A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation

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dc.contributor.advisorKaliski, Seanen_ZA
dc.contributor.authorJacobson, Candiceen_ZA
dc.date.accessioned2017-06-06T09:44:31Z
dc.date.available2017-06-06T09:44:31Z
dc.date.issued2017en_ZA
dc.description.abstractBackground. A court orders a forensic observation of a defendant to determine a defendant's fitness to stand trial and/or ability to appreciate wrongfulness of action (criminal responsibility) at the time of the alleged offence. Fitness to stand trial is the focus of this review rather than criminal responsibility. In this instance, the court requests an expert to determine whether the defendant's current mental state would significantly impair his or her ability to participate meaningfully in his or her own trial. In South Africa, this process involves multiple assessments by a multidisciplinary forensic psychiatry team in a dedicated forensic psychiatry unit. However, at present no standardised format has been adopted for such an evaluation, the findings of which may have dire consequences for the individual being assessed. Furthermore, there is a paucity of current literature on fitness to stand trial evaluation. Objectives. To establish whether fitness to stand trial is adequately assessed in the Western Cape, South Africa. A further objective is to establish whether mental illness is the sole factor that differentiates defendants fit to stand trial from those who are found not fit to stand trial, and whether defendants with mental illness are less likely to be asked the relevant questions to determine fitness to stand trial than those without mental illness. Methods. A descriptive, retrospective review was conducted (via the application of a checklist) of clinical records of the last 100 male defendants' ≥18 years of age admitted to the Valkenberg Hospital Forensic Psychiatry Unit prior to March 2015. Results. 30 defendants (30%) were found to have a psychiatric diagnosis. Of the 30 defendants, all were noted to have a serious mental illness (mostly psychotic disorder or cognitive impairment) and were found not fit to stand trial. Seventy (70%) of the defendants were found fit to stand trial by the expert panel. From the findings, it was noted that the forensic team asked and recorded the necessary factors to determine fitness to stand trial in 56% of the study population (based on frequency of responses: n = 894), with 32% of questions not appearing to have been addressed at all (especially those pertaining to role players in court and a defendant's understanding of his rights). Furthermore, various questions appeared to have been indirectly addressed in fewer than 50% of defendants. No significant difference was noted in how the forensic team conducted its assessments between those defendants found to have a serious mental illness and those without serious mental illness. Conclusion. The results of the study suggest the need for a more in-depth review of the forensic evaluation process in the Western Cape to further ascertain the benefits of using a checklist during the evaluation process. Furthermore, additional research would assist in determining the factors contributing to a number of questions not having been addressed and the consequences thereof.en_ZA
dc.identifier.apacitationJacobson, C. (2017). <i>A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. Retrieved from http://hdl.handle.net/11427/24502en_ZA
dc.identifier.chicagocitationJacobson, Candice. <i>"A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2017. http://hdl.handle.net/11427/24502en_ZA
dc.identifier.citationJacobson, C. 2017. A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Jacobson, Candice AB - Background. A court orders a forensic observation of a defendant to determine a defendant's fitness to stand trial and/or ability to appreciate wrongfulness of action (criminal responsibility) at the time of the alleged offence. Fitness to stand trial is the focus of this review rather than criminal responsibility. In this instance, the court requests an expert to determine whether the defendant's current mental state would significantly impair his or her ability to participate meaningfully in his or her own trial. In South Africa, this process involves multiple assessments by a multidisciplinary forensic psychiatry team in a dedicated forensic psychiatry unit. However, at present no standardised format has been adopted for such an evaluation, the findings of which may have dire consequences for the individual being assessed. Furthermore, there is a paucity of current literature on fitness to stand trial evaluation. Objectives. To establish whether fitness to stand trial is adequately assessed in the Western Cape, South Africa. A further objective is to establish whether mental illness is the sole factor that differentiates defendants fit to stand trial from those who are found not fit to stand trial, and whether defendants with mental illness are less likely to be asked the relevant questions to determine fitness to stand trial than those without mental illness. Methods. A descriptive, retrospective review was conducted (via the application of a checklist) of clinical records of the last 100 male defendants' ≥18 years of age admitted to the Valkenberg Hospital Forensic Psychiatry Unit prior to March 2015. Results. 30 defendants (30%) were found to have a psychiatric diagnosis. Of the 30 defendants, all were noted to have a serious mental illness (mostly psychotic disorder or cognitive impairment) and were found not fit to stand trial. Seventy (70%) of the defendants were found fit to stand trial by the expert panel. From the findings, it was noted that the forensic team asked and recorded the necessary factors to determine fitness to stand trial in 56% of the study population (based on frequency of responses: n = 894), with 32% of questions not appearing to have been addressed at all (especially those pertaining to role players in court and a defendant's understanding of his rights). Furthermore, various questions appeared to have been indirectly addressed in fewer than 50% of defendants. No significant difference was noted in how the forensic team conducted its assessments between those defendants found to have a serious mental illness and those without serious mental illness. Conclusion. The results of the study suggest the need for a more in-depth review of the forensic evaluation process in the Western Cape to further ascertain the benefits of using a checklist during the evaluation process. Furthermore, additional research would assist in determining the factors contributing to a number of questions not having been addressed and the consequences thereof. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation TI - A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation UR - http://hdl.handle.net/11427/24502 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/24502
dc.identifier.vancouvercitationJacobson C. A retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observation. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/24502en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPsychiatryen_ZA
dc.titleA retrospective analysis of factors used to assess fitness to stand trial in adult male defendants referred for psychiatric observationen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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