Forensic Psychiatry Flashcards
Clinical vs. forensic
Forensice - goal is to assess for a sepcific purpose…verify as much as possibly…opinions speak for themselves…assess reasonableness of current tx…opine on causation
Clinical - goal is to treat…advocate for patient
Btoh - diagnose and give prognosis
Criminal evals
Compency to stand trial
Resotration of competency
Insantiy
Post-conviction snetencing hearings
TBI
Workers comp
Occupational law
Malpractice
Mental status exam
Psych symptoms following work related
Hiring and firing
Prosecution and defence
Malingering
Separates forensic from clinical exam
Deliberate and conscious simulation of symptoms, idsorders, and incapacities that are not authenrtic
How to detect malingering
Corrodorating evidence
Bizarre recollections
Verbal description of sx w/out even subtle physical indications
Inconsistent reuslts
When to diagnose as malingering
Reported sx do not match activity
Absurd sx
Flucutations in sx
Unexpected med rxns
4 Ds of malpractice
Dereliction of duty (standard of care)
Direct causation between physician action and injury
Existaence of damages
Harming selves
Sexual activity
Abandonment
Currently civil commitment is SOC for suicidal patients
Even former patients
Even if patient threatens you, must give opportunity (3 months of meds) to find another
To prove malpractice
Pt must demonstrate hamr AND that a reasonable person with all information would have refused
Exceptions to involuntary commitment
Mentally ill
who is Threat to self or others as result of mentally ill
Who could benefit from tx
For whom hospitalization is least restrictive mode of tx available
Dangerousness
Cliniicians have duty to protect pts and others
Must warn individuals who have been threatened
Last resort is to call police