I have written about this before but it has been highlighted by the program for the faculty conference in Perth in Perth in September 2016. The theme is
Goals, purposes and strategies for prisoner and staff mental wellbeing in custody.
In October 2015 I wrote to the head of the faculty:
More and more me and my colleagues are feeling marginalised by the juggernaut of criminal psychiatry. There is only one paper in Canberra at the November 2015 meeting of the Foprensic Faculty relevant to the work I and others do in the civil field “Expert evidence in mental harm claims’ ( I am aware of the plenary session on family law but few of us do that work now). I know you require people to offer papers but you need to be more pro-active. The same goes for the vexed question of suitable training for psychiatrists doing civil work but the views we have seem to be swamped.
The response I received was:
There are two issues, one regarding civil forensic content at the annual conference, and the second on training.
I had intended to table the email for discussion at the committee meeting.
I have forwarded it to Sophie Davison, convenor of the 2016 FFP conference for consideration. From the conference perspective, it would be best if a suitable keynote could be suggested. I suspect this may be too late for 2016 though nothing formal planned for 2017 yet.
It appears that the 2016 conference was set in stone some 11 months before it is to take place. There is nothing in the program about civil forensic matters!
The head of the faculty wrote further about the issue of training:
The training is a more delicate issue which I did raise at the recent college MAC meeting. While I think a formal training program in civil could lead to accredited faculty membership status, this does not fit with current college processes and may take a lot of work from a dedicated faculty committee to implement.
The Victorian Branch of the Faculty had a one-day conference two or three years ago. The conference was deliberately designed to cater for civil forensic psychiatry, criminal forensic psychiatry and those dealing with Family Court matters. We invited speakers and suggested topics. The conference was very successful, it can be done.
If this Faculty is to succeed there has to be an awareness of the legitimacy of the work done by civil forensic psychiatrists. this is not reflected in either the theme or the program for the conference in Perth where civil forensic psychiatry does not feature.
Today I received an email informing Faculty members of sessions in our area of interest at the College Congress in May 2016.
Several sessions may be of interest to members of the Faculty of Forensic Psychiatry, with highlights including:
Sunday 8 May Pre- Congress Workshop
· Civil Forensic Psychiatry Workshop
· Medico Legal Opinion Construction
Monday 9 May
· The Symphonie Fantastique: 3 Victims stories in respect to a person affected by Pseudological Fantastica
· Using Online Data in the Assessment of Psychiatric Disability
Tuesday 10 May
· Invited speaker Dr Scott Harden: Homicidal threats, ideation and behaviour in Adolescents – A clinicians view
· The injured motorist and the Psychiatrist
· A Survey of Mental Health Exclusion Clauses in Life Insurance Policies
· An assessment of the Reliability and Validity of the Guide to the Evaluation of Psychiatric Impairment for Clinicians (GEPIC)
The last session will be presented by myself! This is a step in the right direction but I believe we have a long way to go. For years we have been battling to be seen as a legitimate subspecialty. It has been very disappointing that the juggernaut of criminal forensic psychiatry appears to have ignored that.
I have had similar concerns recently about the Victorian Medical Panels where there has been an active program of recruitment of new young psychiatrists although, paradoxically, the work has been drying up. What has also been drying up is training for these new members. The high reputation of the Medical Panel in Victoria has come from outsiders recognition of the expertise of members of the Medical Panel. This is no longer the case, recently I did a training session for those people experienced in the use of the GEPIC, one young psychiatrist admitted that he had never used it. I asked him why he was there. He said he was a member of the Medical Panel and had been instructed to attend! I wrote to the convenor expressing concerns about his lack of expertise.
The response from the convenor was:
I can assure you that all of the psychiatrists added to the list ( which was only a small number to fulfil certain requirements ) are appropriately experienced and qualified. There is a wide range of issues that we need expertise in and impairment assessment is only one component
The view continues to permeate that the work we do requires no extra expertise and can be done by any experienced psychiatrist. Periodically various schemes bring an influx of psychiatrists to do this work but most psychiatrist find, to their dismay, that the work is difficult, often emotionally taxing, time-consuming and sometimes requires court appearances. There is a high dropout rate. The various schemes then revert to using the familiar faces, the problem is that there are not enough familiar faces, we need more of them.
I have argued and will continue to argue that there needs to be some system of training. The argument from faculty members has sometimes been that training in criminal forensic psychiatry has a component to deal with civil assessment and that that should be enough. This is nonsense.
So it goes