.


Once guilt has been established, (before sentencing), the defence can make a plea in mitigation designed to ameliorate the disposal. This may include reference to hardship, social circumstances, mental disorder or any other relevant factors.

Psychiatric Disposal : Assessments

  • A remand for a report.                  (Section 35 of the Mental Health Act 1983)
  • Remand for treatment.                 (Section 36 of the Mental Health Act 1983)
  • Interim Hospital Order.                 (Section 38 of the Mental Health Act 1983)
  • Hospital Order.                                 (Section 37 with or without a Restriction Order – Section 41)
  • Probation Order with a                  (Powers of the Criminal Courts Act 1973, Section 3)
  • condition of psychiatric treatment.         


  • False confessions.
  • General recommendations concerning other possible disposals, e.g. deferment of sentence, Community Service Order, or conditional discharge.


The propensity to cause serious physical or lasting psychological harm.

Significant Offences

  • Against Person

Homicide (murder, manslaughter and infanticide) – child abuse, sexual offences (indecent exposure, indecency, indecent assault, buggery, incest, rape).

  • Against Property
  • Arson, criminal damage, endangering life, shoplifting.
  • Alcohol and Drug Related Offences


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