Journal of the American Academy of Psychiatry and the Law Online current issue

A Call to Evaluate Our Forensic Treatments

Michaelsen, K., Wasser, T. — 2026-03-12T17:50:33-07:00

Forensic Violations and Therapeutic Shortcomings in the Use of AI Chatbots for Therapy

Chambers, D. M. — 2026-03-12T17:50:33-07:00

Homelessness, Grave Disability, and Mental Health Legislation

Olaolu, O., Kumar, V., Gulrajani, C. — 2026-03-12T17:50:33-07:00

Philip J. Candilis, MD: The Quiet Revolutionary

Weiner, J. J. — 2026-03-12T17:50:33-07:00

Dr. Larry Faulkner: Enduring Effort from Northwest Forests to Chicago Lights

Keepers, G. A. — 2026-03-12T17:50:33-07:00

Recognizing the Existence of Quack Experts in Forensic Psychiatry and Exploring Hard Truths

Wagoner, R. — 2026-03-12T17:50:33-07:00

The quack expert pretends to have some peculiar knowledge or skill that the expert does not possess or that may not even exist at all. Within forensic psychiatry, the response to quack experts has been varied and largely ineffective in mitigating their effect. Previous efforts to address quack experts have primarily relied on the courts, sanctions from professional organizations, or state board intervention. A shift to more globally addressing the misinformation itself and creating education of what appropriate testimony entails is likely far more helpful than trying to identify and punish each quack expert. At the individual level, new avenues of intervention include forensic psychiatrists taking advantage of educational opportunities and engaging in self-reflection. At the regional and national level, potential interventions include the American Academy of Psychiatry and the Law’s educating courts and attorneys, developing resource documents conveying basic principles of appropriate practice, and expanding peer review.

Medicolegal Considerations in the Psychiatric Management of Pregnancy and Postpartum Disorders

Horan, A. R., McNiel, D. E., Binder, R. L. — 2026-03-12T17:50:33-07:00

Psychiatrists who treat mental disorders in pregnancy must navigate the risks associated with prescribing medication to pregnant and breastfeeding people alongside the risks associated with untreated mental illness. This article examines how U.S. courts have engaged with this complex landscape when tasked with evaluating allegations of clinician and pharmaceutical negligence in cases involving pharmacological management of perinatal mental health disorders (PMHDs). We begin first with a review of the legal theories that form the basis of negligence lawsuits related to PMHDs. We then explore cases of both pharmaceutical negligence (which are usually pursued under product liability claims) and professional negligence (i.e., malpractice), distinguishing how the courts’ interpretation of liability has varied for errors of omission and errors of commission. We then provide an analysis of relevant themes in this area of case law with the goal of informing expert witnesses of considerations when called to opine upon questions related to negligence in the treatment of PMHDs.

Threats to Objectivity in Risk Assessment for Individuals with Borderline Personality Disorder

Wood, M. E., Evans, S. E., Anderson, J. L. — 2026-03-12T17:50:33-07:00

Borderline personality disorder is unique in many ways from other diagnoses contained in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Most salient, however, are the negative connotations often associated with the label itself and the resulting bias of providers. The ways in which these biases manifest are especially problematic in violence risk assessment, wherein evaluators are tasked with systematic consideration of data, with most data coming from available records. In this article, we describe some of the ways in which bias and objectivity are encountered in risk assessment with this population, describe a relevant case example, and offer practical recommendations for evaluators.

A Systematic Review of the Predictive Validity of the VRAG-R

Au, V., Naeem, A., Benassi, P., Bonato, S., Jones, R. M. — 2026-03-12T17:50:33-07:00

Structured risk assessment tools are essential in forensic psychiatry to evaluate the likelihood of recidivism. The Violence Risk Appraisal Guide-Revised (VRAG-R) was developed as an update to the VRAG, but its predictive validity across offender populations remains underexamined. Our study aimed to examine the predictive validity of the VRAG-R for general, violent (including and excluding sexual offenses), and sexual recidivism. We conducted a systematic review and meta-analysis, searching 10 databases and gray literature sources for studies reporting psychometric outcomes for the VRAG-R published since 2013. Risk of bias was assessed using Prediction Model Risk of Bias Assessment (PROBAST) and data extraction followed the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) checklist. Area under the curve (AUC) values were pooled using random-effects meta-analysis. In total, 15 studies comprising 3,932 participants were included. The VRAG-R showed acceptable predictive validity for general recidivism (pooled AUC = .71, 95% CI: .67 to .75) and violent recidivism (AUC = .72, 95% CI: .69 to .75). Predictive validity for sexual recidivism was modest (AUC = .65, 95% CI: .61 to .68). In conclusion, the VRAG-R demonstrates acceptable predictive validity for general and violent recidivism, comparable with other tools. Its performance in predicting sexual recidivism, however, is limited and concerns about generalizability remain. Future research should prioritize diverse samples, reporting of calibration, and continued evaluation of performance.

The Supreme Court of Canada Clarifies the Interpretation of the Insanity Defense in R v. Bharwani

Curry, D., Quinn, J. — 2026-03-12T17:50:33-07:00

In Canada, the insanity defense is outlined in both legislation and judicial case law and finds original basis in M’Naughten’s case. Federal jurisprudence in Canada has addressed the second and more complicated branch of the not criminally responsible on account of mental disorder (NCRMD) test on wrongfulness, yet legal ambiguity persists in provincial courts. A recent Supreme Court of Canada decision, R v. Bharwani, adds clarity. Finding agreement on the primary matter of fitness, the Court’s dissenting opinion, delivered by two of its esteemed jurists and joined by a third, casts aside the obiter dictum of the court of appeal on NCRMD and was unrefuted by the majority. Thus, Bharwani resists easy classification as to its jurisprudential authority. We review the relevant case law and consider application of hybrid authority to the NCRMD portion of the Bharwani dissent.

Recent Political and Research Appraisals of the Psychiatric Security Review Board Model

Michaelsen, K., Shankar, C., Norko, M. A. — 2026-03-12T17:50:33-07:00

Professional, political, and public debates are ongoing regarding the best way to assess risk and monitor individuals who have been found not guilty by reason of insanity (NGRI). Political and public impressions are often confounded by few, often dramatic and highly publicized cases of NGRI acquittees reoffending, rather than by an accurate understanding of the process and actual rearrest rates. States have implemented their own policies and practices for NGRI pleas (if allowed) and the subsequent evaluations, monitoring, and care for acquitted individuals, resulting in significant variation across jurisdictions. In the last five years, Arizona dissolved its Psychiatric Security Review Board (PSRB) and there were calls for ending the Connecticut PSRB. We review some of the past and current practices and evidence from PSRBs in Oregon, Arizona, Connecticut, and Washington. We discuss the challenges of comparing state practices because of variation in the connections between policy and practice and competing stakeholders’ interests.

Appellate Review of Competence to Stand Trial

Ellis, G., VanDercar, A. H. — 2026-03-12T17:50:33-07:00

Mental Illness, Capital Punishment, and the Limits of Ford and Panetti

Douglas, N. C., Bruce, N. B. — 2026-03-12T17:50:33-07:00

Veterans Court Review Process for Disability Benefits Clarified

Hicks, C., Cerny-Suelzer, C. — 2026-03-12T17:50:33-07:00

Waiver of Statutory Right to Competency Hearing

Gill, G., Bodnar, T. — 2026-03-12T17:50:33-07:00

Qualified Immunity Protections for Mental Health Providers

Fok, A., Brooks, N. — 2026-03-12T17:50:33-07:00

Providing Gender-Affirming Care to Minors

Benjamin, T., Armontrout, J. — 2026-03-12T17:50:33-07:00

Mental Illness and Persecution in Immigration Proceedings

Luu, K.-Y., Keshishian, T. — 2026-03-12T17:50:33-07:00

Evidentiary Standards for Challenging Competency to Stand Trial

Provosty, W., Botello, T. — 2026-03-12T17:50:33-07:00

Surrogate Testimony and the Sixth Amendment

Dodge, M., Bechler, K. — 2026-03-12T17:50:33-07:00

Constitutionality of Compelled Suicide Prevention Speech

Cameron, C., Cipriano, T. — 2026-03-12T17:50:33-07:00

Delusions and Competence to Be Executed

Reed, E. J., Dike, C. — 2026-03-12T17:50:33-07:00

Limits on Expert Testimony in Insanity Defense Trial

Weir, R., Ravven, S. — 2026-03-12T17:50:33-07:00

Temporal Standards in Police Use-of-Force Analysis

Wemakor, S., Burke, C. — 2026-03-12T17:50:33-07:00

Solicitation of Improbable Violent Crimes and Self-Representation at Trial

Howard, T. L., Wasser, T. — 2026-03-12T17:50:33-07:00

Conditional Release Requirements for Sexually Dangerous Persons

Obiozor, C., Baranoski, M. — 2026-03-12T17:50:33-07:00

Definition of Mental Disorder

Chou, L., MacIntyre, M. R. — 2026-03-12T17:50:33-07:00

Diagnostic Uncertainty in Involuntary Commitment

White, N. M., Kambam, P. R. — 2026-03-12T17:50:33-07:00

Warrantless Entry in Mental Health Emergency

Igwe, P., Darby, W. C. — 2026-03-12T17:50:33-07:00

A Review of Two Netflix Menendez Brothers 2024 Portrayals

2026-03-12T17:50:33-07:00

Our Thanks to Reviewers

2026-03-12T17:50:33-07:00