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LetterLetter to the Editor

Letters

Kristen C. Ochoa
Journal of the American Academy of Psychiatry and the Law Online December 2023, 51 (4) 608; DOI: https://doi.org/10.29158/JAAPL.230092-23
Kristen C. Ochoa
Los Angeles, CA
MD, MPH
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  • over-incarceration
  • racism
  • social justice

Editor:

In their recent article, “Illuminating Sociocultural and Ethnocultural Consciousness in Forensic Practice,” Griffith and colleagues make a call to action for forensic practitioners to become more aware of social and ethnocultural factors affecting their lives and the lives of the persons they evaluate. The authors state that we “must attend more closely to the effects of sociocultural and ethnocultural experiences on ourselves and our evaluees” (Ref. 1, p 263). I would like to take their thoughtful proposal one step further: it is imperative that forensic psychiatrists and the forensic psychiatry community actually do something to change the lives of the people with whom we work.

In a world where institutionalized racism, exposed and undeniable, causes vulnerable persons of color with mental disorders to be incarcerated in large numbers in our jails and prisons,2,3 it is the forensic psychiatrist who is in the best position to understand, to act, and to create change. It is the forensic psychiatrist who knows the patient, the system, and the law and is thus able to intervene in what are often complex clinical and legal predicaments of the persons and populations with whom we work.4

It is time to step past the neutrality we were trained to maintain; as ethical professionals, we can no longer be bystanders when so much harm is being done in and by the systems and institutions of which we are a part. We must move our field to action, where neutrality maintains its place, but where we can also consider ourselves to be leaders in creating solutions to one of the most important problems of our time: the over-incarceration of vulnerable people with mental disorders.

There are a growing number of forensic psychiatrists who are already actively engaged in this type of change and cultural shift. We are finding ways to use the law and our clinical expertise to benefit people and populations, turning outpatient competency restoration programs into community housing opportunities for the homeless, or expanding jail clinic interventions to include collaboration with justice partners to divert persons into treatment programs.5

Forensic psychiatry as service, like other specialties of medicine, must be our new culture. As our field grows with more young, aware, and diverse physicians, let us not lose them to our traditional approach. Let us modernize our field to include expert service, not for legal ends alone, but also for social justice. Let us bring our knowledge and skills to the courtrooms, jails, prisons, and community to benefit people and assist the professionals who work with them. Let us create and operate programs and services that meet the needs of the patients involved in the justice system. There is no better medical specialty prepared to do this than our own.1

Footnotes

  • Disclosures of financial or other potential conflicts of interest: None.

  • © 2023 American Academy of Psychiatry and the Law

References

  1. 1.↵
    1. Griffith EE,
    2. Sreenivasan S,
    3. DiCiro MS,
    4. Wagreich EM
    . Illuminating sociocultural and ethnocultural consciousness in forensic practice. J Am Acad Psychiatry Law. 2023 Jun; 51(2):263–71
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Zeng Z
    . Jail inmates in 2021: Statistical tables. Bureau of Justice Statistics [Internet]; 2022 Dec. Available from: https://bjs.ojp.gov/library/publications/jail-inmates-2021-statistical-tables. Accessed September 26, 2023
  3. 3.↵
    1. Appel O,
    2. Stephens D,
    3. Shadravan SM,
    4. et al
    . Differential incarceration by race-ethnicity and mental health service status in the Los Angeles County Jail System. Psychiatr Serv. 2020 Aug; 71(8):843–6
    OpenUrl
  4. 4.↵
    1. Chaimowitz GA,
    2. Simpson AF
    . Charting a new course for forensic psychiatry. J Am Acad Psychiatry Law. 2021 Jun; 49(2):157–60
    OpenUrlFREE Full Text
  5. 5.↵
    1. Ochoa K,
    2. Appel O,
    3. Nguyen V,
    4. Kim E
    . Decriminalization in action: Lessons from the Los Angeles model. CNS Spectr. 2020 Oct; 25(5):561–5
    OpenUrl
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Journal of the American Academy of Psychiatry and the Law Online: 51 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 51, Issue 4
1 Dec 2023
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Kristen C. Ochoa
Journal of the American Academy of Psychiatry and the Law Online Dec 2023, 51 (4) 608; DOI: 10.29158/JAAPL.230092-23

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Kristen C. Ochoa
Journal of the American Academy of Psychiatry and the Law Online Dec 2023, 51 (4) 608; DOI: 10.29158/JAAPL.230092-23
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