On Being Insane in Medico-Legal Places: The Importance of Taking a Complete History in Forensic Mental Health Assessment

Rosenhan's experiment (1973) showed that it is not difficult to simulate symptoms of psychiatric illness. A Parliamentary Committee in New South Wales and research from overseas have shown that, in the medicolegal context, such practices continue to exist. To illustrate the argument, there will be a discussion of Post Traumatic Stress Disorder. It is argued that such practices not only bring the area of mental health into disrepute, they also have the effect of distorting negatively the outcomes of litigation and raise ethical questions about the misuse of mental illness for personal benefit. It remains the case that expert mental health practitioners have an ethical duty to educate both the practitioners who employ them and the courts in general as to the reality of what constitutes mental illness. They can begin this action by taking thorough histories from plaintiffs. The term 'mental injury' or variations thereon, used in most criminal injuries compensation legislation, provides an opportunity to appreciate that being a victim of crime is often likely to result in distress that is more than transient and hence compensable, but not necessarily something that has to become pathological. That does not mean that some people will not develop psychopathology or have pre-existing psychopathology exacerbated. To adopt such an approach for personal injury matters in general may resolve some of the tensions experienced by mental health practitioners when they enter the forensic arena.