1 Dev. Mental Health L. 1 (1981)

handle is hein.journals/dvmnhlt1 and id is 1 raw text is: r   A Quarterly Publication of the Institute of Law, Psychiatry & Public Policy at the University of Virginia -

Forensic Psychiatry and Community Mental Health

by John Petrila*
The criminally insane are feared and
reviled. They are kept in overcrowded,
understaffed hospitals located in rural
areas, surrounded by barbed wire, with
entry doors easily opened and exit
doors always locked. This population
has as its members those not fit to
stand trial, those acquitted by reason of
insanity, transfers from correctional
institutions and the special offenders
who come with labels like criminal
sexual psychopaths. This is the
province of forensic psychiatry, long a
stepchild of psychiatry and
misunderstood by a public that thinks
of Quincy when the word forensic is
mentioned.
Public attention, when given at all, is
focused on notorious trials in which the
insanity defense is pursued. The outcry
which surfaces when a defendant is
acquitted on the basis of psychiatric
testimony is as predictable as the
legislative tinkering with the defense
which emerges every few years.
However, there is today a great deal
of ferment in forensic psychiatry. This
acitivity is occuring largely out of the
public eye. It is concerned primarily not
with the clinical or legal aspects of
forensic psychiatry (though certainly
both are implicated), but rather with the
administrative side. For the first time,
public departments of mental health
and corrections are paying attention to
forensic psychiatry as practiced in the
public sector.
One visible sign of movement is in
the increased numbers of states
creating director of forensic services
*Mr. Petrila, who received a L.L.M. in
Mental Health Law from the University of
Virginia in 1978, is presently Director of
Forensic Services for the Missouri
Department of Mental Health.

positions. These are usually high-level
administrative positions located in the
department's central office. In most
states, the creation of a position like
this marks the first time that the
particular state has had an individual
with system-wide authority who spends
all of his or her time working for
forensic services.
The creation of these positions has
given forensic services much higher
visibility within those mental health
departments that have them. If there is
no such position, the ranking forensic
administrator may be the head of the
state's forensic unit, a position often
subordinate to hospital superintendents

and department administrators and far
removed from the actual locus of
administrative authority. Increased
visibility in a central administrative
capacity means, among other things, an
increased voice for forensic service in
department debates over the budget. In
public psychiatry, where budgets are
subject to increasingly cost-conscious
state governors and legislators, higher
visibility for an advocate for a particular
service becomes critical.
Many states are moving away from a
system in which one or two maximum
security units provide all forensic
services. In its place is a forensic
continued on page 2

Institute Awarded Two Contracts

The Virginia Department of Mental
Health and Mental Retardation recently
awarded two major training contracts
to the Institute of Law, Psychiatry and
Public Policy. These contracts called for
the creation within the Institute of two
seperate Centers.
Over the next two years, the Center
for Forensic Evaluation Training and
Research will provide intensive clinical
training at the Institute to selected
community mental health professionals
in performing competency to stand trial
and insanity defense evaluations on a
local, outpatient basis. The immediate
goal of the program is to train
interdisciplinary teams of mental health
professionals in Alexandria, Charlottes-
ville, Henrico County, Richmond,
Roanoke and Portsmouth to perform
these two specific evaluations. The
impact of the training on the quality of
evaluations received by courts in these
jurisdictions and the savings in the use

of state hospital facilities and state
transportation will be studied to
determine whether the program should.
be offered on a continual, statewide
basis and whether changes in state law
providing for these evaluations are
merited.
The Mental Health Law Training and
Research Center's mission is a broader
one, involving such services as
-providing legal consultation and in-
service training to community mental
health programs throughout Virginia
-drafting revisions of statutes and
regulations affecting the rights of the
mentally disabled citizen in Virginia
-presenting conferences and
preparing conference training materials
for judges, lawyers, and mental health
professionals
-publishing Developments in Mental
Health Law

Developments In
Mental Health Law
Box 100, Blue Ridge Hospital, Charlottesville, VA 22901 (804) 924-5435  Vol. 1, No. 1 January 1, 1981

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