Forensic History
This is an important part of the history in psychiatry as patients with psychiatric disorders have a higher incidence of forensic involvement [1]
It can be awkward probing into an individuals forensic past, normalising it by adopting a 'matter-of-fact', non judgemental approach can help. It is unlikely a patient will tell you all about any criminal past unless you ask. Inquire about both occasions when the law was involved and those when it was not. Its a good idea to remind the patient of confidentiality before broaching this area.
Chronologically record the details of all offences, charges, convictions and sentences passed. It is also important to make mention of any impact this has had on the patients life and their attitude towards their past.
'Have you had any involvement with the law ?'
'Do you have a criminal record?'
'Have you ever done anything against the law, or had any allegations made against you?'
'How has this affected you and your life?'
'How do you feel about what you done, looking back?'
| Example. Jeremiah |
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| 'Jeremiah has a criminal record. He was not bothered by this at all "So what man, in my ends every mans got a sheet as long as his arm, do you understand me..."
('sheet' = criminal record 'ends' = neighbourhood)
Grievous bodily harm (May 2000) attacked a black youth in Lambeth "...the dick head deserved it". Received suspended sentence.
Public disorder (Jan 2001) Intoxicated and abusive, Threatened police "shouldn't have go that pissed , but my bird had just left me then...". Fined £90
Shop lifting (Jan 2001) Stole alcohol and food from local Sainsbury's "what's man meant to do? starve to death?" 150 hours community service
Mugging (Feb 2003) Stole a hand bag and attacked a mother outside local primary school "It was a dare man... I don't reckon I'd do it again...". 6 months prison sentence.
Jeremiah also mentioned 6 violent muggings (mobile phones, wallets and bags) and a 5 year history of drug dealing ("ganga, ez, meth and white"*) which went undetected by the law.'(*cannabis, ecstasy, methamphetamine and cocaine)This has caused Jeremiah family and work problems. Three of his past relationships broke up due to his criminal behaviour. His mother and sister have distanced themselves markedly from him since his violent offence in February 2003 - only seeing him at Christmas and birthdays.
Emotionally Jeremiah seems largely unaffected by the past, he displayed no remorse or regret. He seemed angered by the punishments he received. |
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1. Zaman, R., Makhdum, A. Churchill's Pocketbook of Psychiatry. Churchill Livingstone., 2000, pp. 41
