“If you don't do it, someone worse will.” Richard Rosner, MD, Clinical Professor of Psychiatry at New York University School of Medicine, Director of NYU's Forensic Psychiatry Residency Program, and seminal figure in North American forensic psychiatry enjoys his own pithy observation. He trots it out to encourage his students to run for political office in professional organizations and to explain why he is current or past president of many organizations linked to forensic psychiatry. The statement also reflects Dr. Rosner's confidence in his abilities and his skepticism of personage, including his own.
We speak about Dr. Rosner's accomplishments over lunch at the Union Square Cafe. It is a warm spring day. Dr. Rosner is wearing a green khaki suit and a bright red tie, and walks with a cane. He is portly and has arthritis in his knees. It is Restaurant Week in Manhattan, and participating restaurants offer reduced prices on prix fixe menus. The arrangement suits two of Dr. Rosner's extraprofessional accomplishments: his epicurism and his renown, among his friends, for pinching a penny. He remarks that his parsimony has allowed him—even on his paltry academic salary—to retire comfortably should he ever wish to do so. I comment that Dr. Rosner is extraordinarily generous with the time he gives his students. He was one of my teachers during my forensic psychiatry residency and remains a mentor. I am a beneficiary of his generosity.
I am aware of his accomplishments and prefer to chat about his upbringing and preferences, aspects of his life that he does not divulge to his students. Nonetheless, over lunch on a spring day, with a former student now a peer, Richard Rosner obliges me. Before he does so, however, he presents me his curriculum vitae. He intends for his biography to focus on his accomplishments. As if that weren't enough, a week after our lunch, he e‐mails me. Hinting that we didn't speak much about his professional accomplishments, he “supplements” our conversation with a list of what he regards as his significant contributions to forensic psychiatry. The list is replete with bibliographic references and meticulously provides names of professional organizations, dates of publication, and the like.
Dr. Rosner did not include his presidencies in his list of significant accomplishments. Nonetheless, here they are. He is or has been president of the Tri–State Chapter of the American Academy of Psychiatry and the Law (AAPL; 1976–1986), national AAPL (1987–1988), the American Board of Forensic Psychiatry (1989–1990), the Accreditation Council on Fellowships in Adolescent Psychiatry (1992–present), the American Academy of Forensic Sciences (AAFS; 1996–1997), the Association of Directors of Forensic Psychiatry Fellowships (1996–1998), and the American Society for Adolescent Psychiatry (2003–2004.) He is also responsible for the creation of regional chapters of AAPL, beginning with New York. During his presidency of AAFS, he fostered a productive alliance between AAPL and the Psychiatry and Behavioral Science Section of AAFS. His approach to membership is the inverse of Groucho Marx's aphorism that he would never join any club that would have him as a member. Dr. Rosner will never join any organization of which he has no chance of becoming president.
His accomplishments extend beyond political office. He is the Medical Director of the Forensic Psychiatry Clinic of Bellevue Hospital. The clinic turns out hundreds of competency‐to‐stand‐trial and other forensic reports annually in the busy Supreme Court building in lower Manhattan. He is the author of numerous articles and book chapters in forensic psychiatry and is the editor of 10 books in that field. In his writing, he has emphasized the importance of ethics in forensic psychiatry training and practice. (See, for example, Ethical Practice in Psychiatry and the Law, with Robert Weinstock (1990); and “Foundations of ethical practice in the forensic sciences,” Journal of Forensic Sciences, Vol. 42, Nov. 1997.) His most recently published work, Principles and Practice of Forensic Psychiatry (ed 2, 2003), is the standard textbook in the field. Both editions have earned him Honorable Mention from the American Psychiatric Association's prestigious Manfred Guttmacher Award.
Yet it is his work in forensic psychiatry education that is his greatest achievement and the one of which he is proudest. He, along with Henry Weinstein, Sergio Sager, and Peter Guggenheim, created New York University's forensic psychiatry program. In addition to developing that program, he established cooperative relationships with other academic programs in the City. Thus NYU, Albert Einstein, New York Medical College, and Columbia/Cornell share their resources and the same core educational program operated under the auspices of Tri‐State AAPL.
In 1982, under the aegis of AAPL and AAFS, Dr. Rosner authored a report, “Standards for Fellowship Programs in Forensic Psychiatry” (Bulletin of the American Academy of Psychiatry and the Law, Vol. 10, 1982) that promulgated common didactic and clinical curricula for North American training programs. As founding president, in 1989, of the Accreditation Council on Fellowships in Forensic Psychiatry (ACFFP), he used his published standards as the basis for accrediting fellowship programs. The ACFFP, a component of AAPL, accredited fellowships from 1989 until 1997, at which time the Accreditation Council for Graduate Medical Education assumed responsibility for this activity. Dr. Rosner's Standards also remain the foundation for today's standards for forensic psychiatry training programs. As such, all graduates of accredited forensic psychiatry residencies have benefited from his work.
Dr. Rosner developed and published the widely recognized “four‐step model of forensic psychiatry,” a conceptual framework for organizing and analyzing data in forensic psychiatry. (The model was first published in 1978, in the Alumni Magazine of New York University School of Medicine. The exact citation appears in the references to the article: “Medical Disability Compensation: A Practicum,” Critical Issues in American Psychiatry and the Law, 1982.) The four steps of the model are: (1) issue: what is the specific psychiatric‐ or psychological‐legal issue?; (2) legal criteria: what are the legal criteria that will be used to resolve the issue?; (3) data: what are the data relevant to the legal criteria that will be used to resolve the issue?; and (4) reasoning: how may the data be applied to the legal criteria to establish a rational psychiatric or psychological opinion? Dr. Rosner has taught this method to hundreds of forensic psychiatry residents and continues to teach the method to this date. Countless other psychiatrists have learned of the method from his publications. This model, like many useful ideas, is profoundly simple in its articulation and thus enjoys widespread application in clinical practice.
Richard Rosner enjoyed a middle‐class upbringing in Brooklyn. His family was educated. His father was a Certified Public Accountant, the first college graduate and professional in his own family. His father's cousin is a Nobel Prize winner, the economist Milton Friedman. Dr. Rosner's brother is a retired professor of medicine. His mother was an elementary school teacher whom he credits for his self‐deprecatory sense of humor. He recalls how he once took his mother to France to show her his appreciation. They dined at Taillevent, one of the world's greatest restaurants. His mother ordered a simple boiled chicken, like the kind she made at home. Boiled chicken was not on the menu, of course, but Taillevent aimed to please. The sniffing waiter asked Madame how she found her chicken. “OK,” she said, “But mine is better.”
Dr. Rosner's interest in political office dates to elementary school when he ran for some class office he has long forgotten. His academic talent was already evident in high school when he was a semifinalist in the Westinghouse Science Talent Search. He attended Princeton University at the time when the first woman faculty member was appointed. He recalls there were in his class two African princes, no Asians, and a strict quota on both Jews and Catholics. The quota on Jews was enlarged a bisl because Jews gave a lot of money to Princeton. His father refused an offer of a scholarship for his son. The father didn't want people to think he couldn't afford it. Richard Rosner was secretary of the Princeton Hillel Association and the Jewish representative to Princeton's Student Christian Association during his senior year at Princeton.
He originally wanted to be a surgeon. However, when he didn't get into a surgical residency and was faced with being drafted for the Vietnam War, he decided to become a psychiatrist. During his residency at Mount Sinai School of Medicine, he took two courses in forensic psychiatry. He liked them. He recalls that his uncle, a prominent lawyer who helped create the field of pharmaceutical patent law, told him that a physician working at the interface of law and medicine could accomplish more than a lawyer.
After graduation, he found a position at the Forensic Psychiatry Clinic for the New York Criminal and Supreme Courts (now the Forensic Psychiatry Clinic of Bellevue Hospital) under his officemate and friend, Robert Goldstein. When Dr. Goldstein resigned in 1974, Dr. Rosner became director of the clinic and remains so today. As the incoming director, he concluded that he should learn something about forensic psychiatry if he intended to be successful in this new position. He attended his first AAPL meeting accompanied by his friend and fellow forensic psychiatrist, Robert Weinstock. Dr. Rosner reports that he attended the meeting because he wanted to be president of AAPL. He liked the informality of the organization and its members, whom he described as young, although he concedes that there were a few gray‐haired practitioners in their midst. He decided that in the organization he would be recognized once he worked hard. He knew little about forensic psychiatry, but decided he could learn.
Richard Rosner met his wife Bernice after he graduated from medical school. She was a nurse who eventually rose to be Executive Director of the Visiting Nurses' Association of Brooklyn. They were first introduced at a party, and he was impressed by her homemade apple pie. They dated for eight years before deciding on marriage. He determined their compatibility by administering to Bernice a battery of psychological tests. I asked him why she put up with that nonsense. “She loved me,” he said. Even his marriage proposal was indirect. While her apartment was under repair, he asked her to live with him. They subsequently remarried six times, for the fun of it, including a licensed‐in‐Liberia wedding. She helped him not to underrate himself, but also not to take himself too seriously. They wanted children, but by the time they decided they were ready, they were too old. In any case, he says he has many children, by which he means his rewarding relationships with his students. His wife died on July 17, 2001. He says that 9‐11 did not mean a lot to him.
In 1982, he published his first book in forensic psychiatry, Critical Issues in American Psychiatry and the Law. The work, published by Charles Thomas Company, would become a series of seven books on various topics in forensic psychiatry, including juvenile psychiatry, correctional psychiatry, and ethical practice. He wished someone else had written such books, but no one else did. “I didn't realize the job was impossible,” he says, “so I did it.” He wanted to create a core body of literature in forensic psychiatry through a series that was “consciousness raising.” He took a dialectical approach in the books, presenting conflicting views to clarify opinions. After seven volumes, he realized that people wanted answers, not a dialectic. He proceeded to publish, in 1994, the first edition of Principles and Practice of Forensic Psychiatry.
Dr. Rosner continues to learn. Several years ago, while we were waiting for the plane to the AAPL convention, I observed him reading Camus' The Stranger. I was impressed and bemused. No one ever reads Camus after college. But then, Dr. Rosner is genuinely interested in philosophy. What is mind, self, person? To what extent is a person regarded as responsible? These are questions that fascinate him. He addressed these matters in volume one of his Critical Issues series. He subsequently took graduate philosophy courses in NYU's Department of Philosophy. He is attracted to the rigor of thinking demanded by philosophy and is himself a rigorous thinker. He imparts this rigor to his students. I recall in my forensic residency how he politely, clearly, and firmly said of one of my conclusions in a competency‐to‐stand‐trial report: “That, Dr. Reeves, is a non sequitur.” I checked. It was a non sequitur. I was as surprised by his close reading as I was by the criticism. He is currently enrolled in a program to become a New York credentialed alcoholism and substance abuse counselor. He is also enrolled in a course in empirically validated cognitive‐behavioral therapy. He remains skeptical of what psychiatry purports to accomplish. Yet he has not given up hope and is not resting on his laurels.
Richard Rosner, MD
- American Academy of Psychiatry and the Law
