The Criminal Mind and Mental Health - A Paradigm of Complex Psychiatry

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By Maroun Tarabey

October 14th, 2024

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

“I do not understand what I do. For what I want to do I do not do, but what I hate I do.”1 As seen with these words from Saint Paul, the understanding of human disobedience goes beyond modern history, with crime remaining eternal. The human mind is a complex labyrinth of contradictions, oxymorons, and unexplainable phenomena that escape the minds of most. However, what is clear is that the mental health of many lawbreakers typically reaches rock bottom, leading to depravity. How, then, can we come to understand the minds of criminals with mental illnesses? Furthermore, can we even begin to treat what plagues their minds in the first place?

 

Criminal psychiatry, otherwise known as forensic psychiatry, is an isolated practice that involves treating individuals in the criminal justice system, with an even bigger role of decrypting their psychological processes for the court. 

 

A unique aspect of this profession is their relationship with the patient. What would be a typical patient-doctor relationship does not exist for forensic psychiatrists. Since they work in a tribunal setting, they refer to their patient as the defendant or the claimant. While uncommon, they are also subject to making court appearances to testify as expert witnesses. This is because they are also involved in evaluating defendants for trial and diagnosing patients. They will determine the mental state of the individual and conclude if they are dangerous/ready for criminal pardon or if they are suitable for psychiatric rehabilitation. 

 

Their role also includes:

• Performing medical history evaluations

• Psychological and psychiatric assessments of mental health

• Assessment of social factors 

 

According to Salary Expert, their salaries can be ∼ $244,280 a year.2 However, the true range is about ∼ $165,250 to $315,609 a year based off of seniority.

 

The typical path to becoming a criminal psychiatrist

Under normal circumstances, this career necessitates the following steps:

• Undergraduate bachelor’s degree - 4 years

• Medical school (MD) - 4 years

• Completing a psychiatry residency - 5 years; This includes:

  • 1 year of general training in subjects related to psychiatry

  • 2 years of junior residency: Hospital-based and ambulatory care placements, with patients from all walks of life

  • 2 years of senior residency: While taking on the mantle of training junior residents, they also take on more research-related electives

• Completing a forensic psychiatry fellowship - 1 year

• Becoming board certified (Must complete the Royal College of Physicians and Surgeons of Canada Examination in Forensic Psychiatry)

 

Where do they work?

The main work environments for forensic psychiatrists are hospitals, private offices,

courtrooms, and correctional facilities

 

“Aren’t criminal psychiatrists also called criminal psychologists?”

No, actually, they are not. These two fields are extremely similar, which is why it is

important to distinguish them apart. The main difference comes from their set

responsibilities and education. Forensic psychologists do not hold MDs. Instead, they

will obtain a master’s in psychology or a PsyD (Doctorate in psychology), and will

mostly either do research in understanding criminal mental health and the causes

of deviancy, while also evaluating trial competency and/or perform risk assessments. While criminal psychiatrists also hold these roles, they cannot formally diagnose people in the system. They equally prescribe medications, and therefore cannot suggest any course of action involving treatment.

 

For more information involving the residencies of this sub-specialisation, I recommend visiting the following university websites:

 

University of Ottawa - Division of Forensic Psychiatry

McMaster University - Forensic Psychiatry Program

University of Toronto - Forensic Psychiatry Fellowship

University of British Columbia - Residency Program in Psychiatry

University of Alberta - Forensic Psychiatry Residency Program

It’s important to denote the significance of this profession in all walks of life. In particular, they tackle a fundamental issue in modern society that is extremely amplified in prisons: the stigmatisation of mental health. Their work in understanding and treating the individuals that pass through the justice system is therefore priceless, since the more we come to understand each other’s problems, the better we become at treating them.​​