Principles and Practice of Forensic Psychiatry, 2nd ed.

This is a weighty volume literally and figuratively (it weighs more than 5 lb). When the first edition appeared in 1994, it paralleled the belated recognition of forensic psychiatry as a psychiatric subspecialty (1). When the American Board of Forensic Psychiatry (now disbanded) was formed in the 1970s to give recognition to the field, the American Board of Psychiatry and Neurology did not give its imprimatur by way of recognition and examination. The “Added Qualification in Forensic Psychiatry” was not made available until 1994.

The final official arrival of a subspecialty presented the need for an accompanying textbook of forensic psychiatry. The single chapter in the back of standard textbooks of psychiatry would no longer suffice. Although there had always been a scattering of forensic articles in diverse publications ranging from psychiatric journals to law reviews, there was a need for a text discussing the topics typically encompassed by forensic psychiatry. The first edition of Rosner’s textbook met this need, as does the second. Both of these volumes were authorized by, and edited for, the Tri-State Chapter of the American Academy of Psychiatry and Law (New York, New Jersey, and Connecticut). The continued expansion of the field, in its academic and participatory aspects, along with dating of certain materials, led to the need for a new edition. Dr. Rosner, as the editor, has pulled together a diverse set of 105 author experts in 92 chapters for another winning production.

It is amazing how rapidly the subspecialty of forensic psychiatry has grown and achieved recognition. Perhaps it has to do with the collapse of the old model of psychiatric practice, according to which patients and physicians directly engaged each other without the intrusion and regulation of third parties. Forensic psychiatry offered the possibility of continuing a variation of the old model by contracting directly with retaining parties. It has also led to an influx from other mental health fields into the forensic arena with a hope of maintaining autonomy in their respective fields. When I was finishing my psychiatric training and expressed an interest in psychiatry and law to a respected professor, I was informed that was something a few psychiatrists did after they retired and were no longer engaged in practicing psychiatry. What a dramatic change in the course of a few decades.

The topics covered in the second edition illustrate the broad scope of the current field. The text is divided into nine overall sections: History and Practice of Forensic Psychiatry; Legal Regulation of Psychiatric Practice; Forensic Evaluation and Treatment in the Criminal Justice System; Civil Law; Family Law and Domestic Relations; Correctional Psychiatry; Special Clinical Issues That Arise in Forensic Psychiatry; Basic Issues in Law; and a final section summarizing landmark cases. There are several chapters in each section that are quite thorough and detailed. However, in some areas changes are occurring so quickly that constant monitoring would be needed, such as in the areas of sex offenders and juveniles. This is partly attributable to the constant rendering of appellate legal decisions that alter the holdings on certain issues but also to the changing social conditions that impinge on key psychiatric-legal areas.

Creating a textbook requires judgment on what material to cover. This is especially noted in the selected landmark cases, which deal with key issues in forensic psychiatry or illustrate historical interactions between psychiatry and the law. The cases summarized in this volume have been taken from a list published by the American Academy of Psychiatry and Law in 1999. The problem is not only the obvious 5-year gap in the list but also the fact that any such list is always debatable, as the book acknowledges. A reader also needs to keep in mind that nothing substitutes for the actual reading of the legal cases. Law students have learned this from trying to rely on “canned briefs” of cases, which may not always be complete or accurate. As the text notes, “Careful attention to the court’s reasoning may likewise reveal unexpected subtleties or (to the critical mind) inconsistency, tortured logic, or intellectual dishonesty.”

One area that is not covered is the massive amount of material from the social sciences dealing with psychiatry and law. However, who can complain in a volume of this size and breadth, given what it does cover? It is the kind of publication that I longed for in my own training days and still turn to when searching out an area and wanting a review chapter.