Forensic psychiatry

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Forensic psychiatry at the Ansbach district hospital
Entrance building of the LVR clinic Cologne , forensic psychiatry

The Forensic Psychiatry is a branch of psychiatry that deals with the assessment , the accommodation is concerned, and the treatment of mentally ill offenders. Psychiatrists can use the designation “focus on forensic psychiatry” if they meet the conditions defined by the Medical Association in the further training regulations.

In a narrower sense, forensic psychiatry deals with questions raised by courts and authorities in the field of psychiatry. Expert opinions in forensic psychiatry are more important than in other medical specialties because they can be followed by custodial measures . The expert assessment preferably deals with the prerequisites for criminal liability of criminals, which in Germany are regulated in Paragraphs 20 and 21 of the Criminal Code.

tasks

Expert opinion on culpability

In their reports on the culpability of accused , accused and convicted criminals, forensic psychiatrists answer the question of whether a perpetrator was able to recognize the injustice of his actions and to act on this insight when committing the act. A forensic expert opinion is usually indicated if the perpetrator suspects psychological or neurological illnesses that may impair his ability to understand or control. Authorities can judge, official and be prosecutors or lawyers. Comprehensibility and transparency of the statements in the report of a forensic psychiatrist are of particular importance, especially since they can be the basis for the decision on custodial measures .

On the basis of the expert opinion, the court decides whether the perpetrator was incapable of guilt at the time of the offense ( Section 20 of the Criminal Code ) or of reduced criminal capacity ( Section 21 of the Criminal Code). The examining doctor himself will not make a statement about the culpability, since the culpability is a legal question that must be answered by the court during the main hearing. He only expresses himself on the question of whether the conditions for assuming a culpability are met.

In major criminal proceedings, the psychiatrist's expertise is often followed with great interest by the media and the public.

Accommodation

If the court comes to the conclusion that a perpetrator was not at fault, or at least that this cannot be ruled out, it will decide (final decision-making power) after examining the expert opinion for plausibility and depending on the severity of the guilt and the risk of recurrence, if necessary, to accommodate and treat the Offender in a psychiatric hospital . This type of housing is called forensic unit in contrast to the prison . In 2010, over 10,000 people were housed in hospitals in Germany.

The German penal code provides for two types of forensic-psychiatric placement: placement in a psychiatric hospital ( Section 63 StGB) and (for addicts ) placement in a rehab facility ( Section 64 StGB).

Crime forecast

In addition to assessing guilty responsibility, the prognostic statements made by the forensic psychiatrist are of great importance. In the context of criminal prognostic reports, on the basis of all available information about a person, it is named with what probability this particular person who has already committed a criminal offense will again commit certain illegal acts in the future. A distinction must be made here between prognostic statements in the cognitive procedure (e.g. during criminal proceedings) and a prognostic assessment in the execution of sentences (e.g. to clarify to what extent the requirements for subsequent preventive detention exist).

treatment

Forensic psychiatry secured by walls in Cologne-Porz

The tasks of forensic psychiatry are to improve and protect offenders with mental illness and addiction. The aim of treatment in forensic psychiatry is to minimize the risk of future crimes. It should be noted here that many patients in the penal system are not only due to their mental illness, but z. B. are also restricted in their ability to lead a life free from crime due to developmental and educational deficits. The treatment offered in a forensic institution should therefore cover a broad spectrum and also include social-educational measures. Therapy in a forensic context always takes place under the aspect of risk assessment. This means that risk aspects arising from the patient must be kept in mind. In this respect, treatment and prognosis in forensic psychiatry are very often linked, since prognostic questions must always be taken into account when relaxing or discharging.

This constellation is problematic. For example, there is a risk that accommodation conditions or relaxation measures will be used for the purpose of motivating therapy. In addition, both the initiation of psychiatric therapy and an objective prognosis can hardly be guaranteed if the therapist of a particular patient is to regularly comment on the prognosis of this patient to the supervisory authority.

Statements in accordance with Section 67e of the Criminal Code, which are requested by the Penal Enforcement Chamber, are then primarily intended to represent the progress made in therapy and do not contain the express question of whether a new offense is to be expected in the event of a parole.

The responsibility for the implementation of easing measures rests primarily with the measures regulating institution. The responsible supervisory authorities, such as the public prosecutor's office, must be informed prior to implementation.

In cases of doubt, the correctional facility can commission an external expert opinion on the current risk prognosis prior to the planned relaxation measures.

Chairs and professorships

In Germany there are the following chairs or professorships for forensic psychiatry:

criticism

Forensic psychiatrists are commissioned by the enforcement chambers of the criminal courts to provide prognostic reports for murderers and perpetrators of other serious crimes when it comes to their early release from prison . Since these convicts of life imprisonment and long time sentences were mentally healthy when the crime was committed, the question arises as to why a psychiatrist should be able to make a prediction in the case of a non-mentally ill person as to whether he or she will commit further serious offenses after his release .

The former President of the Vienna Higher Regional Court, Harald Krammer, said to the press : “The omnipotence of the expert is a necessary evil.” And: “The expert represents the eyes and ears of the judge. Where the judge's knowledge fails, he looks through the eyes of the expert. But just as our eyes sometimes deceive us, the borrowed eyes deceive us. That is fatal. ”Bernd Wager (1989) speaks of a January-faced institutional psychiatry. This raises the question of whether the methods promise success or are charlatanism on the one hand, and whether they represent fair or unjust treatment on the other. Helmut Pollähne (1992) complains that the therapeutic treatment models of forensic psychiatry are in an ongoing experimental stage. There are no objective treatment methods. The treatment “ lege artis ”, which is widespread in the field of other medicine, is particularly sought in vain in forensic psychiatry.

With regard to the Mollath case , the lawyer, journalist and author Heribert Prantl wrote in the Süddeutsche Zeitung in November 2012 that Section 63 of the Criminal Code was a dark place in German criminal law. A placement in a psychiatric hospital because of alleged public danger is worse for a defendant than any prison sentence. Those housed in this way do not know whether and when they can leave the closed institution again. The judicial reports prepared by psychiatrists, which are supposed to check the dangerousness of the detainees, are often qualitatively "miserable". For reasons of liability, psychiatric experts are also less and less prepared to take a risk, and in case of doubt a high level of danger is therefore predicted. The number of people who have been judicially admitted to psychiatry has more than doubled in the last twenty years, this is also due to the increased security expectations of society. The judiciary is increasingly giving in to public pressure that “expects the rapid disposal of sources of danger”. After Mollath's release in August 2013, Prantl wrote that Section 63 of the Criminal Code remained a paragraph “which in theory and practice does not meet the rule of law”.

See also

literature

Web links

Individual evidence

  1. ↑ Prison statistics. ( Memento from November 15, 2012 in the Internet Archive ) (PDF)
  2. ^ Manfred Seeh: The republic of the court experts . - Expert omnipotence. Who advises the judges? And how? ( Memento from August 15, 2018 in the Internet Archive ) In: Die Presse. September 12, 2008.
  3. ↑ Bernd Wagner: Are psychiatric therapy methods fair? In: Law & Psychiatry. 1989. Doubtful legal protection against doubtful therapeutic measures. In: Law & Psychiatry. 1990.
  4. ↑ Helmut Pollähne: Positive rights against negative reinforcers. In: Law & Psychiatry. 1992.
  5. ↑ Heribert Prantl: Mollath case - Psychiatry, the dark place of law. In: Süddeutsche Zeitung . November 27, 2012.
  6. ↑ Heribert Prantl: Gustl Mollath is allowed to leave psychiatry - you can't see them in the dark. In: Süddeutsche Zeitung. August 6, 2013.