Forensic Psychiatry: Clinical, Legal and Ethical Issues, Second Edition, 2nd Edition (Pack - Book and Ebook) book cover

Forensic Psychiatry

Clinical, Legal and Ethical Issues, Second Edition

By John Gunn, Pamela Taylor

© 2014 – CRC Press

1,035 pages | 20 B/W Illus.

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Pack - Book and Ebook: 9780340806289
pub: 2014-01-06

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Highly Commended, BMA Medical Book Awards 2014

Comprehensive and erudite, Forensic Psychiatry: Clinical, Legal and Ethical Issues, Second Edition is a practical guide to the psychiatry of offenders, victims, and survivors of crime. This landmark publication has been completely updated but retains all the features that made the first edition such a well-established text. It integrates the clinical, legal, and ethical aspects of forensic psychiatry with contributions from internationally regarded experts from a range of clinical professions.

The Second Edition features updates to all current chapters and several new chapters that explore:

  • The genetics of antisocial behavior
  • Disorders of brain structure and function that relate to crime
  • Offenders with intellectual disabilities
  • Older people and the criminal justice system
  • Deviant and mentally ill staff

Although the book focuses on jurisdictions in the UK, a substantial comparative chapter written by an international group from all five continents explores the different philosophies, legal principles, and style of services elsewhere.

This book is an essential reference for specialists and postgraduate trainees in forensic psychiatry but also for general psychiatrists, and clinical and forensic psychologists. It is also an invaluable resource for other forensic mental health professionals, including nurses, social workers, occupational therapists, probation service staff, police, attorneys, criminologists, and sociologists.


"Though penned primarily for those with more advanced knowledge of forensic issues (including those practicing within the justice system), this work might prove useful for anyone interested in the various intriguing and complicated challenges in the subspecialty of forensic psychiatry."

—Steven T. Herron, MD, University of Arizona Health Sciences Center, USA

" … a very comprehensive and thorough review of the whole field of forensic psychiatry. It is a book that every practising forensic psychiatrist would benefit from having. There is no other textbook as comprehensive as this concerned with UK forensic psychiatry: subjects are covered in depth with a vast array of references and articles synthesised. By and large it’s accurate and up-to-date. It’s a real achievement … . Highly Commended."

—2014 BMA Medical Book Awards

Table of Contents


Forensic psychiatry

A victim-centred approach


Medical language

Achieving the knowledge and skills

Further enquiry

Criminal and civil law for the psychiatrist in England and Wales

Common law and civil or Roman law

European courts

Court structure, England and Wales

Criminal law in England and Wales

Agencies of the law

Civil law

The Coroner’s court

Mental health and capacity laws including their administering bodies


Human rights legislation

Historical background

Mental capacity

Mental Health Act 1983 amended by the Mental Health Act 2007

Mental Capacity Act 2005 (MCA)

Legal arrangements in the rest of the British Isles and Islands



Northern Ireland

Military law in the United Kingdom

Isle of Man

Channel Islands

Republic of Ireland

Concluding comments

Forensic psychiatry and its interfaces outside the UK and Ireland

The scope and limits of the comparative approach

The scope and limits of this chapter

National, subnational and supranational legal structures

Controversial issues and shifts in public and professional opinions

Forensic mental health (FMH) services and interventions under criminal and civil law:

Germany and the USA

Forensic psychiatric services and interventions under criminal and civil law:

The Nine Nations (SWANZDSAJCS) Study

Specialist recognition in Europe and SWANZDSAJCS countries

Research in forensic psychiatry, psychology and allied professions

Illustrative cases


Further reading

Psychiatric reports for legal purposes in England and Wales

The forum of the court: Background issues

Constructing a report

The use of reports in criminal proceedings

Civil matters

Examples of other documents which may be consulted

The psychosocial milieu of the offender


Measurement and epidemiology

The natural history of offending

Factors associated with delinquency and offending

Explaining the development of offending

Implications for prevention


Genetic influences on antisocial behaviour, problem substance use and schizophrenia: evidence from quantitative genetic and molecular genetic studies


Basic genetics

Genetic study methods

The genetics of antisocial behaviour, problem substance use and schizophrenia



Theoretical background

Violence as a health issue

Crimes of violence

Disordered and offensive sexual behaviour

Sex offending, sexual deviance and paraphilia

Sex offending by females and adolescents

Psychiatric questions

Risk assessment

Sex offender treatment

Treatment or control

The majority of crime: theft, motoring and criminal damage (including arson)


Recording of crime

Acquisitive offending

Criminal damage


Motoring offences


Disorders of brain structure and function and crime

Expectations and advances: Conceptualization and measurement of brain structure

Epilepsy in relation to offending

Sleep disorders

Amnesia and offending

Brain imaging studies as a route to understanding violent and criminal behaviour

Serotonergic function in aggressive and impulsive behaviour: Research findings and

treatment implications

Implications of current knowledge of brain structure and function for forensic mental

health practice and research

Offenders with intellectual disabilities

Clinical and legislative definitions

People with intellectual disability detained in secure health service facilities in the UK

Crime and people with intellectual disabilities

Theories of offending applied to people with intellectual disabilities

Offenders with intellectual disabilities and additional diagnoses

Genetic disorders, intellectual disability and offending: Genotypes and behavioural phenotypes

Alcohol and substance misuse

Care pathways for offenders with intellectual disabilities

Assessment and treatment of anger and aggression

Assessment and treatment of sexually aggressive behaviour among people with intellectual disability

Fire-setting behaviour among people with intellectual disability

Assessment and management of risk of offending and/or harm to others among offenders with intellectual disabilities

Legal and ethical considerations in working with offenders with intellectual disabilities


Psychosis, violence and crime

Vulnerable to violence and vulnerable to being violent

Psychosis and crime: The epidemiology

Pathways into violence through psychosis: Distinctive or common to most violent offenders?

Psychosis, comorbid mental disorders and violence

Clinical characteristics of psychosis associated with violence

Environmental factors which may be relevant to violent outcomes among people with functional psychosis

Management and treatment


Pathologies of passion and related antisocial behaviours

Erotomanias and morbid infatuations



Persistent complainants and vexatious litigants


Personality disorders

Concepts of personality disorder

Personality disorder assessment tools

How common are disorders of personality?

Clinical assessment and engagement in practice

Causes and explanations of personality disorders

Treatment of personality disorder

Dangerous and severe personality disorder (DSPD): The rise and fall of a concept

Personality disorder: Some conclusions

Deception, dissociation and malingering

Deceptive mental mechanisms

Pathological falsification

Dissociative disorders


Addictions and dependencies: their association with offending


Other substance misuse

Pathological gambling

Juvenile offenders and adolescent psychiatry

Juvenile delinquency

UK comparisons

Mental health

Pathways of care and the juvenile justice system

Government policy for England

Special crimes

Adolescent girls


Women as offenders

Why a chapter on women?

Women and crime

Women, mental disorder and offending

Services for women


Older people and the criminal justice system

How many older offenders?

What sort of crime?

Associations between psychiatric disorder and offending in older age

Older sex offenders

Service and treatment implications



Theoretical issues

Risk assessment and structured judgment tools

Threat assessment and management

Communicating about risk

Risk assessment and management: Bringing it all together


Principles of treatment for the mentally disordered offender

Creating a therapeutic environment within a secure setting

Occupational, speech and language, creative and arts therapies in secure settings

Pharmacological treatments

Physical healthcare

Psychological treatments

Attachment and psychodynamic psychotherapies


Forensic mental health services in the United Kingdom and Ireland

Cycles in fear and stigmatization: A brief history of secure mental health services

Specialist forensic mental health services: Philosophies and a theoretical model

The nature of hospital security

Specialist community services within an NHS framework

Health service based forensic psychiatry service provision in Scotland

Health service based forensic psychiatry service provision in Northern Ireland

Health service based forensic psychiatry service provision in Ireland

Offenders and alleged offenders with mental disorder in non-medical settings

Working with the police

People with mental disorder in prison

Working with the Probation Service

Working with voluntary agencies

Service provision for offenders with mental disorder in Scotland

Service provision for offenders with mental disorder in Northern Ireland

Offenders and alleged offenders with mental disorder in non-medical settings in Ireland

Ethics in forensic psychiatry

Codes and principles

Teaching and learning ethics

Some contemporary questions

Heuristic cases

The death penalty

Deviant and sick medical staff

The medical power balance

Boundaries and offences

Abuse in institutions

Sexual assault

Clinicide and CASK


Victims and survivors

Learning from victims and survivors

Voluntary and non-statutory bodies inspired by victims

The growing centrality of victims of serious crime in the criminal justice system

Reactions to trauma and forms of post-traumatic disorder

Psychological understanding of post-traumatic stress disorder

From victim to survivor: Help and treatment

From victims to survivors: Conclusions


Appendix 1: ECHR

Appendix 2: MHA 1983

Appendix 3: Experts’ Protocol

Appendix 4: Hippocratic Oath

Cases cited



About the Authors

John C Gunn CBE FRCPsych FMedSci Member, Parole Board, England & Wales

Emeritus Professor of Forensic Psychiatry, Institute of Psychiatry, King's College London, UK

Pamela J Taylor FRCPsych FMedSci Professor of Forensic Psychiatry, School of Medicine, Cardiff University, UK

Subject Categories

BISAC Subject Codes/Headings:
LAW / Forensic Science