Expert Witness Journal Issue 64 December 2025 - Flipbook - Page 64
The Importance of Clear Instruction
extends beyond diagnosis and treatment. Their
unique role in the criminal justice system allows
them to recommend compulsory assessment and
treatment within a legal framework, providing
courts with crucial advice on cases involving mental
illness.
Clear communication between legal professionals
and forensic experts is essential. Dr McAllister
stresses the importance of specifying in the letter
of instruction whether the psychiatric assessment
should be conducted in person or remotely.
Miscommunication about this can lead to delays
in court proceedings, as Dr McAllister recounts in
an example where a misunderstanding about the
location of an assessment caused an unnecessary
delay.
A common task for forensic psychiatrists is assessing
whether a defendant is mentally 昀椀t to stand trial.
Fitness to plead encompasses several factors,
including whether the defendant can understand
the proceedings, instruct their defence, and
participate meaningfully in the trial. A failure to
assess this accurately can lead to miscarriages of
justice, making the role of the forensic psychiatrist
indispensable.
This issue is becoming more relevant as remote
assessments have become more common since the
COVID-19 pandemic. While remote assessments
o昀昀er convenience, they may not always be
appropriate, particularly for complex cases where
face-to-face interaction may provide more reliable
insights into the defendant’s mental state.
Case Studies: Understanding the Work of
Forensic Psychiatrists
Dr McAllister shared several anonymised case
studies that illustrate the complexities forensic
psychiatrists navigate when working as an expert
witness.
Legal professionals must also ensure that the
instruction provided to the expert are as detailed
and clear as possible. This enables the forensic
psychiatrist to tailor their assessment to the speci昀椀c
needs of the case and, if necessary, refer the case to
a colleague with more relevant expertise.
One case involved Mr Trumpton, a defendant who
claimed that a conspiracy involving the media
proved his mental illness. During his psychiatric
assessment, Mr Trumpton referenced articles in
a newspaper as evidence of his delusional beliefs.
While his behaviour was odd, he remained calm
and coherent throughout the interview, raising
questions about whether his presentation was
authentic, or a performance designed to mislead
the court. Dr McAllister noted that truly unwell
individuals often display confusion or an inability to
maintain coherence during questioning—traits Mr
Trumpton did not exhibit.
The Future of Forensic Psychiatry:
Changes in Mental Health Law
As the legal landscape evolves, so does the practice
of forensic psychiatry. Dr McAllister touches on
signi昀椀cant changes on the horizon, particularly
reforms to the Mental Health Act. A governmentcommissioned independent review led by Sir Simon
Wessely has proposed several changes that could
have a profound impact on forensic psychiatry.
One of the key recommendations is that magistrates’
courts should have similar powers to Crown Courts,
such as the ability to demand psychiatric assessments
without conviction. Additionally, there are calls for
statutory time limits to be introduced for the transfer
of individuals from prison to psychiatric hospitals,
ensuring that mentally ill individuals receive timely
treatment.
In another case, Mr Jiggly had a long history of
mental illness and drug misuse. At the time of his
o昀昀ence, a serious assault, he was o昀昀 his prescribed
medication and was consuming street drugs, which
aggravated his condition. When Dr McAllister
interviewed him in prison, Mr Jiggly initially
appeared calm and cooperative. However, when
asked about his nickname, he became enraged and
abruptly ended the interview, making it di昀케cult to
assess his 昀椀tness to plead. This case highlighted the
challenges forensic psychiatrists face when trying to
extract meaningful insights from individuals who
may not be in a stable mental state.
Another signi昀椀cant proposal is to expand the powers
of tribunals in deciding patient care. Currently,
tribunals can only recommend that patients be
transferred to other hospitals, but they do not
have the authority to enforce these decisions. The
proposed changes would grant tribunals the power
to direct patient transfers, o昀昀ering more robust
oversight of patient care and ensuring that mentally
ill individuals are not forgotten within the system.
In both instances, the expertise of the forensic
psychiatrist was critical in providing the court
with a thorough understanding of the defendant’s
mental health. These assessments informed not only
whether the individuals were 昀椀t to stand trial but
also whether they required compulsory treatment
under the Mental Health Act.
EXPERT WITNESS JOURNAL
These reforms, if enacted, will likely enhance the
role of forensic psychiatrists in the criminal justice
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DECEMBER/JANUARY 2025-2026
