What is forensic mental health?

Broadly, forensic mental health captures the crossover between mental health and the law. Forensic mental health spans criminal and civil legal matters and the regulation of mental health delivery. 

Criminal legal sphere

In the criminal legal sphere, forensic mental health includes the treatment and assessment of individuals involved in the criminal legal system who have a mental illness. The forensic mental health specialty is broadly concerned with all points of intercept between an individual (or group of individuals) with mental illness and the carceral system. Accordingly, forensic mental health experts may work to prevent criminal legal system involvement, to expedite access to high-quality and person-centered mental health services once an individual has become involved, or to facilitate egress to right-fit mental health treatment outside of the criminal legal system. 

Civil sphere

In the civil sphere, forensic mental health has even broader applications, including involuntary commitment and treatment, child custody evaluations, assessments of various competencies, fitness for duty evaluations, and evaluations related to psychological injury claims. Forensic aspects of the regulation of mental health encompasses understanding and appraisal of mental health laws and their impact on the delivery of care to persons with mental illness. 

Forensic mental health clinicians

Forensic mental health clinicians, including forensic  psychiatrists, psychologists, and social workers, receive specialized training in the procedures and processes of the legal system and in the administration of mental health services (e.g., assessments, treatment) that are aligned with their respective scopes of practice. 

Forensic mental health clinicians

  • may assist courts by providing opinions to address medical or psycho-legal questions, such as forming a professional opinion as to whether a criminal defendant met legal criteria for insanity at the time they committed a criminal act or whether an individual is competent to stand trial.
  • may provide treatment to individuals with mental illness who are involved with the criminal legal system. Such treatment can take place in various settings from Forensic Assertive Community Treatment Teams, in outpatient clinics, or in forensic and correctional facilities. 
  • employ evidence-based strategies to assist people with re-entering the community after incarceration and to minimize the risks of institutionalization. Because they have received education and training in laws and regulations that govern mental health practice, forensic mental health experts commonly advise courts, health systems, and providers on issues relating to the regulation of mental health, mental health ethics, and other psycholegal matters. 
  • ask empirical questions that are relevant to the courts, individuals with mental illness, public health systems, and mental health practitioners. Forensic mental health research has been instrumental in advancing assessment and care practices for this vulnerable population, which has historically suffered harms associated with the quadruple of stigma of mental illness, criminal involvement, minoritized race, and poverty.