A study of forensic psychiatric screening reports and their relationship to full psychiatric reports

Abstract

In Norway the prosecuting authorities can request a forensic psychiatric screening report in order to determine whether a full forensic psychiatric report is required. This study explores three research questions. Are such screening reports considered relevant by the prosecution authorities? To what extent are their recommendations followed? What is the concordance of the conclusions of the screening reports and the full reports? This study analysed the screening reports issued on 419 defendants by Oslo Police District's Office for Forensic Psychiatry in 2002 -2005, and the 91 (22%) full reports issued on these defendants. All reports were evaluated using a structured rating form. Of the 118 screening reports that recommended a full report, 50% were followed up by the prosecution authorities. In contrast, non-recommendation of a full report was almost always followed, while 16% of open recommendations resulted in a full report. Instigation of a full report was significantly associated with major crimes, and with positive recommendation compared to open recommendation. The concordance between screening and full reports was 46% regarding psychosis, 78% regarding unconsciousness, and 94% regarding mental retardation. Based on these findings, the value of the system of screening reports seems to lie primarily in negative recommendations. Low concordance between screening and full reports, and the limited follow-up of expert recommendations for full reports, indicate that the system has questionable validity.

Challenges at the interface of working between mental health services and the criminal justice system

“…They see this as having a negative impact on both court process and the defendant themselves. By identifying delays as a key issue, and recognising that abbreviated reports such as screening reports are a way of alleviating these delays, respondents have confirmed findings of other studies nationally and internationally (Vaughn, 2004;Grondahl et al, 2007). They suggest other measures in addition to this that include a change in the division of labour surrounding report writing, moving towards a greater involvement of a wider range of mental health professionals.…”

“…It aims to provide further evidence that will facilitate the flow of information on a defendant with a mental illness between the courts and the mental health services. One challenge to information transfer identified by Vaughan (2004) and Grondahl et al (2007) is the delay in report writing. This has been addressed with varying success through the introduction of screening reports.…”

“…Although it is widely accepted in practice that the provision of mental health assessment and report writing are unsatisfactory, there are few research studies that have explored this in any detail ( (Vaughan et al, 2003;Vaughan, 2004;Grondahl et al, 2007). Vaughan, (2004), for example, evaluated a system in the courts in which abbreviated screening reports replaced unnecessary requests for lengthy and more time consuming full psychiatric reports.…”

“…He found that introducing screening reports reduced the time spent by the defendant in the court and the number of adjournments necessary when waiting for reports to be completed. Similarly Grondahl et al (2007) evaluated a scheme in which screening reports were introduced as a mechanism to determine if full forensic psychiatric reports were required. In this instance, the relevance of screening reports was evaluated, specifically the validity of the recommendations and the degree to which the recommendations of screening reports were followed.…”

Scandinavian forensic psychiatric practices – an overview and evaluation

“…We obtained 42 forensic psychiatric screening reports from the Office for Forensic Psychiatry, Oslo Police District, Norway, issued after 2002 (after a revision of the penal code). Such screening reports are regularly used within the Norwegian penal system to check to see if a full psychiatric report is needed (Grøndahl, Ikdahl, & Dahl, 2007).…”