Psychiatric expert witness for Scottish criminal courts
A psychiatric report in a criminal case answers a narrow, precise legal question — fitness to stand trial, criminal responsibility at the time of the alleged offence, or the appropriate disposal following conviction — and it must do so in language the court and the jury, where there is one, can follow without diluting the psychiatric reasoning. He is instructed by defence agents, by the Crown and, on occasion, directly by the court, in the sheriff court, the High Court of Justiciary and on appeal.
Instructions of this kind carry a short timetable and a heavy burden of accuracy. The report must engage directly with the statutory tests in the Criminal Procedure (Scotland) Act 1995 and with the relevant case law, and it must be defensible under cross-examination at a proof or trial diet.
What Dr Qureshi can advise on
- Whether the accused is unfit for trial under section 53F of the 1995 Act, and if so, the mental disorder said to give rise to that unfitness.
- Whether, at the time of the alleged offence, the accused's ability to determine or control conduct was substantially impaired by mental disorder, relevant to a plea of diminished responsibility.
- Whether the criteria for the special defence of insanity at the time of the offence are met.
- Mental state and diagnosis at the time of interview, with reasoned comment on mental state at the material time so far as the evidence allows that to be reconstructed.
- The presence and severity of mental disorder relevant to sentencing, including the likely response to a community disposal, a hospital order or a compulsion order.
- Risk of harm to self or others, and the treatability of any disorder identified, where the instruction asks for this.
- The effect of custody, remand or the proceedings themselves on an existing psychiatric condition.
- Whether a further or different assessment — forensic psychiatric, psychological or neuropsychological — is required before the question can be properly answered.
Where the question is properly one for a forensic psychiatrist with a current NHS forensic caseload — for example, detailed risk assessment for a compulsion order with restriction — he says so and identifies the appropriate route rather than answer outside his competence.
Typical instructions
- Fitness for trial in a case with a long psychiatric history
- An accused with a documented history of psychotic illness whose engagement with the agent and understanding of the proceedings are in doubt. The report addresses each of the statutory elements in turn — understanding the nature of the charge, the ability to instruct and follow proceedings — rather than a single global impression.
- Diminished responsibility following a sudden violent episode
- An instruction to consider whether a depressive illness or an acute stress reaction substantially impaired the accused's ability to determine conduct at the time of the index event, drawing on GP records, any contemporaneous presentation to services, and the account given at interview.
- Disposal report after conviction
- A sheriff seeks an opinion on whether a hospital order or a community-based mental health disposal is appropriate, following conviction, where a moderate depressive or anxiety disorder is present alongside social and substance-use difficulties.
- Remand assessment with a tight court timetable
- An accused on remand where the next calling date is fixed and a report is needed quickly to inform bail or further procedure. Availability is confirmed against the court date before the instruction is accepted.
What the report includes
The report sets out the instructions received, the statutory question or questions being addressed, the documents considered — including any prior psychiatric records, custody healthcare records and police interview material — and the account given by the accused at interview, distinguished clearly from information drawn from other sources.
The mental state examination and diagnostic reasoning are set out in full, followed by an opinion section that addresses each statutory test in turn, in the terms used in the 1995 Act, so that the reasoning can be followed by the court without further interpretation.
Where the evidence supports more than one reasonable psychiatric view — for example on the degree of impairment at the material time — that range is stated candidly, together with the view preferred and the reasons for preferring it, and the report closes with the required statement as to the duty owed to the court.