title: Is the French criminal psychiatric assessment in crisis?
abstract: The criminal psychiatric assessment in France seems to be facing growing criticism related to disagreements between experts and, on the other hand, a lack of interest of psychiatrists for the assessment. We start by explaining the current framework of the criminal psychiatric assessment in France, which differs from the assessment used in English-speaking countries, where Roman law applies. Then, we will describe the disagreements through a literature review and two clinical vignettes. Finally, we will try to understand the causes of discrepancies between experts and the reasons for a supposed lack of interest of the psychiatrists for the expertise. For this, we conducted a survey among the psychiatric experts. We individually questioned experts on the discrepancies and on their awareness of the expertise. We found that 75% of the experts we surveyed had already faced the divergent opinion of a colleague. In addition, the experts were divided on their conclusions related to the fictional scenario we gave them for an a priori assessment (a person with schizophrenia who was accused of murder), particularly in the specific contexts that we submitted to them. The main cause of disagreement between experts was the various schools of thought that influence the psychiatric experts in the forensic discussion and, therefore, the conclusions of a case. Moreover, the experts believed that the decrease in the number of psychiatric experts could be attributed to the adverse financial situation of the assessment, the considerable workload required, and the extensive responsibility that falls on the expert. Calling on a team of forensic experts to perform assessments seems to be the first solution to this crisis. Furthermore, if the experts were better compensated for the assessments, more people would want to undertake this work.
authors.affiliation: Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Institut des Sciences Criminelles, Poitiers, France. Electronic address: Jokthan.Guivarch@ap-hm.fr.
authors.forename: J
authors.initials: J
authors.lastname: Guivarch
authors.affiliation: Service de Médecine Légale et Droit de la Santé, CHU Timone, 13385 Marseille Cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix Marseille Université, 13916 Marseille, France.
authors.forename: M-D
authors.initials: MD
authors.lastname: Piercecchi-Marti
authors.affiliation: CRIR AVS PACA, CHU Sainte Marguerite, 270 Boulevard Sainte Marguerite, 13274 Marseille Cedex 9, France.
authors.forename: D
authors.initials: D
authors.lastname: Glezer
authors.affiliation: Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France.
authors.forename: V
authors.initials: V
authors.lastname: Murdymootoo
authors.affiliation: Service de Psychiatrie Adulte, CHU Conception, 147 Boulevard Baille, 13385 Marseille Cedex 5, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Chabannes
authors.affiliation: Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France.
authors.forename: F
authors.initials: F
authors.lastname: Poinso
mesh_terms: D003415:Crime / Q000331:legislation & jurisprudence / Q000523:psychology; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005555:Forensic Psychiatry / Q000331:legislation & jurisprudence / Q000458:organization & administration; D005602:France; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis; D011570:Psychiatry / Q000331:legislation & jurisprudence / Q000458:organization & administration
keywords: Criminal psychiatric assessment; Disagreement between experts; Forensic psychiatry; French law