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. I am 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 I 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 genuinely one for a forensic psychiatrist with a current NHS forensic caseload — for example, detailed risk assessment for a compulsion order with restriction — I say so and identify the appropriate route rather than answer outside my 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.
Timescales and format
Assessment is normally carried out in person, whether in the community, in custody or in hospital, since the diagnostic and risk questions in criminal instructions are rarely suitable for remote examination. Timing is arranged around the court diet and, where relevant, the institution holding the accused.
Report turnaround runs from receipt of the complete papers, including any Crown productions and custody records: [CLIENT TO CONFIRM: X weeks]. Where a trial or disposal diet is already fixed, that date is confirmed at enquiry stage before the instruction is accepted.
Supplementary reports addressing further material, joint reports prepared with the opposing expert, precognition and attendance at a proof or trial diet are all available on the basis set out under fees and timescales.
Frequently asked questions
- Can you assess an accused who is currently in custody?
- Yes. Assessment can be arranged at a prison or police custody setting, subject to the institution's access arrangements. I will confirm what documentation and notice the establishment requires before the appointment is fixed.
- Do you accept instructions from the Crown as well as the defence?
- Yes. Instructions are accepted from defence agents, from the Crown, and directly from the court. A conflict check is carried out against all named parties before any instruction is accepted.
- What is the difference between a fitness for trial report and a diminished responsibility report?
- A fitness for trial report addresses the accused's mental state now, in relation to the ability to understand and participate in current proceedings. A diminished responsibility report is a retrospective opinion on mental state at the time of the alleged offence. The two questions require separate reasoning even where they arise in the same case.
- Will you comment on risk for the purposes of a hospital or compulsion order?
- Where the instruction asks for a general opinion on risk relevant to disposal, I will provide one so far as it falls within general adult psychiatric practice. Detailed forensic risk assessment for a compulsion order with a restriction direction is better addressed by a forensic psychiatrist with current secure-setting experience, and I will say so where that applies.
- How quickly can a report be produced before a trial diet?
- This depends on the complexity of the question and the volume of records to be reviewed. Confirm the diet date and the nature of the question at enquiry stage so that realistic timescales can be given before the instruction is accepted.
Related expertise
- Personality disorders — Opinion on personality disorder, its interaction with claimed injury and its effect on function.
- Alcohol and substance misuse — Addiction psychiatry opinion on dependency, relapse risk and treatment needs.
- Mental health tribunals — Section 22 approved reporting for the Mental Health Tribunal for Scotland.
- Letter of instruction — model letter and the records to enclose
Instructing Dr Qureshi
Instructions are accepted from pursuer and defender agents, insurers, regulatory bodies and occupational health providers. A conflict check is carried out before any instruction is accepted.
Or call 07739 587092.