Fitness to be interviewed: decision-making in the mental health in-patient setting

Abstract

SUMMARY When a patient in an in-patient psychiatric setting allegedly commits a crime, psychiatrists are sometimes asked to assess their fitness to be interviewed by the police. This article describes how to conduct this assessment, outlines the criminal justice process leading to police interviews (with particular reference to the legal system in England and Wales) and highlights practical issues to consider when assessing fitness to be interviewed in this context.

A 23-Year-Old Woman with Psychotic Mania and a Report of Sexual Violence During a Psychiatric Hospitalization

“…In England, where similar rights are afforded to accused individuals, guidance for inpatient psychiatrists about assessing capacity for police interview includes whether the accused patient's mental state interferes with their ability to understand the reason for and nature of the interview and to appreciate the significance of their answers (or lack thereof ). 27 If the accused patient would not otherwise meet discharge criteria, enabling release to police custody, hospital systems may want to facilitate the interview on-site but off the unit. This maintains the accused patient's privacy and precludes detrimental impact on the unit's therapeutic milieu.…”

“…The United States does not have a clearly defined legal standard for mental health professionals related to the capacity, or fitness, to be interviewed by law enforcement. In England, where similar rights are afforded to accused individuals, guidance for inpatient psychiatrists about assessing capacity for police interview includes whether the accused patient’s mental state interferes with their ability to understand the reason for and nature of the interview and to appreciate the significance of their answers (or lack thereof) 27 . If the accused patient would not otherwise meet discharge criteria, enabling release to police custody, hospital systems may want to facilitate the interview on-site but off the unit.…”