Psychiatric recommendations to the court as regards homicide perpetrators

Background: Psychiatric reports can be prepared in homicide cases, pretrial, to determine the mental state of the offender at the time of the offence and to make recommendations to the court. Objective: To explore the recommendations and agreement between authors in the psychiatric court reports of homicide offenders and to establish the affect these have on court outcome. Method: Analysis of a five-year (1996-2001) consecutive national sample of homicide perpetrators in England and Wales. Results: The agreement between prosecution and defence report writers regarding diagnosis was moderate (56%, κ = .49), but rose to very good levels between authors for the same party (prosecution: 89%, κ = .87; defence: 95%, κ = .94). Report writers for the defence were more likely to diagnose a mental illness at the time of the offence (127 cases, 50% v. 136 cases, 28%) and to state that the perpetrator had an 'impairment of responsibility' (36 cases, 28% v. 23 cases, 17%). Conclusions: There is at best a moderate agreement between psychiatric report writers regarding diagnosis, abnormality of mind, and impairment of responsibility. A focus on symptoms would result in improved agreement between report authors which, in turn, would assist court in reaching verdicts. © 2009 Taylor & Francis.