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Forensic psychiatry is a subspecialty of Psychiatry . It encompasses the interface between law and psychiatry. Some practitioners of forensic psychiatry have taken extra training in that specific area. In the United States one year fellowships are offered in this field to psychiatrists who have completed their general psychiatry training. In Britain one is required to complete a three-year subspeciality training in forensic psychiatry, after completing one's general psychiatry training, before one can be registered as a forensic psychiatrist. In some countries general psychiatrists can practice forensic psychiatry as well. However, some countries require a specific certification from the government to do this type of work (e.g. Japan). COURT WORK work with Court s in evaluating an individual's competency to stand Trial , defences based on Mental Disease s or defects (e.g., the "insanity" defence), and Sentencing recommendations. There are two major areas of criminal evaluations in forensic psychiatry. These are Competency to Stand trial (CST) and Mental State at the Time of the Offence (MSO). Competency to stand trial (CST) This is the determination that a defendant has the mental capacity to understand the charges and assist his attorney. This is seated in the Fifth Amendment to the US Constitution, which ensures the right to be present at your trial, to face your accusers, and to have help from an attorney. In English and Welsh law a similar concept is that of " Fitness To Plead ". As an expert witness Forensic psychiatrists are often called to be Expert Witness es in both Criminal and Civil proceedings. Expert Witnesses give their opinion about a specific issue. Often the psychiatrist will have prepared a detailed report before testifying. The primary duty of the expert witness is to provide an independent opinion to the court. Please note the Forensic Psychiatrists are NOT psychic, nor are they engaged in profiling, a job better done by experienced police. Mental state opinion This gives the Court an opinion, and only an opinion, as to whether a defendant was able to understand what he was doing at the time of the crime. This is worded differently in many states, and has been rejected altogether in some, but in every setting, the intent to do a criminal act and the understanding that it was a criminal act bear on the final disposition of the case. Much of forensic psychiatry is guided by significant Court ruling or laws that bear on this area. " Not Guilty By Reason Of Insanity " is one potential outcome in this type of trial. It is important to note that Insanity is a legal and not a medical term. Often there will be a psychiatrist(s) for the defense as well as the prosecution. Forensic Psychiatrists are also involved in the care of Prison ers, both those in Jail s and those in prisons, and in the care of the mentally ill and dangerous (such as those who have been found not guilty by reason of insanity). BRITAIN In Britain most forensic psychiatrists work for the National Health Service , in specialist secure units caring for mentally ill offenders (as well as people whose behaviour has made them impossible to manage in other hospitals). These can be either medium secure units (of which there are many throughout the country) or maximum security hospitals (also known as Special Hospitals), of which there are three in England and one in Scotland, the best known of which being Broadmoor Hospital . The other 'specials' are Ashworth hospital in Maghull, Liverpool and Rampton hospital in Nottinghamshire. There are also a number of private sector medium secure units, which sell their beds exclusively to the NHS, as there are not enough secure beds available in the NHS system. (There are no 'private' paying patients in Forensic Psychiatry!) Forensic psychiatrists often also do prison inreach work, in which they go into prisons and assess and treat people suspected of having mental disorders; much of the day to day work of these psychiatrists comprises care of very seriously mentally ill patients, especially those suffering from Schizophrenia . Some units also treat people with severe Personality Disorder , Learning Disabilities (by which is meant, in Britain, intellectual impairment), autistic spectrum disorders or other illnesses. The areas of assessment for courts are also somewhat different in Britain, because of differing mental health law. Fitness to plead, and mental state at the time of the offence are indeed issues given consideration, but the mental state at the time of the offence is also a major issue, and it is this assessment which most commonly leads to the use of mental health legislation to detain people in hospital, as opposed to their getting a prison sentence. Court work (medico-legal work) is generally but not exclusively undertaken by psychiatrists (most often 'forensic' psychiatrists who are consultants (senior doctors) in the National Health Service (NHS). FICTIONAL DEPICTIONS The television show, '''' is a forensic psychiatrist. In addition, the CBS crime-drama '' Criminal Minds '' features a young forensic psychiatrist (portrayed by Matthew Gray Gubler (Dr. Spencer Reid)) on the FBI profiling team the show centers around. Another fictional Forensic Psychiatrist is in the television show '' Bones (TV Series) Bones '', where Dr. Gordon Wyatt (portrayed by Stephen Fry) is assigned to counsel one of the protagonists (Agent Booth) after he shoots up an ice cream truck. This occurs in the episode "The Girl In The Gator". Hannibal Lecter from the novels Red Dragon , Silence Of The Lambs , Hannibal and Hannibal Rising by Thomas Harris and their respective film adaptions is a Forensic Psychiatrist until it is found hat he is a serial killer and is captured and incarcerated. EXTERNAL LINKS
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