Mental Health and capital cases; 10 things you need to know about forensic psychiatry in Kenya

11:30:00 AM

With Dr. Lukoye and Dr. Kiima
On Saturday, I had the honor of sitting in a room full of doctors and lawyers at the amazing Ole Sereni for a forensic psychiatry workshop organised by The Death Penalty and CLEAR Kenya. I say honor because the only papers I had where my experience of living with a mental health condition and constantly blogging about my highs and lows.
Forensic reports are those reports prepared by psychiatrists for law enforcement agencies so as to assist them when making rulings. This is done mostly when the agencies want to make a clear distinction between criminal offenses and mental disorders e.g pedophilia and child sex offenses or infanticide and murder

Here are a few tit bits from the training;
1. In Kenya, three times a forensic report will be requested are
- by a court before passing judgement,
- by defence lawyers for free to plea
- by police on suspect in custody so as to guide what they will charge one with

2. The forensic report is prepared by a psychiatrist with the assistance of a psychologist and is done by
- conducting interview with client,
- gathering collateral info eg interviewing relatives and witnesses, medical history and case papers. 

3. The issue of safety when conducting the interview was discussed with some psychiatrists stating they allow people in the room with client's consent but most times police insist on staying.

4. Since there are few psychiatrists in Kenya, all of them do forensic reporting as and when called upon.

5. During court proceedings, the report from the psychiatrist is used and they may be called in as expert witnesses or to give expert opinions.

6. Psychologists assist in preparation of the report but not in writing the final report. They are the ones who do most interviews and background check including MRI, EEG and CT Scan exams if need be and court pays.

7. It was stated that in Kenya public institutions, there is only one MRI machine and two EEG machines and this coupled with the courts unwillingness to pay for those tests to be done after psychiatrists advice lead to half baked forensic reports.

8. Sometimes lawyers manipulate results leading psychiatrists on what they'd want on the final report which most say discourage them in doing forensic work.

9. Through the forensic reports, the courts want to determine if
- There is a mental health condition at play,
- If there is, which one (psychiatrist should give diagnosis, description of diagnosis, current status of client)
- Was it present when the crime was being committed
- Absense of mens rea and fitness to plea (relevance of illness to the case, impact of illness to clients ability to be part of the case and prognosis if need be)
- Complete collaborated assessment (important especially if the client wont talk or says they cant remember what happened during the time of the crime)

10. Dr. Kiima (Director of the Div of Mental Health which is apparently scrapped off) mentioned that there are discussions to have mental health courts set up in Kenya so that cases of persons with mental health conditions are handled with the urgency and sensitivity they deserve.

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