Forensic Psychiatry: Risk, Law, and Ethics
Core concepts
Understand risk assessment (static and dynamic factors), the legal frameworks for involuntary detention and treatment, fitness to stand trial, and criminal responsibility. Know the difference between risk of violence to others and risk of self-harm, and the role of structured professional judgement tools. Be familiar with the principles of confidentiality and its limits, consent, and the duty to protect.
Traps
Questions often test whether a patient meets criteria for detention, or whether a risk factor is static (unchangeable) versus dynamic (modifiable). Avoid conflating risk assessment with prediction; structured judgement estimates probability, it does not guarantee outcomes.
Worked example
A patient with psychosis makes a credible threat to a named individual. The rule of thumb: assess risk using structured judgement, document the reasoning, and consider the balance between confidentiality and the duty to protect, involving the treating team and appropriate authorities.
Key points for revision
Risk assessment informs management; it does not predict certainty.