Psychiatric Assessments of Parents in Care Proceedings

Over 250,000 new cases are brought to the Family Courts each year, according to statistics published on the Ministry of Justice website.  Almost half of these are divorce proceedings, but over 10% relate to Public Law Family cases.  Public Family Law proceedings are notoriously complicated and difficult cases to manage and can often involve multiple agencies and parties.  Unfortunately, whilst there has been a reduction in the time taken for these proceedings, the average disposal time for care and supervision cases is still very long, at 36 weeks.

Psychiatric Expert evidence can be called upon in Public Family Law cases if one of the parties, generally the parents has a history that includes issues such as mental health problems, drug or alcohol abuse, domestic violence or a criminal record.  There may also be additional factors such as potential abuse or neglect that could put a child at risk.  In such circumstances an Expert Psychiatric report can offer valuable insight into an individual or family.  We provide over 250 Expert Psychiatric reports of parents in care proceedings each year and receive joint or single instructions from Local Authorities as well as the Parent’s or the Children’s solicitors.  We pride ourselves on offering a highly professional but also rapid service, with our average timescale for an Expert Psychiatrist’s report being 4-6 weeks.

Our Expert Psychiatrists are asked to give an opinion on a wide variety of questions in their reports in Care Proceedings such as:

Whether or not there is any mental health or personality disorder present in Respondent mother/father.

Whether or not respondent mother/father has any historical mental health illness and whether or not she/he is still suffering from these.

Whether or not respondent mother/father has any mental health or personality disorder condition and how that may impact upon her/his ability to offer adequate parenting.

Whether or not treatment/therapy may be available for respondent mother/fathr, together with details of any timescales involved, and whether respondent mother/father has the ability to engage in any treatment and the effectiveness of this treatment.

To comment on the prognosis for recovery for respondent mother/father if she/he is indeed suffering from some form of mental disorder.

Advise on whether or not respondent mother/father would require any further input from outside agencies with regards to assisting with her/his parenting.

To comment upon whether or not the respondent mother/father has the capacity to understand the concerns of the Local Authority.

To report on any other matter that the Expert Psychiatrist considers is within her/his expertise that she/he considers it is important for the Court to be aware of.

When undertaking an expert assessment of a parent in care proceedings, Expert Witness Psychiatrists, as doctors, employ the time-honoured processes of history-taking and examination in order to achieve a formulation of the subject that encompasses diagnosis, aetiology (causation), treatment recommendations and prognosis. Examination may and often does include physical examination but examination of the mental state is an important psychiatric skill.

During their assessment & report of a parent in care proceedings many of our Expert Psychiatrists approach the process of differential diagnosis based on normal clinical practice and a hierarchical system of psychiatric classification. This means that they consider diagnosis in the order in which mental disorders appear section by section in the ICD–10 Classification of Mental and Behavioural Disorders (World Health Organisation, Geneva, 1992): organic, including symptomatic, mental disorders; mental and behavioural disorders due to substance misuse (including alcohol); schizophrenia and related disorders; mood disorders; neurotic, stress-related and somatoform disorders; personality and related disorders; and learning disabilities. At each level they consider the evidence for and against the diagnosis of a mental disorder at that level and then proceeded to the next level. They would highlight, if there are any, factual assumptions, deductions from factual assumptions, and any unusual, contradictory and inconsistent features of the case. The multiaxial nature of this system of classification facilitates a more comprehensive and systematic evaluation.

The approach to aetiology adopted by many of our Expert Psychiatrists in care proceedings assessments is to apply to the subject’s case their knowledge of the causes of psychiatric disorder in order to be able to give an opinion, if requested, as to how the psychiatric disorder came about or why it ran the course it did.

Where Psychiatry Experts make recommendations for treatment, or comment on treatment already given as part of en expert psychiatric report on a parent in care proceedings, they often rely on approaches that have wide acceptance by psychiatrists and, if possible, give weight to treatments for which there is the strongest evidence base with regard to effectiveness and safety. However, as in medicine in general, there are many treatments which are accepted as effective but for which there have not been trials that satisfy the most stringent criteria of evidence-based medicine.

So far as prognosis is concerned, Expert Psychiatrists apply their knowledge of the course and outcome of psychiatric disorders to the features of each individual case. Their approach to psychiatric risk assessment of a parent in care proceedings is often based on structured clinical judgement. By this they mean that they use their training, experience and skill to relate what is known about the prognoses of mental disorders in general to the specific features of the case, endeavouring to make predictions about identified risks with which they would expect other Expert Witness Psychiatrists to concur. However, it is important to realise that the value of predictions diminishes rapidly with time and this is probably because with time circumstances change so much.

Clinical practice, including psychiatric practice depends in part on knowledge for which there is a sound evidence base and partly on experience-based knowledge which has stood the test of time but lacks a robust foundation in the rigorous research that now forms the basis of ‘evidence-based medicine’. In relying on both categories of knowledge, Expert Psychiatrists do so in accordance with what they would regard as a responsible body of psychiatric practice.

Our Expert Psychiatric reports are of the highest standard and are proof read by trained staff before being released to the client.  A medico-legal report on a parent in Care Proceedings prepared by one of our Expert Psychiatrists might include points such as:

– The background to the case and issues

– Details of documents studied

– An investigation of facts and assumed facts

– Statement of the facts and assumed facts

– Opinion & recommendations

If you would like to instruct one of our Expert Psychiatrists to complete a medico-legal report of a Parent in care proceedings or any other matters then please contact us.  We can provide fixed costs for up to 3 Expert Psychiatrists as well as CVs and confirmed timescales within 24 hours of your enquiry.

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