Reason for the Evaluation
In forensic mental health evaluations, the referral question (i.e. the reason the evaluation is being requested) is of primary importance. An evaluator must ensure the purpose of the evaluation is understood and clarify an ambiguous referral with the individual requesting the evaluation. Understanding the legal issue at hand is crucial to remain within the scope of the evaluation.
Three types of data typically form the basis for forensic mental health evaluations:
- Third-Party / Collateral Information. These data are perhaps the most important to collect in a forensic evaluation. This information provides the background for the evaluator to develop specific questions and assist with determining the validity of information self-reported by the evaluee. Evaluators must pay close attention to data pieces that are divergent data and confront the evaluee about these discrepancies. Some examples include:
- Official records that provide relevant details about the current and prior functioning of the evaluee, such as police reports, incident reports, child welfare reports, hospital records, and school records.
- Interviews with individuals who know and can speak about the person being evaluated.
- Interview. Although it is not always possible to interview the subject of a forensic evaluation, it is considered best practice. Interviewing the evaluee is essential when the evaluator is expected to give an opinion regarding their mental health or other functioning, and evaluators who do not conduct an interview must be clear about the limits of their opinions. The purpose is to:
- Gain specific information relevant to the referral question.
- Provide an opportunity for the evaluator to assess the response style of the evaluee.
- Decide whether additional testing.
- Assess the evaluee's current mental state and make clinical observations.
- Psychological. Provide information about an individual's general cognitive, clinical, or personality functioning. Although not specific to the legal issue being evaluated, these data may be relevant for information about an area of functioning implicated by the referral question. For example, intelligence testing can provide information pertinent to the issue of competence to stand trial.
- Forensic Assessment Instruments (FAIs). Developed to assess relevant aspects of functioning related to a specific legal question. They provide structure for legally related inquiries, standardize the evaluation process, increase reliability, and decrease bias. Although there are not FAIs for every domain of forensic evaluations, they are an essential component when applicable, and evaluators are encouraged to incorporate relevant FAIs into evaluations.
Most FAIs have been developed for psycholegal questions in the United States. While other countries may have similar standards for some of these psycholegal issues, evaluators should be cautious about adopting these instruments in other jurisdictions. They should be clear about the potential limitations of such. In addition, even within the United States, culture must be considered when selecting tests. Lastly, when no test data are collected, the evaluator should describe why test data do not apply to the evaluation.
Forensic evaluations include a thorough clinical interview, a comprehensive review of collateral records and interviews, and psychological tests. As the evaluator is collecting and considering the evaluation data, they are formulating several specific and relevant hypotheses to the legal issue being evaluated. The goal is for the evaluator to consider appropriate and competing theories and decide which can be ruled out and which appear valid. Often the evaluator will seek additional information to assist in confirming or ruling out various hypotheses as they work through the case formulation, such as psychological testing or forensic assessment instruments.