title: Forensic mental health assessment in France: recommendations for quality improvement.
abstract: The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.
authors.affiliation: EA 2114, Université François-Rabelais de Tours, 3 rue des Tanneurs, BP 4103, 37041 Tours Cedex 01, France. Electronic address: ncombalbert@hotmail.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Combalbert
authors.affiliation: Laboratoire IPSé, EA 4432, Université Paris Ouest Nanterre La Défense, 200 avenue de la république 92001 Nanterre, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Andronikof
authors.affiliation: Laboratoire IPSé, Université Paris Ouest Nanterre La Défense, 200 avenue de la république, 92001 Nanterre, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Armand
authors.affiliation: Ecole Nationale de la Magistrature, 10, rue des frères Bonie, 33080 Bordeaux cedex, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Robin
authors.affiliation: Ecole Nationale de la Magistrature, 10, rue des frères Bonie, 33080 Bordeaux cedex, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Bazex
mesh_terms: D002983:Clinical Competence; D003417:Criminal Psychology; D005104:Expert Testimony; D005555:Forensic Psychiatry / Q000193:education / Q000941:ethics / Q000379:methods / Q000592:standards; D005602:France; D006801:Humans; D033222:Judicial Role; D001523:Mental Disorders / Q000175:diagnosis*; D024382:Professional Role; D058996:Quality Improvement
keywords: Criminal justice; Forensic expert reports; Forensic mental health assessment; Quality improvement