“Working as an expert witness psychiatrist is a varied, demanding and rewarding job”
For a forensic psychiatrist, it is an expected outcome of one’s training. When a psychiatric expert trains as a forensic psychiatrist, there is specialist training for in the preparation of expert testimony. Forensic psychiatrists learn how to prepare written and oral evidence. It is an advantage that a forensic psychiatrist has, but it is by no means the only route to becoming an expert witness in psychiatry. Working as a psychiatric expert witness requires clinical experience, excellent interview skills, mastery of the diagnostic criteria and a solid knowledge of the issues which arise in medico-legal cases. The ability to speak publicly and project clearly is a skill which should not be underestimated. Expert witness psychiatrists, like any expert witness, are entrusted with privileged information and any expert who does not take this duty seriously is compromising the authority and process of law. A good psychiatric expert witness will belong to a peer group in which he or she will periodically discuss cases to ensure the highest quality of expert witness testimony.
What’s it like to be an expert witness psychiatrist?
The founding member of Expert Court Reports, Dr Andrew Iles, shares his experiences of working as a psychiatric expert witness:
“I was drawn to working in psychiatry from the fourth year of my medical school years. I was captivated by the interface between the courts and psychiatry when I had the opportunity to undertake a specialist placement in forensic psychiatry. I admired the psychiatrists who acted as expert witnesses; they had interested and varied jobs. On one hand, they were respected senior clinicians, providing high quality of care and on the other hand, they had the opportunity to provide expert opinions. Their attendance at court and the demand for their opinion is motivating and enriching.
During my higher training in psychiatry, I took every opportunity to gain experience in providing expert witness testimony. I was fortunate to have many opportunities to assess individuals in different legal proceedings although most of my experience during those years was in the criminal courts and within the prison estate. By maintaining continuous professional development and by acquiring expertise in several clinical settings, I have built up a varied medico-legal practice, which I find probing and rewarding in equal measure.
Although I have always belonged to a peer group where I discuss cases in confidence to ensure highest quality of my expert witness testimony, one of the things which I find so satisfying about being an expert witness is the fact that I am prompted to self-direct my reading, development and reflection. Being able to provide thorough diagnostic formulation and feeling confident in determining thresholds when asked for my opinion about legal tests for issues such as insanity, fitness to plead and disability, is gratifying for a clinician because it places great emphasis on the rigour of psychiatric practice. Being accountable for my opinions and recommendations is strengthening and constantly drives professional development.”
The scope of expert witness testimony
“The incidence of mental disorders is not consistent across legal proceedings. For example, types of clinical presentation which I might encounter in criminal proceedings may be very different to the clinical presentations which I observed in claimants in civil proceedings, such as personal injury and medical negligence claims. I encounter pockets of specific mental disorders in some proceedings. For example, hoarding disorder is prevalent in my assessment of defendants who face eviction proceedings but is seldom encountered in areas such as employment law. The distribution of mental disorders across the various legal proceedings in which I am instructed is not just of academic interest, it shows how diverse the role of a psychiatric expert is. It also means that one who is experienced in his or her work as a psychiatry expert will have greater confidence in his or her assessment of such individuals. Equally important however is the integrity to remain in one’s area of expertise.
I find myself reflecting much on the individuals who I meet in my medico-legal practice. I am constantly reminded of the tremendous variance in the experience of people. Being compassionate is so important in this work; being confident in one’s opinion is important to the integrity of expert psychiatric testimony. So too is the confidence to seek peer support when necessary. Most of all, it is important to remember how stressful the experience of being a party to legal proceedings is for everybody. Whether the subject is a claimant, a defendant, a respondent, an appellant or a patient, the journey is often all-consuming and sometimes, like nothing they have experienced before. Recognising this burden is important when assessing subjects to legal proceedings because it ensures that an expert may address his or work with empathy and humility. Being able to work impartially and to uphold the duty to the court is such an important value and guiding moral principle and ensures that my approach is balanced, fair and compassionate.”
“Being an effective expert witness psychiatrist requires much self-discipline. As with legal professionals, expert witnesses who maintain sizeable medicolegal caseloads, need to be confident in their ability to manage tight deadlines and changing demands. Being able to deliver on time is one thing, but being able to commit to timely communication is often just as important. Parties to legal proceedings need to feel confident that case progression is assured and whne difficulties do arise, that indiviudals have the proper time to address these to avoid further delay. Despite the long hours I work, I would not want to do any other job. I am committed to working in this capacity and which is why I continuously develop my expertise and service.”