Stanley L Brodsky, C Adam Coffey, Eric Y Drogin, Thomas Gutheil
{"title":"Options for the Forensic Mental Health Evaluator When Retaining Counsel Is Impaired.","authors":"Stanley L Brodsky, C Adam Coffey, Eric Y Drogin, Thomas Gutheil","doi":"10.29158/JAAPL.260033-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260033-26","url":null,"abstract":"<p><p>When forensic mental health professionals find themselves working with seemingly impaired attorneys, a substantial dilemma is presented. The forensic professional must consider how, if at all, to respond to legal performance deficits that may reflect dementia, a substance use disorder, a mood disorder, or some other identifiable psychiatric condition. Two de-identified cases are presented that highlight the difficulty of providing expert witness and consultation services under such circumstances. Codified ethics guidance for attorneys, psychiatrists, and psychologists offers relevant, albeit rather limited, direction. Several overlapping options are proposed, including discreet inquiry, frank discussion, treatment referral, and withdrawal from participation.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Legal and Forensic Perspectives on Civil Litigation Capacity.","authors":"Priya Rose Khalsa, Graham Glancy","doi":"10.29158/JAAPL.260032-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260032-26","url":null,"abstract":"<p><p>Although forensic psychiatric assessments of fitness to stand trial are well established in criminal law, the analogous question of civil litigation capacity, particularly the ability to commence or continue legal proceedings, receives far less attention. In this article, we examine the statutory frameworks and case law governing litigation capacity in Canada and the United States. Focusing on decisions such as <i>Carmichael v. GlaxoSmithKline Inc.</i> and <i>In re Mirapex Products Liability Litigation</i>, we analyze the legal criteria used to toll limitation periods, evaluate how courts distinguish functional incapacity from psychiatric diagnosis, and highlight the presumption of capacity as a core principle. We also consider comparative standards, emerging rights-based approaches under the United Nations Convention on the Rights of Persons with Disabilities (CRPD), and the implications for forensic psychiatric practice. Emphasis is placed on the importance of functional assessment and supported decision-making models, offering forensic clinicians practical guidance aligned with contemporary legal values.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Pendulum Swings from Deinstitutionalization to Expanded Civil Commitment.","authors":"Ariana Nesbit Huselid, Armaan Zaré, Joshua Griffiths, Kayla Fisher","doi":"10.29158/JAAPL.260024-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260024-26","url":null,"abstract":"<p><p>Over time, U.S. civil commitment laws have evolved from broad, paternalistic statutes to more narrowly defined legal standards that emphasize individual liberty, least-restrictive treatment, and due process. This shift contributed to deinstitutionalization as state hospital beds decreased and the number of those meeting the new involuntary commitment standards diminished. Subsequent analyses found that, as states narrowed their criteria for involuntary commitment and as community mental health systems strained to absorb the gap, homelessness and criminal justice involvement among people with mental illness increased. Recently, some states and localities have begun to examine their civil commitment frameworks, aiming to broaden eligibility to address complex social and public safety concerns. This article examines these nationwide occurrences and trends through the lens of New York, California, and Minnesota, analyzing their legal reforms and exploring the ethics tensions they raise. These developments reflect a recurring tension between respect for individual autonomy and society's obligations to provide care and ensure public safety, a dynamic that continues to shape modern civil commitment frameworks.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine Burke, Reena Kapoor, Charles Dike, Paul Bryant, Susan Parke, Maya Prabhu
{"title":"A Pilot Curriculum for Teaching Social Justice in Forensic Psychiatry Fellowships.","authors":"Catherine Burke, Reena Kapoor, Charles Dike, Paul Bryant, Susan Parke, Maya Prabhu","doi":"10.29158/JAAPL.260012-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260012-26","url":null,"abstract":"<p><p>Medical schools and residency programs vary widely in the depth and breadth of training offered within their social justice curricula, creating an uneven knowledge base for incoming forensic psychiatry fellows. To address this disparity, a core faculty group in a forensic psychiatry fellowship designed a novel social justice curriculum to ensure that all fellows possess the knowledge needed for competent forensic evaluation and treatment. The course begins with an introduction to the ethics of practicing within an unjust system and utilizes a three-tiered model that explores the social determinants of outcomes within the legal system, bias in forensic evaluation, and special population considerations. The curriculum is designed to provide a space for fellows to discuss the influence of identity on legal and forensic mental health outcomes, enhance their knowledge of social justice, recognize and reduce their biases, and understand the lived experiences of those whom they evaluate and treat. This course provides a potential solution for training inequities and offers a national model to ensure that all fellows, regardless of previous educational experiences, receive training that is vital to competent practice in forensic psychiatry.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Treena Wilkie, Roland M Jones, Margaret Maheandiran, Lisa Ramshaw, Sumeeta Chatterjee
{"title":"Examining Contributors to Burnout and Well-Being in U.S. Forensic Psychiatrists.","authors":"Treena Wilkie, Roland M Jones, Margaret Maheandiran, Lisa Ramshaw, Sumeeta Chatterjee","doi":"10.29158/JAAPL.260014-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260014-26","url":null,"abstract":"<p><p>Burnout and well being in forensic psychiatrists have been insufficiently examined, with most research focusing on vicarious trauma, compassion fatigue, or posttraumatic stress disorder among forensic mental health professionals. Previous research in Canada from 2023 highlighted a high prevalence of burnout among forensic psychiatrists, particularly among early-career psychiatrists, those whose values were misaligned with their institution, and those who had a low perceived control over their workload. Building upon this, the current study provides an assessment of the U.S. workforce in forensic psychiatry, identifying aspects of practice that contribute to, or mitigate, burnout and enhance professional fulfillment. Survey results of American Academy of Psychiatry and the Law (AAPL) members (response rate 11%) indicated that those experiencing burnout were younger, female, perceived to have had less control over their workload, spent more time on the electronic medical record (EMR), and felt their values were misaligned with leadership and colleagues. Factors predicting professional fulfillment were overall job satisfaction, value alignment with colleagues, and mentoring others. The findings of this survey will help to identify interventions at institutional and systems levels to address contributors to burnout, promote professional fulfillment and well being, and enhance recruitment and retention in the field of forensic psychiatry.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Forensic Policy Considerations of Childhood Lead Toxicity.","authors":"Richard Zhang, Marta Herger","doi":"10.29158/JAAPL.260013-26","DOIUrl":"https://doi.org/10.29158/JAAPL.260013-26","url":null,"abstract":"<p><p>Childhood lead toxicity remains a nationwide problem, despite significant progress in reducing exposure sources in the United States since the 1970s. Neurodevelopmental sequelae of lead exposures often persist into adulthood, with limited reversibility. These include long-lasting deficits in intelligence, impulse control, and emotional and behavioral regulation, which can increase one's propensity for aggression and criminality. Yet, despite the strong association between lead poisoning and criminality, there is little agreement thus far among U.S. jurisdictions about how to apply such knowledge to criminal legal proceedings. Here, we explore forensic considerations of childhood lead toxicity for evaluation, sentencing, and staff support in the criminal justice system. We cite both clinical science and case law in navigating this complex intersection of forensic psychiatry, public health, and the environment. We aim to provide preliminary guidance on how forensic psychiatrists can approach and refer to lead toxicity in their medicolegal work. This article may hopefully inspire further forensic research on the topic and the eventual creation of standardized, lead-related guidelines for criminal legal proceedings.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recognizing the Existence of Quack Experts in Forensic Psychiatry and Exploring Hard Truths.","authors":"Ryan Wagoner","doi":"10.29158/JAAPL.250107-25","DOIUrl":"10.29158/JAAPL.250107-25","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"31-38"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary Elizabeth Wood, Sean E Evans, Jaime L Anderson
{"title":"Threats to Objectivity in Risk Assessment for Individuals with Borderline Personality Disorder.","authors":"Mary Elizabeth Wood, Sean E Evans, Jaime L Anderson","doi":"10.29158/JAAPL.250103-25","DOIUrl":"10.29158/JAAPL.250103-25","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"49-58"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Homelessness, Grave Disability, and Mental Health Legislation.","authors":"Olalekan Olaolu, Vikram Kumar, Chinmoy Gulrajani","doi":"10.29158/JAAPL.250092-25","DOIUrl":"https://doi.org/10.29158/JAAPL.250092-25","url":null,"abstract":"","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":"54 1","pages":"12-20"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Supreme Court of Canada Clarifies the Interpretation of the Insanity Defense in <i>R v. Bharwani</i>.","authors":"Dennis Curry, Jason Quinn","doi":"10.29158/JAAPL.2600015-26","DOIUrl":"10.29158/JAAPL.2600015-26","url":null,"abstract":"<p><p>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, <i>R v. Bharwani</i>, 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 <i>obiter dictum</i> of the court of appeal on NCRMD and was unrefuted by the majority. Thus, <i>Bharwani</i> 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 <i>Bharwani</i> dissent.</p>","PeriodicalId":47554,"journal":{"name":"Journal of the American Academy of Psychiatry and the Law","volume":" ","pages":"71-80"},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}