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Medicine meets law:forensic psychiatry

BMJ 2006; 333 doi: (Published 01 September 2006) Cite this as: BMJ 2006;333:0609335
  1. Elisabeth Cottrell, final year medical student1,
  2. Adrian Grounds, senior lecturer in forensic psychiatry2
  1. 1Manchester/Keele Medical School
  2. 2Institute of Criminology, Cambridge

Undergraduate placements in forensic psychiatry enrich general medical training and help us face our prejudices, say Elisabeth Cottrell and Adrian Grounds

Forensic psychiatry is an unknown specialty to many medical students. And if you are aware of the field, you may not be clear about what it involves. All undergraduate medical courses contain student selected components - projects, placements, and the medical student elective. A placement in forensic psychiatry may be an option for any of these.

What is it?

Forensic psychiatry became a specialty in its own right only in the 1970s. It is unusual because it embraces both the med ical and legal worlds: knowledge of both is essential for fair and appropriate management of patients. Patients who have personality disorders or mental illnesses and have offended or are thought likely to offend in the future. Such offending does not have to result directly from mental illness. A minor ity of forensic psychiatry patients have neither committed an offence nor are thought likely to offend. The United King dom's health service, rather than the criminal justice system, refers patients who are too challenging or unmanageable in general psychiatry settings. These patients may have exhausted local resources or may need higher security care.

Forensic psychiatry differs to many other subspecialties. Firstly, forensic psychiatry does not focus on particular disorders, but on patients within a particular situation - offenders or likely offenders. And, secondly, many of these patients do not want or feel a need for treatment and are detained against their will.

Less of the attitude

Judgmental or discriminatory attitudes can exist towards the patients encountered in forensic psychiatry. All healthcare professionals, including medical students, have a duty to remain professional at all times. Forensic psychiatry provides a good opportunity to tackle any preexisting stigma and discriminatory attitudes. If you can shift your focus away from …

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