Foundations of Forensic Mental Health Assessment

Foundations of Forensic Mental Health Assessment (FMHA) is the first in a series of 20 short and user-friendly books devoted to situations involving criminal, civil, juvenile, and family law that are encountered by forensic mental health clinicians and mental health law professionals. The series is authored by three respected forensic psychologists, who begin this introductory text by summarizing scientific and ethics-based developments in forensic mental health during the past quarter-century. The authors' stated goal is to identify an aspirational best practice paradigm for FMHA that satisfies scientific advancement, ethics and professional standards, and legal relevance. Despite this goal, they repeatedly acknowledge that the aspirational standard may not always be attainable.

This book, which contains five succinct chapters, serves as a starting point for the series. Readers are expected to seek additional information from any of the subsequent 19 books, based on their interests and needs. The book's introductory chapter is followed by a discussion of forensic mental health assessment, including basic definitions, and a review of the recent history of forensic psychology and forensic psychiatry, which begins in the mid-20th century. As psychologists, the authors have a more intimate knowledge of the development of forensic psychology than forensic psychiatry. The book's omission of a discussion about the early history of the American Academy of Psychiatry and the Law (AAPL) is attributed to a purported lack of written materials on the early days of AAPL. There is a discussion about the beginnings of the American Psychology Law Society, which was founded within one year of AAPL. The authors attribute the beginnings of a national credentialing system for forensic psychiatry solely to AAPL, and do not cite the contributions of the American Academy of Forensic Sciences (AAFS) to the formation of the American Board of Forensic Psychiatry, which was the first organization to offer formal subspecialty certification in forensic psychiatry. Despite these shortcomings, the authors provide a succinct summary of the history of modern forensic mental health and capture the highlights of the past half-century, which include violence risk assessment, legal competencies, child custody, due process in delinquency cases, and legal admissibility of forensic mental health testimony.

The authors examine the components of their best practices standard in the third chapter. These include: law, knowledge based on the behavioral and medical sciences, professional ethics, and professional practice, which they broadly define to include theory, guidelines, recommendations, and regulation by professional organizations. Within this framework, the authors discuss a variety of topics, including who can be an expert witness; admissibility of testimony including use of third-party information; ultimate issue testimony, including whether the legal standard is met; and most significantly, the formulation of clinico-legal opinions. The authors propose a best practice standard for opinion-making, though this paradigm was articulated at the start of the modern era of forensic mental health by professionals, including Seymour Pollack, MD.

There is a discussion of forensic mental health training in the third chapter that is skewed toward training of forensic psychologists; comparatively little information is presented on forensic psychiatry training or training of other forensic mental health professionals.

The authors use the fourth chapter to develop a set of principles for FMHA. They explore guidelines and principles for FMHA from the literature, distill their findings, and derive 7 general principles of FMHA along with 31 other principles covering specific aspects of FMHA, ranging from preparing for the FMHA to testifying. Although the standards derived by the authors are aspirational, they also may be used to inform forensic mental health practice in various settings.

The fifth and concluding chapter returns to addressing the best practices conceptualization and forms a segue to any of the other 19 books in the series. Overall, this volume on FMHA contains a vast array of important information on the topic. The book captures the essence of FMHA in a readable fashion. For a forensic mental health trainee, it can serve as an invaluable guidepost to learning about FMHA. For the seasoned forensic mental health clinician, it provides a concise and cogent review of the topic.

• © 2012 American Academy of Psychiatry and the Law