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Fitness to be interviewed assessments: are specialist trainees fit enough?

  • Jonathan Green (a1), Suraj Shenoy (a2) and John Kent (a1)
Abstract
Aims and method

The law allows courts to exclude evidence from police interviews if it is obtained unfairly or would have an adverse effect on the fairness of proceedings. The assessment of a detainee's fitness to be interviewed is therefore of paramount importance. We surveyed 70 psychiatrists in higher training within the Yorkshire and Humber Deanery to ascertain their current understanding of this clinically important task. The psychiatrists' level of training received and awareness of local employee guidance in relation to their responsibilities in this field was investigated. We then piloted an interactive teaching session aimed at improving knowledge in this area and gained feedback from attending higher trainees.

Results

There was a 64% response rate to the survey before implementation of the teaching session. The survey found that half of all respondents had been asked to carry out a fitness to be interviewed assessment at some point in their higher training. Only a third of the respondents had attended formal teaching in this area, and only a fifth were aware of local employee guidance. All the trainees who attended the pilot teaching session felt it was beneficial to their future clinical practice.

Clinical implications

It is imperative that all the higher training schemes in the country incorporate training in this field to help satisfy the Royal College of Psychiatrists' intended specialist trainee learning outcomes and, more significantly, to avoid potential miscarriages of justice.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Jonathan Green (jonathangreen@nhs.net)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Gudjonsson, G. ‘Fitness for interview’ during police detention: a conceptual framework for forensic assessment. J Forensic Psychiatry 1995; 6: 185–97.
2 Home Office. Police and Criminal Evidence Act 1984 (Section 78 (1), Part VIII, Chapter 60). HMSO, 1984.
3 Home Office. PACE Codes of Practice: Code C Detention, treatment and questioning of persons by police officers 1984 (Annex G). HMSO, 1984.
4 Kent, J, Gunasekaran, S. Mentally disordered detainees in the police station: the role of the psychiatrist. Adv Psychiatr Treat 2010; 16: 115–23.
5 Protheroe, D, Roney, G. Assessing detainees' ‘fitness to be interviewed’. Implication for senior registrars' training. Psychiatr Bull 1996; 20: 104–5.
6 Rix, KJB. Fit to be interviewed by the Police? Adv Psychiatr Treat 1997; 3: 3340.
7 Royal College of Psychiatrists. A Competency Based Curriculum for Specialist Training in Psychiatry: Specialists in General Psychiatry (updated 2012). Royal College of Psychiatrists, 2010.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Fitness to be interviewed assessments: are specialist trainees fit enough?

  • Jonathan Green (a1), Suraj Shenoy (a2) and John Kent (a1)
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eLetters

Capacity Assessments

Shalini Agrawal, ST6 in Old Age Psychiatry
11 September 2012

I read with great interest this article by Green et al. It is somewhat worrying to note that there has been no significant change in trainees' competencies in assessing detainees in custody over the years. However this article clearly shows that structured training can help significantly in improving these competencies. I am generally concerned about the capacity assessment that are carried out specially in view of the fact that the Mental Capacity Act has been inforce for quite sometime. There is a certain lack of clarity of role of doctors in capacity assessments, specially non psychiatrists. In course ofmy work of liaison assessments, it is routine to get a request to asses capacity or 'place some one under a section' from the general hospital as the patient is not agreeing to an intervention. Any suggestion that theresponsibility of capacity assessment ultimately lies with the treating clinician falls on deaf years. There is a firm belief that this lies in the psychiatrist's court. Anecdotally I've experienced that a patient listening ear and time for the patient, explaining the intervention and consequences of it, solves the problem without resort to more drastic measures.This article has certainly given me ideas as to how to improve knowledge among psychiatry as well as non psychiatry colleagues on this very important issue by providing specific training in this area.

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Conflict of interest: None declared

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