What is Forensic psychiatry? Explained

 Contents 

  1. Introduction
  2. Psychological Autopsy
  3. Benefits of a psychological autopsy
  4. Disadvantages and Limitations of psychological autopsy
  5. Branch of Forensic Psychiatry in India

Introduction

When the nature and cause of death are unknown from the immediate and obvious features of death, particularly when there is a lack of direct evidence to determine whether the unnatural death was accidental, suicide, or murder, a Psychological or Psychiatric Autopsy can be used as an effective tool for death investigation.

Psychological Autopsy

The 'psychological autopsy' is a procedure used to investigate a person's death by reconstructing what the person thought, felt, and did before death. This reconstruction is based on information gathered from personal documents, police reports, medical and coroner's records, and face-to-face interviews with family members, friends, and others who had contact with the deceased prior to death.

A medico-legal autopsy examines the deceased's body, whereas a psychological autopsy examines the deceased's mental state. When there is conflict or a lack of leads that point to more than one possibility of mode of death, or when the manner of death is suspicious and giving divergent indications, this tool of investigation can be used in conjunction with a team of Forensic Psychiatrists, Forensic Pathologists, Toxicologists, and Psychologists to compile information about the behaviours and motive to distinguish between accident, homicide, and suicide.

According to the theory that underpins the concept of psychological autopsy, most suicide victims communicate their intentions in some way. While the technique was developed as a clinical tool for predicting suicide risk, its forensic application has been to determine the cause or circumstances surrounding a death in retrospect. Edwin Shneidman and his colleagues at the Los Angeles Suicide Prevention Center pioneered this field of study in the 1950s.

The psychological autopsy methodology consists of two major components: 
  1. In-depth interviews with family members and other close relatives; and 
  2. Gathering all possible medical, psychiatric, and other relevant documents from the deceased.

Psychological autopsies examine the circumstances of the death as well as the decedent for suicidal risk factors. Shneidman, for example, has identified 14 areas of investigation in psychological autopsy research. 

These are some examples: 

  1. Recognizing information (e.g., age, marital status, religious practices, occupation) 
  2. Specifics about the death 
  3. A synopsis of the victim's background (e.g., previous suicide attempts) 
  4. The victim's family's death history (e.g., family history of suicide, affective illness) 
  5. Characteristics of the victim's personality and way of life
  6. The victim's typical response to stress, emotional upheaval, and periods of disequilibrium
  7. Recent stressors, tensions, or forebodings of trouble 
  8. The role of alcohol and drugs in the victim's overall lifestyle and death
  9. The victim's interpersonal relationship 
  10. Alterations in the victim's habits and routines prior to death (e.g., hobbies, appetite, sexual patterns, and other life routines) 
  11. Information about the victim's personal life (e.g., upswings, successes, plans) 
  12. Intention evaluation 
  13. Lethality rating 
  14. Informants' reactions to the victim's death, and 15. Any comments or unique features of the case.

The information obtained from the interviews may be useful in attempting to reconstruct the deceased's background, personal relationships, personality traits, and lifestyle.

Psychological autopsies have been useful in determining and explaining proximate causation, determining the role of various factors in causing a suicide death.

The most common sources of psychological information are

  • Suicide Note: It is critical to interpreting suicide notes in order to confirm suicide, aid in suicide or homicide, or to determine causation. The correct interpretation of a suicide note necessitates the use of a handwriting expert to confirm that the note was written by the offenders/subject, as its contents may reveal the following:
    (a) Intention: The individual's intention is reflected in the suicide note that they have billed themselves. The history of previous attempts strengthens this intention.
    (b) Physical illness: Changes in handwriting, such as tremors (due to alcoholism, drug poisoning, fear or anxiety), or changes in letter size (gradually becoming smaller due to antipsychotic drug intake), may indicate physical illness.
    (c) Psychiatric illness: The contents of a suicide note may indicate the presence of a mental illness, such as schizophrenia.
    (d) Situational Factor:- Determines whether the individual is threatened or suicidal
  • School/College Records: This section contains information such as changes in academic performance or recent absences and tardiness. 
  • Medical Records: Family history, doctor visits, illnesses and medications taken, and referrals to specialists 
  • Police Records: - These records may reveal information about his previous suicide attempts and involvement in anti-social activities. .

The psychological autopsy is carried out by reconstructing the decedent's character or personality using information obtained from various sources. This reconstructed character or personality is then used to make a retrospective prediction of the decedent's likelihood of committing a specific act. If the data collected and analysed show that there is no indication of suicide, the possibility of the decedent committing suicide is ruled out.

Benefits of a psychological autopsy 

Benefits of a psychological autopsy include:

  • The personality of the decedent is most accurately described and assessed by collecting information from people who have direct or indirect interactions with the decedent, which becomes the most significant inputs to evaluate the decedent's thought process and traits prior to death.
  •  If it is a suicide, the evaluation includes an understanding of the intention and motive. 
  • If the autopsy rules out suicide, the investigators will be able to move forward with the death investigation by ruling out the possibility of suicide in the incident. 
  • As a result, the psychological autopsy provides a clear indication of how the death investigation should proceed.

Disadvantages and Limitations of psychological autopsy

Though psychological autopsies can be an effective tool for investigating suspicious deaths, they are not without drawbacks and limitations. The availability and selection of experts/professionals with research-oriented experience who are potential is always a significant hurdle to overcome. Professional ethics and physician-patient privileges have always been a difficult barrier to obtaining valuable and important inputs. The psychological autopsy concludes with a retrospective prediction of whether or not the subject committed suicide. However, this process is being carried out by experts who never met or interviewed the decedent during his lifetime. The experts gather information from third parties and documents, which may be considered hearsay and thus reduces the evidentiary value. There is no standardised operational method for drawing conclusions from the information gathered during a psychological autopsy. To correlate the inputs, it must be drawn up by the professional based on his experience.

The psychological autopsy is one of the most effective tools in the investigation of a death. It could serve as a solid foundation for the investigation into the suspicious unnatural death in the absence of direct evidence. A methodical psychological autopsy would undoubtedly provide more scientific and accurate leads in death investigations.

Branch of Forensic Psychiatry in India

This branch of Forensic Psychiatry is less commonly used in India. On February 12, 2016, the Chief Judicial Magistrate Court in Ernakulam, Kerala, directed the Central Bureau of Investigation to conduct a Forensic Psychological Autopsy in the investigation of the death of Qazi C.M.Abdulla Maulavi of Chembarika. Following that, the Special Team for Investigation in the Sunanda Pushkar Death Case used a Psychiatric Autopsy and concluded that it was a suicide. Another instance of this tool being used was in the Burari Death case in Delhi, where 11 members of a family were discovered dead by hanging on 01/07/2018. In these cases, the question of whether it was a suicide or homicide must be answered. The availability of experts in this field, including experienced suicidologists, is a current concern, as numerous reports indicate an increase in suicides. As a result, there will be enough concern for the state of established research centres and institutions focused on this branch of forensic psychiatry.

Another source of concern is the application of rigour to the hearsay rule in accepting information and conclusions from psychological autopsies. The expert opinion evidence provided by the experts who conducted the systematic psychological autopsy will be given due weightage in accordance with Section 45 of the Evidence Act of 1872.

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