The struggle between good and evil fascinates us – hence the increase of true crime content on every media platform. People have turned to true crime because it gives them a glimpse into the mind of a person who has committed terrible crimes, such as murder. As a forensic psychiatrist at Atrium Health, Sherif Soliman, MD, assesses the enormity of the ‘evil’ involved by determining if a mental illness or disorder plays a role.
“In forensic psychiatry, we don’t do DNA testing, study fingerprints or analyze blood splatter patterns,” clarifies Dr. Soliman. The forensic psychiatric examination consists of a detailed interview with special emphasis on the psycho-legal issue at hand.
Dr. Soliman and other forensic mental health professionals at Atrium Health interface with defendants before, during, and after trials and apply their medical expertise to help legal professionals answer important judicial questions. For example, forensic psychiatric testimony often assists courts in determining whether a defendant was legally insane at the time of the crime. It’s a crucial medical sub-specialty that combines medicine and the law — and no two days in this profession are alike.
Where medicine meets criminal justice
Like many who enter the field of forensic psychiatry, Dr. Soliman always had an interest in medicine and the law. And as he went through his residency, he learned more about forensic psychiatry and realized it was the ideal combination of his interests.
Forensic psychiatry is all about using medical knowledge to answer difficult legal questions. For instance, a court may order an assessment to help determine whether a defendant is competent to stand trial (i.e., whether they have a rational understanding of the legal proceedings and can adequately assist their attorney in their defense). Their mental state at the time of the offense is also considered to determine if they were able to understand the wrongfulness of their crime. Forensic psychiatric testimony may also be relevant in sentencing hearings. Forensic psychiatrists often testify regarding mitigating factors and conduct risk assessments to assist courts in determining the appropriate level of supervision for a defendant who is being released on probation.
Not a typical 9-to-5
For forensic psychiatrists, each day revolves around solving a psychiatric mystery. A given case might involve conducting interviews with the defendant, their family and friends, and witnesses. Then the forensic psychiatry team obtains collateral information such as police reports, crime scene information, medical records, and more.
“Putting all of this data together is challenging and rewarding,” says Dr. Soliman. And this crucial data represents the evidence Dr. Soliman and his colleagues are working with — then it’s time to use their medical knowledge to make sense of this evidence and reach conclusions.
But the process varies considerably on a case-by-case basis. Some days may involve doing court reports and conducting court-related evaluations. And depending on your practice, a forensic psychiatrist may deal more with civil referrals instead of criminal referrals. Civil referrals might involve evaluating a will to make sure that the person drawing up the will was mentally competent at the time, evaluating psychological damages, or conducting a fitness for duty examination. Dr. Soliman has evaluated police officers and firefighters who have suffered severe trauma in the line of duty. When not practicing forensic psychiatry, Dr. Soliman works in the psychiatric ED at Atrium Health. Many of the same forensic evaluation skills are important in clinical assessment. Risk assessments are critical in determining when patients need to be hospitalized and are a key part of reducing suicide and violence risk. A forensic psychiatrist crucially brings a diverse set of skills to the table to make sense of the evidence.
One case, many skills needed
As you can imagine, a team effort is needed to answer many of these questions. For instance, if Dr. Soliman is seeing a defendant with a suspected cognitive disorder, a neurologist may also be involved in the evaluation to lend their medical expertise. Neuropsychologists also play a critical role. They conduct detailed batteries of psychological tests to assess cognitive disorders such as dementia. Forensic psychologists play a key role, often employing sophisticated instruments to assist in answering complex legal questions. Social workers and attorneys also collaborate with forensic psychiatrists depending on the situation.“It’s my hope that my expertise in this field is used to more accurately and fairly administer justice,” says Dr. Soliman. It’s a sentiment shared by the entire forensic psychiatry team at Atrium Health as they work day in and day out to solve psychiatric mysteries.
