The impact of ethnicity on clinicians' decision making has received a great deal of attention and research. Several studies have documented that client ethnicity significantly influences diagnoses, testing and assessment protocols, recommendations for treatment, and expected outcomes. However, there is limited research examining the impact of a criminal defendant's ethnicity upon forensic menta...

Race, ethnicity, and culture have an effect on all aspects of mental illness. Forensic psychiatrists and psychologists should consider these issues when performing evaluations for legal purposes and when providing treatment to the special populations with whom they work. This article defines race and ethnicity and reviews the available literature on the impact of race and ethnicity on diagnosis...

Many factors influence restoration of competence to stand trial: age, IQ, severity of mental illness, criminal history, treatment history, and others. This commentary poses the question of whether competency to stand trial is also influenced by the setting in which restoration treatment occurs. Jail-based competency-restoration programs, which are in their infancy and have yet to produce large-...

Assessment of capacity to give informed consent in the general hospital setting usually rests on a clinical judgment made of a patient's understanding and appreciation of his or her illness, a process limited by its subjective nature, interexaminer variability, and relative deficiency of quantitative instruments available to provide collateral information. Inasmuch as identification of associat...

This article describes the development of an advanced nurse practitioner (ANP) service in mental health. The ANPs worked within an existing hospital at night team based at Crosshouse Hospital, a district general hospital in Kilmarnock. Set against the agenda of Modernising Nursing Careers and Modernising Medical Careers, the article describes the professional and organisational background to th...

PRIORITY ISSUES IN FORENSIC PSYCHIATRY Sir, Forensic psychiatry is an emerging area of psychiatric specialization in the world. The last few decades have seen many important advances in the field of forensic psychiatry. These include the formulation of newer laws regulating the functioning of mental health care delivery systems, laws relating to the possession and use of psychotropic drugs, as ...

Much more is known about attitudes toward mental illness and social stigma, the viscious cycle of its consequences and how to fight the social stigma in public, but much less is known about how to combat the stigma and self stigma in clinical practice. Stigma theories have not been enough to understand the feelings and experience of people with mental illness. Conceptual framework that understa...

The parental fitness of psychiatrically diagnosed individuals is often questioned in termination of parental rights cases. The goal of this article is to shift the focus from a predisposing bias of unfitness to a functional-contextual analysis of parenting behavior and competency. Three underlying biased assumptions are relevant for the courts' decision making: (a) that a diagnosis (past or pre...

In this issue of the Journal, Wall et al. describe a program designed to restore to competency mentally retarded defendants who have been found incompetent to stand trial (IST). Clearly, individuals with mental retardation vary in their ability to engage in life activities and cognitive processes. For the sake of this discussion, however, I will refer to mentally retarded individuals as if they...