Mental health expert witness yearbook 2019

Special Issue on Mental Health.....

Including: Profiles On Our Leading Psychology Experts

How the countries leading Psychiatrists can help with legal cases

Front cover kindly sponsored by Dr Sounthy Perinpanayagam

Dr Sounthy Perinpanayagam MBBS, MRCPsych, DPM

Adolescent & Adult Psychiatrist Areas of Expertise:

Dr Sounthy Perinpanayagam is a consultant psychiatrist and has been a specialist advisor in adolescent psychiatry to the NE Thames region.

He has undertaken extensive training in psychodynamics and has experience in residential work with adolescents, psychoanalytical psychotherapy, family therapy, small group therapy and forensic psychiatry.

Dr Perinpanayagam can act as an expert witness, including the preparation of medico legal reports and appearing in court, in cases involving all of these areas of expertise. He can take instructions on behalf of either claimant or defendant.

Dr Sounthy Perinpanayagam MBBS, MRCPsych, DPM Adolescent & Adult Psychiatrist 020 8452 3489 020 7813 5723 07774 235005 sounthyperin@aol.com

2019

Federation of Federation of

Expert witnesses Forensic Forensic & Expert&witnesses

Dr Lars Davidsson MRCPsych,MEWI, Accredited Mediator (LSM).

Medico legal work.

with Dr Lars Davidsson Lars Davidsson is a Consultant of almost 30 years standing, who for the last ten years, on a regular basis, has provided more than 2,000 medico legal reports. Lars attends the Courts as an expert witness on a regular basis.

With almost 10 years’ experience from his local Criminal Justice Mental Health Team, Lars has a special interest in anxiety and trauma (including road traffic accidents). However, over the last years Lars has written an increasing amount of reports for the employment tribunals.

Lars attends most Courts including the Magistrates Court, Crown Court, County Courts (mainly family matters) as well as Military Tribunals. He also attends professional hearings as an expert witness for GDC, NMC and GOC. and has also been instructed by a number of reputable solicitor firms including Mills and Reeves, Keeble Hawson, Government Legal Department etc.

Clients can usually be seen within two weeks after having received instructions. The reports are usually provided after another two weeks, provided all the necessary paperwork is available. Clients can be seen in Lars' office at Southend on Sea, Essex or in his consulting room at Suite 4, 7 Harley Street, London.

Areas of expertise include Adult ADHD, Anger Management, Anxiety, Bipolar Disorder, Complex Phobias, Depression and recurrent Depression, Post Traumatic Stress Disorder, Stress and Worry, Low Self Esteem and more.

Fees are based on an hourly rate for all time spent on the case.

This fee is flexible depending upon the amount of credit needed.

For an informal discussion please call 01702 464 099 / 07969 181936 or email Lars Davidsson directly lars.davidsson@angloeuropeanclinic.co.uk

Our practice clinics Anglo European Clinic Prittlewell House 30 East Street, Southend, Essex, SS2 6LH Anglo European Clinic Suite 4, 7 Harley Street, London, W1G 9QY

Dr Nick Cooling Consultant Psychiatrist MBBS, MRCPsych, Dip Clin Psych

My career as a full-time Psychiatric expert began with three disasters: Hillsborough, The Bradford Fire Disaster and The Sowerby Bridge Disaster.

The Hillsborough Disaster was extremely traumatic for family members, as the whole unfolding disaster could be seen on television. I remember watching the match in my

living-room and coming to the realization that there were going to be multiple fatalities. Subsequently, as psychiatric expert for one of the families, I saw a large quantity of forensic evidence, post mortem evidence and police statements on blank sheets of paper! Over subsequent years, it became increasingly apparent that there was a credibility issue which was on-going.

The family members were further traumatized by their sense of injustice and failure of closure. There was mounting anger regarding the lies and dishonesty displayed by some of the police officers.

In later years I have provided evidence for multiple terrorist events. The Omagh Bomb case was a legal landmark because it was the first time that victims, families and survivors sued the alleged perpetrators for damages and won their civil case. The case went to a full hearing, but I was the only psychiatric expert.

No defendant expert was appointed.

The Childers Fire Disaster in Australia provided me with useful experience of an horrific fire-setting event which caused multiple fatalities amongst international backpackers staying in a hostel. I assessed the Dutch victims in Amsterdam, after their return from Australia. I was the single named expert.

Of course, not all my work involves major disasters and terrorist events. I also carry a large case-load of road traffic accident victims, workplace accidents and victims of emotional, physical and sexual abuse.

Assessing multiple victims for the Irish Redness Board was particularly challenging.

My Experience of the Interface Between Serious Personal Injury Cases and Psychiatry:

Lessons Learnt in Twenty-Five Years For legal practitioners and my fellow psychiatric experts my key learning experiences have been in the following areas: 1.

The types of psychiatric injury that are common in serious personal injury cases:

Depression, anxiety, specific isolated phobia, post-traumatic stress disorder, somatic symptom disorder, obsessional presentations, adjustment disorder and substance-abuse are frequently identified. Previous psychiatric vulnerability is an important factor which shapes the psychiatric manifestations and consequences of trauma. Psychologically robust individuals may have very little in terms of mental health consequences, even in the face of prolonged torture or almost unimaginable horror. The medico-legal assessment provides a unique opportunity to gain insights into how the long-term mental health of the individual may have been impacted. Often, the assessment uncovers psychological disorder which has never been recognized at the primary or secondary healthcare level. Medico-legal psychiatry can provide an entirely new perspective in terms of diagnosis, causation, prognosis and treatment. My work as a Panel Member for The South East Fermanagh Foundation, providing support and treatment for victims of terrorist events has provided me with further insights into the longterm social and community impact of such events.

2.

Issues relating to timely psychiatric diagnosis, early treatment and the effect that early psychological treatment may have on long-term prognosis:

In primary healthcare a significant proportion of cases of depression are never diagnosed. Victims of road traffic accidents often present with traumatic stress and phobic anxiety, but diagnoses are often missed, meaning that symptomatic chronicity becomes an issue, with significant impact on social and family life, occupational functioning and overall quality of life.

It is well-recognized in clinical practice that up to 20% of cases of depression may approach chronicity and people may be left with residual symptoms, even if remission has taken place. Modern antidepressant treatment and cognitive-behavioural therapy can be very effective in terms of reducing the length of depressive episodes. Maintenance prophylactic treatment may reduce future recurrent episodes.

Routine NHS healthcare may miss important psychiatric presentations which follow trauma and personal injury cases may provide a different route to obtaining accurate diagnosis and then appropriate treatment.

The modern civil litigation process now provides an additional opportunity for victims to access effective treatment. This can be life-changing In my experience, even in cases of historical trauma, the medico-legal process, challenging and traumatic as it can be, may well provide a pathway to receiving effective treatment, achieving a sense of closure and finality.

Victims of road traffic accidents and industrial injuries may well be able to access effective psychotherapy in a timely fashion, without languishing on an NHS waiting-list!

Experts are required to provide joint statements of areas of agreement and disagreement. The opportunity of having the diagnostic understandings of two experts assists the Court, but it can also assist and inform clinical understanding, providing a potential pathway for best-practice treatment and ultimate recovery.

Experts have an important opportunity for improving and enhancing psychiatric prognosis, even in severe and difficult cases.

3.

The influence of the litigation process on the psychiatric/psychological injury:

There is often an assumption that the litigation process is anxiety-provoking and traumatic for the Claimant.

Certainly, prolonged litigation can be very dispiriting for individuals, but effectively managed litigation, with prompt access to expert opinion can be very helpful. Legal practitioners need to be aware of their role in terms of assisting the identification of accurate medical diagnosis and subsequent treatment. Providing regular feedback to claimants and being proactive in terms of moving cases forward towards settlement can be a very helpful process. The process can be greatly assisted by the development of a good dialogue between legal practitioners and their chosen experts. This can transform outcomes. The provision of information for claimants and managing expectations is very important. Well-conducted cases may well produce much better outcomes from the medical perspective, reducing long-term psychiatric/psychological morbidity.

4.

The need for Insurers to agree and facilitate requests for early treatment in order to improve the outcomes for claimants:

Given the fact that psychiatric chronicity can have such a negative impact on individual functioning, Insurers have a particularly important role in terms of identifying and facilitating treatment pathways. In terms of psychiatric conditions, this may well reduce the ultimate level of exposure financially, as well as achieving fair and helpful outcomes for concerned individuals. Similar gains can also be identified in Orthopaedic and Pain Management cases.

5.

Picking the right expert:

Psychiatric experts may have an important role in terms of how a PI case develops and unfolds. One size of expert rarely fits all. Careful research of an expert’s curriculum vitae to ensure that they have the relevant expertise and up-to-date practice is very important. In my opinion a particular thing to watchout for is a balanced practice, being instructed by Defendants and Claimants in roughly equal measure.

Picking an expert with an unbalanced practice can be fraught with dangers. In the field of serious personal injury cases, previous track-record and experience is very important in terms of producing an accurate, well-evidenced diagnostic formulation, assessment of causation and a convincing prognosis, with advice regarding best-practice treatment.

My long involvement in medico-legal psychiatry has given me a particular interest in social history. My book Twelve Shaldon People was published last year. This year I am working on Twelve Teignmouth People and Twelve St David’s People. Publishing local social history can have a powerful influence on community cohesion and understanding.

Dr Nick Cooling MBBS, MRCPsych, Dip Clin Psych Consultant Psychiatrist With grateful thanks to Abraham Kallis of Chris Kallis Solicitors for support and advice Shaldon, Devon March 19

01626 873 466 | 07976 797 017 | nickcooling4@aol.com

Joanne Caffrey

Expert Witness

I am an Expert Witness for ‘Safer Custody’ and the management of challenging behaviour & use of force. The main sectors I work with are the custody (prison and police) and education sectors. I have also experience of hospitals and security settings.

The use of force in custody, education, care and clinical settings varies greatly with many staff having limited, or no, knowledge of risk associated with certain demographics of service users. Too many injuries and deaths are avoidable in my opinion. I have trained several thousands of staff over the years concerning safer restraints and the managing down of physical interventions.

For Safer Custody, the use of force and the management of challenging behaviour

‘Safer Custody’ refers to the safeguarding of staff and detainees within the custodial system, from the moment of arrest to detention at police custody, court cells, prisons and all associated transport between.

I was a custody sergeant from 1996 to 2003 inclusive, then progressed to custody staff training and assessment, and joint police/prison custody planning. In 2012 I received a British Excellence in Performance Award for my contribution to ‘safer custody’ on a national basis.

The Criminal Justice System custody estate has progressed significantly since 1996 when custody was seen as a punishment for detainees.

Staffing was usually by newly appointed sergeants, as I was, or sergeants heading towards retirement, or being disciplined.

Safer Custody aims to prevent, or reduce to the minimum, deaths or injuries connected with self-harm, suicide, use of force, underlying medical conditions, head injuries, malicious or accidental incidents.

The whole custody process is holistically governed by the principles of ‘Safer Custody’, regardless of which institution, or agent, is providing the service to the detainee. Providing a common framework of understanding and care of the detainee and having the ability to share information via systems such as the PNC. (Police National Computer).

The same principles of ‘safer custody’ can apply to children within the care and custody of the education system, who may also be suffering from special educational needs and disabilities.

Safer custody covers a wide variety of issues for safeguarding the staff, the service users and others, which are applicable for police and prison custody, court cells and contractor transport companies, such as:

• Custody staffing, training levels, and paperwork • Risk assessment processes for condition of detainee / prisoner • High risk issues e.g. head injuries, positional asphyxia, excited delirium • Building risk assessments e.g. ligature points, alarm systems, fire safety • Information sources e.g. PNC, PER, • Health conditions and use of the health care providers • Control & restraint techniques and use of • Transportation e.g. fleet management issues, PECs (prison escort and custody services), • Management & supervision e.g. visits and rousing • Equality & individual needs e.g. females, juveniles, disabilities, foreign nationals • Healthcare & medication needs • Cell occupancy • Out of cells – exercise, showers or interviews • Hygiene e.g. bedding, toilets, clothing & cleaning • Food safety – choking assessments, food hygiene • Dependencies – alcohol, drugs • Mental health – assessments, medical needs, adaptations • Technology – CCTV, audio recording • Deaths or injuries in custody procedures

Custody officers and staff should be familiar with the signs or behaviours of a detainee that may indicate an increased level of risk and/or requirement for a higher level of monitoring.

Custody officers need to be aware of the enhanced risk of suicide and self-harm during periods of detention.

Detainees who are deemed to be a high risk of suicide or selfharm must be seen by a healthcare professional (HCP) and kept under close proximity supervision. This allows officers and staff to engage with the detainee and intervene if required.

Deaths in custody increase disproportionately during the early days in custody, with younger male prisoners being at increased risk and the larger demographic, however although women prisoners account for only 5.5% of the prison population they account for half of all self-harm incidents.

The governance of the education system may be easier to understand, but there are currently no national restraint techniques or principles of practice for safeguarding children in the education system and use of force on them. The Department of Education leaves it to each school to decide their approach to training and what systems they will implement.

I work with over 200 schools and there is little common understanding or application of systems, unlike the criminal justice custody systems. Schools are under immense pressure to reduce costs and often sub standard training is introduced to a school which is not tailored to the demographics of the child or staff.

This makes it unsafe and unfit for purpose. For example a child with downs syndrome is highly likely to have heart disease, respiratory disorders and hyper mobility of joints. Even special schools who should be the most knowledgeable in dealing with these children lack the understanding of risk associated with restraint and conduct too many restraints.

The emphasis in many schools is the application of restraints rather than the avoidance of restraints.

A current issue I am concerned with is the increase in creation of ‘calming rooms’ within the care and education sectors. With little national guidance service providers are creating ‘calming rooms’ which are not therapeutic and contain many ligature points plus the adopted practices of such rooms is dubious and potentially abuse and false imprisonment.

The cases I have worked on in the last 12 months include: • Prison custody suicides and self harm where staff have failed to identify risk factors and control measures for prisoners; • Prisoners being assaulted by other prisoners despite risks being reported to staff; • Custody staff being injured in assaults from prisoners due to staff shortages and failure to communicate risk; • Injuries to staff and service users from hand cuffs and other equipment; • School staff injured by children due to lack of training in de escalation and inappropriate restraint techniques; • Children being injured by excessive use of force by staff without any pro active attempts to manage down cases of violence; • Failure to identify ligature points in custody areas which have allowed the opportunity for prisoners to then self harm; • Security staff in a hospital restraining a person who died during the restraint • Inappropriate use of calming rooms I have worked for coroner, civil and criminal cases and deliver training and consultancy on these topics.

www.joannecaffreyexpert.co.uk / www.totaltrain.co.uk

FORENSICS INDUSTRY

E-MAGAZINE

AWARD NEWS

PSYCHOLOGICAL SERVICES AWARD 2015 It gives us great pleasure to announce that MIDLANDS PSYCHOLOGICAL SERVICES LTD has been chosen as this year’s winner of the coveted PSYCHOLOGICAL SERVICES AWARD 2015, an independent Award Scheme sponsored by Forensic & Expert Witness E-Mag. In presenting this Award the team at Forensic & Expert Witness E-Mag were particularly impressed with the fact that Chartered Clinical Psychologist and founder of the company Dr. Dennis Trent, a Associate Fellow of the British Psychological Society, has been providing Expert Witness Reports for over 20 years dealing with Child Protection/Custody issues, Pre-Sentence Reports, Risk Assessments, Fitness to Plead, Learning Disabilities and other court related psychological assessments.

This Award Scheme was created in order to recognise those businesses and individuals who have made an outstanding contribution to their particular field. Forensic & Expert Witness E-Mag is always keen to bring attention to those who are providing a product or service that stands out from the crowd and deserves to be appreciated not only by its’ readers, but also by a wider audience.

Acknowledged both locally and nationally this Award is a milestone for Midlands Psychological Services Ltd and forms the final piece of the jigsaw that confirms the company's success.

Gains Recognition with Top Award On receiving this accolade Dr. Trent has this to say:

“All of us at Midlands Psychological Services are honoured to have received this award. It is the combined efforts of many who have made it possible and it is shared by all of us.”

Explaining the need for psychology in child protection Dr. Trent added: “It has often been said that the greatest asset of any culture is its children. To say that they are our future is like saying that day is light and night is dark. Someone who has been blind from birth may not understand that and it would appear that kind of blindness is more common than we would sometimes like to admit. The protection of children, while a widely recognised ideal, is often derailed by political and financial based decisions which are not in the best interest of our children.

Children tend to see the world in a markedly concrete manner. That is to say that in a child’s life there is black and white with little or no grey. Things are either good or bad, right or wrong with little ability to recognise nuances between the two extremes. If a child has done a ‘bad’ thing, it is easy for the child to assume that he or she is a bad person.

They also tend to take on responsibility for events and situations over which they have no control. Although they will often attempt to evade responsibility by denying an obvious action, they make connections which make sense at a concrete level, but which do not stand up to rational examination. “If I had eaten my corn Mum and Dad wouldn’t be fighting. If they weren’t fighting they wouldn’t be getting a divorce, therefore it is my fault they are getting a divorce” is a good example of concrete reasoning. It appears to be linear in that one leads to the next, but when examined the components, i.e., eating corn and getting a divorce, are very tenuously related at best.

In years of clinical practice I have never met a couple who divorced because the child did not eat their corn.

While to an adult it may be a flashpoint, to a child it is the reason.

Children rely on adults for their very existence.

We know that nurturing a child is essential to the development of the child. Shortly after World War II children in an orphanage were investigated because the infant nearest the door always did better than the others and it was not known why. When cameras were placed in the room it was noted that when the matron would turn out the lights at the end of the day she would reach down and caress the child nearest her before she left the room. Even a seemingly simple gesture as a passing caress is enough to have a positive impact on an infant’s life.

The primary damage, other than physical, of child abuse is a breach of the trust relationship between children and adults. When the very person a child relies on for safety, security and nurturing creates an environment which is not safe, secure or nurturing, the child will often take responsibility for having created that environment.

Anyone who has worked with abused children will recognise such statements as, “I deserved it”, “if I hadn’t....”, and “it was my fault”. These same statements are frequently heard when working with adult survivors of child abuse. If children cannot trust the environment, then when they become adults their ability to trust themselves as well as others is likely to be impaired, thus having a marked effect on both their self-concept and their ability to empathise with others.

Most parents recognise that it is important to have a consistent meal and bedtime schedule for their children. It establishes a structure within which a child can experiment and play, and forms the basis for the child’s sense of security and stability. When a child is abused there is little ability for the child to experiment or play as most of the child’s efforts will be directed at stabilising the environment and ‘pleasing’ the abuser in an attempt to avoid future abuse. This is likely to set a pattern for future behaviour as an adult. Since the individual sees little self value, efforts are often directed at gaining a sense of value from others, often by establishing a relationship to gain that sense of value. The problem is that people will not accept something they do not believe to be true, and therefore the individual will negate any value given by a partner. The lack of trust will cause a ‘testing’ of the relationship to find the breaking point and, when reached, another partner will be sought to gain the sense of value which was not obtained in the first relationship. As such, a pattern of unstable relationships follow, often with significant domestic violence inherent within those relationships.

Sex enters into the equation in that within the Western culture, sex is frequently seen as an indicator that emotional intimacy, acceptance, love and approval or value has been established. While the individual in almost all cases is searching for an emotional intimacy, that is acceptance and security, what is achieved is a physical intimacy devoid of the very thing being sought.

It is often seen by the individual that the answer to this dilemma of poor self-concept, lack of trust in others and feelings of estrangement is to have a baby. A baby is often viewed as someone who will love unconditionally and give worth to the individual.

The child is viewed as there for the parent, not the parent there for the child. What is not recognised is that within a poor relationship a child is demanding and an added stress. Now the pattern repeats as the parents are not receiving what they wanted from the child and the child is therefore often seen as the problem.

The problem is now exacerbated by taking the child out of the family and placing him or her in care, a process designed to protect the child. While it is understood that a social worker wants to progress a career, multiple changes of social workers only increases the instability in the child’s life. The same applies to Foster Parents. While there are many very good foster parents, children who have been taken from families present many problems for those foster parents who are less able or willing to deal with those problems.

Placement in multiple foster homes is not uncommon and again will be more damaging than helpful.

Unfortunately, there is no formal psychological assessment of potential foster carers or children’s homes workers and while experts in social care systems, social workers are not always best placed to assess the psychological make-up of parents who are very adept at covering over abuse and presenting themselves as caring individuals.

Enter the psychologist. Psychologists are extensively trained to make the assessment of risks to children.

With tested and proven instruments, many of which identify information the individual is not aware is being sought, the underlying risk presented by taking a child from a family unnecessarily, or placing a child into a high risk environment, often can be avoided. As fully independent experts we have the ability to view parents, children and environments from a completely objective viewpoint keeping the needs of the child paramount. We can make recommendations to the Court as to the needs of the child as well as ways in which the parent can improve themselves and their parenting skills in order to provide a more safe and secure environment for their child. We can assess the level of risk a parent or potential partner presents to a child. While past behaviour is a good indicator of future behaviour, it is not an absolute predictor. It is well accepted that the best place for a child is with the parents when that is safe and appropriate.

In conclusion Dr. Trent went on to say:: "Psychologists are best placed to help tease out that level of appropriateness.

They can also assist Social Services in assessing the appropriateness of potential foster carers and support social workers in working with both children and adults.

Most importantly, they can assist the Court to make a decision which is in the best interest of the child. Failure to do so will only build a significantly greater problem for the future. It is commonly accepted that the incidence of mental disorders in the prison population has markedly increased over the past years. The protection of children and early intervention facilitated by formal assessments of risk posed to them by parents, partners and carers is the first step in reducing, and turning around, a time bomb with huge personal, social and financial costs for the future."

For further information contact: Dr. Dennis Trent, MIDLANDS PSYCHOLOGICAL SERVICES

Tel: (0121) 224-3051, Fax: (0121) 224 3252, Email: mps@midpsych.co.uk Website: www.midpsych.co.uk

Graham Rogers

Consultant Psychologist and former Head of Service.

Consultant Psychologist with over 27 years’ fully qualified experience within Education, Health, Social Services and the Courts. Former head of department with responsibility for 18 fully qualified psychologists.

First gave live evidence as a professional witness in 1991. Has appeared as an expert witness providing live evidence at numerous courts, including The Central Criminal Court and The Central Family Court.

Graham Rogers and Associates Limited are experts in assessment.

• Adolescents and adults • Learning and intellectual disabilities • Mental Health • Special Measures • Fitness to plead • Immigration The courts have also sought our views regarding 'others' assessments.

Graham Rogers Associates Ltd

Extensive experience with adolescents and adults

"When selecting an expert, ask yourself if you want an expert in treatment, or assessment?"

“Treatment reflects one aspects of psychological practice, whereas assessment reflects another�.

Graham Rogers Associates Ltd 01279 301 676 07952 170 627 info@grahamrogers.org.uk www.grahamrogers.org.uk

Bernard J. B. Kat

BA, MSc, DipClinPsychol, CPsychol, FBPsS PROVIDING PSYCHOLOGY, PSYCHOTHERAPY & EXPERT WITNESS SERVICES Registered as both a Health and Clinical Psychologist, Bernard Kat worked as a clinician and manager in the NHS for 28 years. In 2005 he formed his own company Psynapse (Psychological Services) Limited based in Newcastle upon Tyne.

He provides services as a Psychologist, a cognitive behavioural psychotherapist and as an Expert Witness throughout what he calls “the true North of England” i.e. from Northumberland down to Teesside in the East, across to Cumbria in the West.

A Cardiff University / Bond Solon certificated Expert Witness, Bernard is able to draw on the extensive 7 year training undergone by all clinical psychologists which includes the study of normal human development and functioning as well as specialist knowledge concerning mental health, disabilities and the problems of children and young people.

Bernard told us: “The philosphy component of my undergraduate degree has been particularly useful and taught me how to approach and write about complex problems. The psychology component emphasised the scientific and statistical skills on which my work is still based.”

As an NHS clinician Bernard specialised in work with general practitioners and community teams. This wide experience enables him to offer a rounded service as an Expert Witness.

He explained: “Throughout my career, in both my clinical and managerial responsibilities I was responsible for psychological services for clients of all ages and disorders.

My own cases were mainly working age adults. Many of my patients suffered from psychological disorders resulting from traumatic events and experiences. I was also involved with psychological aspects of primary health care, general medical services, acquired brain damage services, systemic approaches to relationship and organisational problems, as well as public health psychology.”

Bernard has seen many changes in Expert Witness work since 2005 owing to Government policies concerning funding: “I used to be instructed in criminal, family, personal injury and clinical negligence cases and I had Court experience in all of them. At present my Expert Witness work is primarily reports for the Court in criminal cases, initiated by the Defence. However Expert Witnesses do not act for either side. Psychologists’ reports are addressed to the Court and will very likely say the same whomever commissioned the report in the first place, so my reports are often accepted by the Prosecution and there is no need for me to attend Court. But I am fully aware of the formalities required when attending Court, which I do perhaps a couple of times a year on average.”

FOR MORE INFORMATION PLEASE CONTACT: Bernard Kat Psynapse (Psychological Services) Ltd Churchill House, 12 Mosley Street Newcastle upon Tyne NE1 1DE Tel: 0191 230 6461 Email: b.kat@psynapse.co.uk Website: www.psynapse.co.uk

The Role of the Psychologist in Assessing Fitness to Plead and Stand Trial

The law on unfitness to plead is concerned with whether or not an accused is able to stand trial and, if not, the procedure that should be used to deal with that accused.

If at any time during the Court process the defendant’s competency to stand trial is questioned a full and detailed assessment should be sought. An example would be a defendant who as a result of very low intellectual ability is unable to follow the process of his or her trial. In England and Wales, the test known as the Pritchard test is applied by the courts when deciding whether a defendant is unfit to plead, however the test is outdated and inconsistently applied.

Following a consultation paper in 2010 and an issues paper in 2014, on 13 January 2016 the Law Commission published its report on unfitness to plead. The Law Commission proposed that the new test should centre upon the defendant’s decision making capacity and capacity for effective participation in their trial. This brings the new test in line with modern Court proceedings and the test for capacity in civil proceedings which focuses on decision making abilities (Mental Capacity Act 2005).

U

p until recently the determination of a defendant’s lack of capacity relied on the evidence of two or more registered medical practitioners in general such practitioners were psychiatrists. The new legislation has recognised that other professionals are suited for this role.

In particular psychologists are routinely involved in assessing, formulating and treating mood and cognitive disturbances and consideration of the assistance required for defendants to participate effectively in the trial process may be better suited to the expertise of a psychologist than a psychiatrist.

Consequently, the Law Commission has stipulated that one of the experts must be a registered medical practitioner duly approved under section 12 of the Mental Health Act and the second expert can be either a registered medical practitioner, registered psychologist or an individual having a qualification appearing on a list of appropriate disciplines approved by the Department of Health.

A separate but closely related issue is criminal responsibility, major mental illnesses and cognitive difficulties if severe enough, may impact upon criminal responsibility and the input of a Psychologist in these cases can also be invaluable. Cases can range from trying a juvenile as an adult, to capacity to form intent, to assessing diminished capacity in an individual with a learning disability or older person who is suffering from dementia.

Assessment by a psychologist can identify areas of concern to help inform whether any cognitive factors would mitigate criminal responsibility. For example, in the case of an adolescent with autism and moderate learning disabilities and who commits an offence it may be that age-related knowledge, poor cognitive skills, social understanding, theory of mind deficits (being able to evaluate others perspectives, emotional reactions and thoughts) are important factors to take into consideration.

A psychological assessment will usually include a detailed evaluation of the defendant’s mental health, cognitive functioning, verbal reasoning and comprehension skills, attention and concentration, short term memory, decision making abilities, suggestibility and any other relevant psychological factors. This information will be used in order to form an opinion about whether the defendant is deemed to be fit or unfit to plead and/or stand trial but more importantly the expert can make recommendations to the Court which will allow a vulnerable defendant to fully participate in the proceedings. At the heart of the Law Commissions’ recommendations is the belief that there should be a full trial wherever possible. This is because only such trials engage all the fair trial processes and guarantees for those involved. A departure from a full trial should be a last resort that is only taken when it is in the best interests of the defendant. In order to fulfil these criteria reasonable adjustments to the criminal process should be made.

Dovehouse Psychology Services Dr Sharna Lewis BSc Hons, MSc, DClinPsy, CPsychol Chartered Clinical Psychologist and Expert Witness (Midlands Area) I have considerable experience of conducting Court reports in matters of personal injury, clinical negligence, mental capacity, assessment of cognitive functioning, mental health and personality, fitness to plead/stand trial. I am registered with the BPS and HCPC.

T: 07716846488 E:info@dovehousepsychology.com w:www.broadoakshealthclinic.com

Fitness to plead – case example one – a woman with learning disabilities Reason for assessment

Ms Karim an Asian lady in her 40’s was referred for an assessment. She was facing serious allegations of fraud (including dishonestly obtaining a British passport and beach of immigration) which she denied and was due to appear at Crown Court. Her solicitors reported that she did not appear to understand what was happening at her last Court hearing and appeared to agree with everything that was being suggested to her which made it difficult to take her instructions.

Assessment

The assessment included a detailed background history (including early developmental history, educational and occupational functioning) an assessment of mental health, cognitive functioning/IQ, adaptive functioning, verbal memory/recall and suggestibility.

Ms Karim spoke Punjabi and her English was very poor. The assessment was conducted with the use of an interpreter.

Ms Karim reported that her father was from Pakistan and her mother was English she was born in the UK. She was sent to Pakistan to live when she was four years old and never received any formal schooling. Ms Karim married in Pakistan and then came back to live in the UK when she was 18 years old.

Although a full IQ assessment could not be completed due to language barriers Ms Karim was found to have a nonverbal IQ of 63 and extremely poor adaptive functioning. She was unable to read or write and relied upon family and neighbours to assist her with most aspects of independent living (including cooking, washing, finances). Ms Karim had a very poor understanding of the charges and the proceedings and did not understand her role in instructing a solicitor. She was also found to be highly suggestible and presented with acquiescence i.e. tendency to agree with questions/statements put to her.

Summary and conclusions

It was concluded that Ms Karim even with the use of an intermediary did not have capacity to take part in proceedings and therefore was deemed unfit to stand trial. Although a separate issue the assessment also highlighted the fact that it was highly unlikely that Ms Karim possessed the cognitive and literacy skills needed to have physically committed the offences she was charged with and it was unlikely that she was criminally responsible.

Fitness to plead – case example two – a man with a head injury Mr Davies was referred for an assessment in connection with charges of historical sexual abuse. He had pleaded not guilty and was due to attend a trial at Crown Court. Mr Davies was in his sixties and had suffered a series of strokes three years previous to the allegations been made.

The assessment included a detailed background history, assessment of mental health, cognitive functioning/IQ, adaptive functioning, assessment of executive functioning and memory.

Although Mr Davies non-verbal IQ was found to be in the normal range he presented with cognitive deficits in working memory and verbal comprehension which impacted on his ability to respond verbally to questions put to him. Mr Davies was relatively independent in the home but required support to access the community. Before his stroke Mr Davies was of average intelligence had worked as a bus driver. Mr Davies was found to have a good understanding of the charges against him, the role of the professionals involved and of the prosecution evidence.

It was concluded that with the appropriate support Mr Davies did have capacity to stand trial as long as the recommendations suggested were put in place. This included the use of an intermediary to support Mr Davies throughout the whole of the trial process and reasonable adjustments being made e.g. extra breaks in order to recap and summarise proceedings, practical support getting to and from the Court, avoiding leading questions during cross examination and questions to be written down with extra time allowed for Mr Davies to formulate a considered response.

References: Assessment of Capacity in Adults: Interim Guidance for Psychologists (2006), The British Psychological Society.

Code of Practice for Mental Capacity Act (2005), Department of Health.

Unfitness to Plead, Volume one and two, (2016) Law Commission.

Dr Sounthy Perinpanayagam MBBS, MRCPsych, DPM

Adolescent & Adult Psychiatrist Areas of Expertise:

Dr Sounthy Perinpanayagam is a consultant psychiatrist and has been a specialist advisor in adolescent psychiatry to the NE Thames region.

He has undertaken extensive training in psychodynamics and has experience in residential work with adolescents, psychoanalytical psychotherapy, family therapy, small group therapy and forensic psychiatry.

Dr Perinpanayagam can act as an expert witness, including the preparation of medico legal reports and appearing in court, in cases involving all of these areas of expertise. He can take instructions on behalf of either claimant or defendant.

Dr Sounthy Perinpanayagam MBBS, MRCPsych, DPM Adolescent & Adult Psychiatrist 020 8452 3489 020 7813 5723 07774 235005 sounthyperin@aol.com

2019

Federation of Federation of

Expert witnesses Forensic Forensic & Expert&witnesses

Dr Pravir Sharma

FRCPsych DPM MSc MBBS Consultant Psychiatrist • 0121 227 0785 • 0121 227 0786 • 07747 563631 •info@privatepsychiatristbirmingham.co.uk • www.privatepsychiatristbirmingham.co.uk Dr Pravir Sharma specialises in mental health disorders in the elderly although he also has extensive experience of general adult psychiatry. He is experienced in assessing memory problems comprehensively and in the treatment of Alzheimer’s disease and difficult behaviours associated with it and other dementias.

He also has a special interest in treatment resistant anxiety and depressive illnesses.

Dr Sharma can act as an expert witness, including the preparation of medico legal reports and appearing in court, in personal injury and clinical negligence cases relating to these areas of expertise. He can prepare medico legal reports for road traffic accidents and other accidents in the work place as well as reports for employment tribunals.

Mental capacity: Dr Sharma has extensive experience of assessing capacity in complex cases where mental illness or memory disorders affect the person. He has prepared reports for the court of protection on matters concerning mental capacity, lasting power of attorney, testamentary capacity, capacity to make decisions concerning money affairs and care arrangements, and fitness to stand trial or follow court proceedings. He has extensive experience of the use of the Mental Health Act and is Section 12(2) approved.

Clinical negligence: Dr Sharma has experience of producing causation and condition reports in clinical negligence cases with respect to psychological injury and psychiatric illness. He does not take on paediatric cases involving children below 18 years of age and does not see clients for criminal court reports or forensic cases.

Dr Sharma can act on behalf of either claimant or defendant or as a Single Joint Expert. He is able to offer quick appointments and usually provides reports within 2-4 weeks of assessment.

Dr Sharma has consulting suites at: • Spire Little Aston Hospital, Little Aston Birmingham B74 3UP • Sutton Medical Consulting (Ashfurlong Surgery) 233, Tamworth Road, • Sutton Coldfield, Birmingham B75 6DX He can also see clients for medico legal report assessment at their homes.

Dr Sharma offers home visits for patients in the Midlands who are unable to travel.

Dr Nireeja Pradhan MBBS, FRCPsych, MA Medical Ethics & Law

Consultant Psychiatrist

Dr. Pradhan assesses clients nationally and normally provides reports one to two weeks from assessments (urgent reports in 2 -5 days). She is regarded as a leading Expert witness in Psychiatry and assists lawyers nationally with free expert medico-legal advice and by making referrals to fellow high quality psychiatrists and other medical specialty experts based on draft letter of instructions. (Please email draft letter of instruction to info@drpradhan.co.uk for appointments and quotes).

Expert Witness Awards Winner:

Consultant Psychiatrist of the Year 2017

Lawyers can submit case details online for instant appointments and quotes on her website www. drpradhan.co.uk Telephone Dr. Pradhan on 0800 161 3395 for free medico-legal advice and appointments.

Dr. Pradhan has extensive experience in provision expert witness reports across all areas of law for over 15 years. She has earnt a strong reputation with leading barristers for her comprehensive reports and court attendances. She has vast experience in Fast Track and Multi Track Personal Injury cases involving assessing psychiatric injuries in historic child abuse, clinical negligence Inc. Birth Injuries, personal injury cases Inc. catastrophic RTA’s, complex cases and equality act assessments.

Dr. Pradhan was awarded as Consultant Psychiatrist of the Year at Expert Witness Awards 2017.

Dr. Pradhan was also awarded the Fellowship of the Royal College of Psychiatrists for her expert witness services and excellence in psychiatry.

Working in the inner-city area of Birmingham as the lead Consultant Psychiatrist Dr. Pradhan has extensive clinical experience in patients with a range of complex mental health issues often precipitated by social factors. This highly relevant clinical expertise ensures that she is considered an appropriate psychiatrist to assess the General Adult population who may have suffered from sudden or past traumatic events whether mental, physical or emotional in civil and criminal matters.

Dr. Pradhan has been appointed on numerous panels in high profile cases as an expert and in high value and contentious cases involving numerous experts and court attendances where clients had been awarded record compensation.

Expert Witness Training: Dr. Pradhan has completed a comprehensive professional course in Medical Report Writing and Giving Expert Evidence in Court.

References from lawyers in Personal Injury, Clinical Negligence, Abuse, Employment Family Cases available upon request.

PERSONAL INJURY & MEDICAL NEGLIGENCE CASES : • Birth Injuries • Road Traffic Accidents • Workplace Accidents • Trauma Sequelae • Post-Traumatic Stress Disorder • Psychosomatic Disorders/ Munchausen / Malingering – fraudulent simulation or exaggeration of symptoms assessments • Psychopathology / Psychiatric Disorders • Anxiety Disorders / Depression / Stress Disorders • Psychiatry Injury due to Medical Negligence / Clinical Negligence • PTSD, Post-Traumatic Stress Disorder • Criminal Injuries : Victims • Victims of Abuse including childhood abuse • Employment Tribunals / Equality Act / DDA • Medical Negligence / Clinical Negligence Inc. catastrophic injuries • Fitness to work/ Return to Work • Sexual Harassment, Bullying, Racial Discrimination • Psychiatric Injury ; Depression, Anxiety , enduring personality change • Trauma Sequelae • Psychosomatic Disorders/ Munchausen / Malingering • RTA’s and Accidents at work • Psychopathology / Psychiatric Disorders • Anxiety Disorders / Depression • Psychiatric Injury / Stress Related • Medical Negligence / Clinical Negligence • Military Claims : PTSD, Bullying, Abuse • Catastrophic Injuries • Assessment of Adults who suffered Childhood Injury

CRIMINAL LAW : • Pre-sentencing reports • Fitness to Plead and Stand trial • Risk assessments including Arson • Pre-sentencing Reports • Suggestibility • Loss of control • Hospital Orders • Diminished Responsibility / Intent • Sexual / Violent crime • Parole Board Assessments • Mental Health Review Panels • Personality Disorders • Personality Disorders/Psychoses • Dangerousness/Risk Assessment • Violence/Self Harm/Suicide • Offender Assessment • Witness Assessment/ Testamentary Capacity • Abnormal Behaviour • Mental Disorders • Psychiatric Rehabilitation • Rape / Sexual abuse • Crime Victims / Torture Victims • Child Abuse • Section 18, Section 37 • Arson Cases • Murder Cases

Expert Witness Consultant Psychiatrist of the Year 2017

Dr Nireeja Pradhan receives her award

Consulting rooms nationwide Contact: Dr. Pradhan Tel: 0800 161 3395 E: contact@drpradhan.co.uk W: www.drpradhan.co.uk

Psychiatry Experts Chambers House 75 Harborne Road Birmingham B15 3DH

EMPLOYMENT LAW :

• Work Related stress • PTSD • Fitness to Work / Return to Work • Employment Tribunals / Equality Act • Psychiatric Injury: Depression, Anxiety, • Sexual Harassment • Bullying • Racial Discrimination

FAMILY LAW :

• Assessment of parents in child contact and custody cases • Parental Psychiatric assessments • Risk Assessments / Domestic Violence • Mental Capacity Assessments

IMMIGRATION & ASYLUM CASES : Training Extensively trained and experienced in CPR quality Expert Witness Reports Expert Training Expert Witness Training Membership Sweet & Maxwell Checked, Expert Witness Institute, Society of Expert Witnesses, Medico-Legal Society and APIL, Member of European Society for Traumatic Stress Studies, The Federation of Forensic and Expert Witnesses.

Dr. Pradhan offers free medico-legal advice and screening

Dr Naresh Buttan MBBS, DPH, DPM, DNB (Psy), CESR,Sec 12 (2) AC

Consultant Psychiatrist Tenacity Consulting Service Ltd PO Box 295, Glenfield Road, PLYMOUTH Devon PL5 9DB www.nuffieldhealth.com/consultants

Areas of Expertise:

I specialise in general adult psychiatry and have been working a consultant in NHS since February 2008. I previously worked in Australia and India as a Consultant Psychiatrist and Clinical Director since 2001.

My special interest areas are in transcultural psychiatry, asylum seekers and refugees’ mental health, impact of war, trauma and physical, emotional and sexual abuse on mental health, bullying and harassment at work and impact on mental health.

Also specialise in diagnosing and treating common and severe mental disorders such as: • ADHD. • Schizophrenia and psychoses including drug induced psychosis.

• Depression, bipolar mood disorders.

• Anxiety spectrum disorders including GAD, phobias, OCD and PTSD. • Dissociative conversion disorders.

• Eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder.

• Psychosexual disorders such as erectile dysfunction and impotency.

• Self-harming or suicidal behaviours.

• Personality disorders.

• Alcohol and drugs dependence.

Areas of Expertise: I’ve been working as a full time substantive Consultant Psychiatrist in NHS since Feb’08.

Previously, I worked as a Consultant, Clinical Director and Deputy Medical Superintendent in various hospitals in India & Australia since 2001.

I also specialise in using psycho-pharmacological (antidepressants, anti-psychotics, mood stabilizers) and psychotherapeutic treatments including CBT for mental illnesses.

I have provided Medicolegal Expert Witness Psychiatric Reports for over 50 cases to various legal firms and other organizations with high success rates. I’m able to see clients at mutually convenient places and times and provide time efficient high quality expert reports”.

I currently work in NHS contracted organization and also see patients privately at Harley Therapy Ltd, London and Nuffield Health Plymouth Hospital by appointments in my private time. For medico-legal cases, please contact me by phone or email to arrange appointments.

Dr Abbas Lohawala Consultant Neuropsychiatrist

Dr Lohawala has practised as a psychiatrist for 15 years and as a Consultant Neuropsychiatrist for the last 7 years. He works across the spectrum of NHS, Independent sector and Expert Witness fields in Neuropsychiatry.

He has a unique blend of qualifications and experience with Postgraduate Diplomas in Neuropsychiatry and Holistic psychotherapies . He was the Medical Lead for St Andrews Brain Injury Services and has worked for major Neuropsychiatry providers including Cambian, Huntercombe and BIRT groups.

He runs an outpatient Neuropsychiatry clinic in the NHS in Birmingham and acts as a Visiting Consultant Neuropsychiatrist at PJ-Care, providers of specialist Neurological care in addition to Expert Witness work. His skills stand out in being able to work with Complex Care clients with combinations of physical, psychiatric and cognitive disabilities.

He works in the Personal Injury and Clinical Negligence fields with 50:50 Claimant and Defendant instructions.

Areas of Expertise • • • • • • • •

Brain Injury- causation, severity and Post Concussion Syndrome.

Dementia -Early and Late Onset and Memory disorders in adults Alcohol induced Brain Injury and Korsakoff’s syndrome.

Somatisation, Conversion Disorders including Non Epileptic Attacks.

Huntingtons Disease Epilepsy and Sleep Disorders General Adult Psychiatric Disorders with combination of Physical, psychiatric and cognitive issues.

Capacity assessments for all above areas.

194 North Road Stoke Gifford South Gloucestershire BS34 8PH

0117 979 3773 07709 911052 abbas.lohawala@neurochambers.com www.mss-medicolegal.co.uk

Dr James Craig MB, ChB, MPhil, FRCPsych

Consultant Psychiatrist Jim Craig has had a rewarding 32 year career in NHS General Adult Psychiatry, followed by 10 years as consultant in Alcohol and Addictions at Castle Craig Hospital, Borders, Scotland, an independent hospital for those with these problems.

Since 2005 Jim has had increasing involvement with medico-legal practice through Mental Health tribunals Scotland and Pensions Appeals Tribunal for Scotland (Veterans' appeals for war injuries); designated medical practitioner for Mental Welfare Commission for Scotland; and in last five years writing reports for VETS UK, CICA and legal representatives.'

• • • • • • • •

Dr Craig’s Areas of Expertise Include

General adult psychiatry.

Alcohol and addictions.

Post-Traumatic Stress Disorder (PTSD).

Mental capacity.

Fitness to plead.

Pre-trial and pre-hearing independent psychiatric reports.

Veterans mental health, e.g. reports for VETS UK. Personal injury (psychological) post-crime/trauma, e.g. for CICA.

87 Greenbank Crescent EDNINBURGH Scotland EH10 5TB

07895 178604 jimcraig@doctors.net.uk

Dr Anantha P P Anilkumar MBBS, MRCPsych, CUBS (Civil & Family)

Consultant Psychiatrist I am Dr A.P.P. Anil Kumar, Consultant Psychiatrist at the Maudsley for the last thirteen years.

I have more than twenty one year’s experience in psychiatry, have been approved under section 12 of the mental health act and a member of the Royal College of Psychiatrists since July 2000.

I am included in the GMC specialist register, with general psychiatry as my speciality, and substance misuse psychiatry as my sub speciality. I accept instruction on Civil and Family cases only.

I have researched at the Institute of Psychiatry, Psychology and Neuroscience, King's College London for the last 17 years on clinically relevant areas. I have been a Royal College examiner, an interview panel member for CT and ST doctors and am a honorary clinical senior lecturer at IoPPN.

Federation of

Forensic & Expert witnesses

I have a wide range of experience in medico-legal work commencing from 2003. The cases I have undertaken (approximately 30-50 per year) have been in family proceedings, personal injury cases, housing related matters assessing in relation to the disability discrimination act, immigration cases, mental capacity assessments and employment tribunals. I have been awarded the Cardiff University Bond Solon Civil Expert Witness Certificate in April 2017 and the Family Expert Witness Certificate in October 2017.

I have recently been appointed as a Fee-paid Medical Member of the First-tier Tribunal Health, Education and Social Care Chamber (Mental Health).I also have an Honorary Clinical Senior Lecturer post at Institute of Psychiatry, Psychology and Neuroscience, since January 2016 and am the firm head for the Longitudinal Mental Health Placements for Medical Students at GKT School of Medical Education.

My areas of expertise include: • Psychosis- Schizophrenia, Acute Psychosis, First episode psychosis, Delusional Disorder • Substance misuse and Dual Diagnosis • Dissociation disorders, Post Traumatic Stress Disorder( PTSD) and Complex PTSD • Personality disorder.

• Anxiety and phobic disorders.

• Depression and other mood disorders.

• Adjustment disorder.

• Factitious illness.

• Impact of mental illness on parenting.

• Chronic pain.

• Bipolar disorder.

• Abuse and domestic violence.

For Further Information plase contact Dr Anilkumar

46A Selborne Road | Park Hill | CROYDON | Surrey | CR0 5JQ Mani - 07533268342 | Susan - smurchison@nhs.net | Nora - nora.roberts@slam.nhs.uk

www.dranilkumar.co.uk

Dr Harsh Jhingan Consultant Adult Psychiatrist

MBBS, MD (Psych), MRCPsych, CCST 2003, Section 12(2)

Areas of Expertise include:

I am section 12 approved. I have done reports for personal injury, clinical negligence, fitness to plead, PTSD, capacity assessments, stress at work place, occupational health, alcohol and drug dependence cases and tribunals.

For more information please contact Mr Jhingan 07969 384997 | hpjhingan@yahoo.co.in

Dr Sohom Das MBChB, MRCPsych, BSc, MSc Consultant Forensic Psychiatrist

Looking for a medico-legal expert?

Dr Sohom Das has extensive experience in undertaking medicolegal assessments. He regularly prepares high-quality reports on a number of psychiatric issues for a variety of courts, including the Criminal Court, Civil Court, Immigration Tribunals and Mental Health Review Tribunals, and has authored in excess of 500 reports in his career.

His specialist areas of expertise include: Civil court work • • • • • •

High value and complex personal injury cases High value and complex clinical negligence cases - including Breach of Duty, Causation, and Prognosis and Condition Historical sexual abuse Psychiatric consequences of a wide range of incidents and accidents - including post-traumatic stress disorder, issues at work and physical disability Recommendations for psychiatric treatment AvMA approved expert

Criminal court work • • • • • • •

Fitness to plead Defendants’ mental state at the time of offences Mental health disposals - including hospital orders, restriction orders and community orders Mental health defences - including not guilty by reason of insanity, diminished responsibility and automatism Capacity to form intent / mens rae Risk assessments - including violence, sexual offending and risk of reoffending Assessments carried out on male, female and adolescent defendants in secure hospitals, prisons and court

Other areas of expertise • • • • • • •

Mental health review tribunal reports Parole Board reports - including giving oral evidence Immigration tribunal reports Family court reports Employment tribunal reports - including grievance investigation assessments Formal capacity assessments Psychiatric assessments for housing issues

Dr Das can take instructions on behalf of either claimant or defendant or as a Single Joint Expert. He offers unlimited free telephone consultations to solicitors about any medicolegal case. His consultation rooms are based in North London, though he is able to travel to assessments.

sohom.das@nhs.net | www.sigmadeltapsych.co.uk

Dr Sunkanmi Osunsanmi Child/Adolescent Psychiatrist

MBBS, MSc, MRCPsych, Certificate in Family Law, Section 12 approved.

Dr Osunsanmi is a Consultant Psychiatrist based in Gloucestershire, his specialised area is Child and Adolescent Psychiatry.

His duties involve providing psychiatric leadership and input to a specialist Child and Adolescent Mental health team. He also provides psychiatric input to a countywide Neurodevelopmental Clinic and a Schoolbased Learning Disability Clinic. In his role as a clinician, he has extensive experience of a broad range of psychiatric and Neurodevelopmental difficulties in both in and out-patient settings.

His experience includes; • Expertise in psychopharmacology • neurodevelopmental disorders such as ADHD and ASD. • Cognitive Behavioural therapy • Behavioural modification and therapy • Medico-legal writing for MHA tribunals and the court systems • Assessment of capacity and consent • Use of standardised Continuous Performance tool for assessing ADHD in children, adolescents and adults •Ffitness to plead/stand trial assessment.

Dr Osunsanmi has published a number of book reviews relevant to child and adolescent psychiatry and articles in relevant scientific journals on ADHD and learning disability in the child and adolescent population. He has also presented (both Oral and Poster presentations) at a number of national and international conferences.

Training

Completed the Cardiff University Bond Solon Certificate course on Family law and procedures, British Association for Psychopharmacology scholarship award to attend the European College of Neuropsychopharmacology- was one of 3 selected candidates across the UK for the 1st school of Child/ Adolescent psychopharmacology- 2012. Fully up to date with CPD activities with the Royal College of Psychiatrists.

Membership

Member of the Royal College of Psychiatrist, membership awarded following success in the membership examinations (stages 1 and 2) in 2006. Registered with the General Medical Council, UK with full registration and on the specialist register of Child and Adolescent Psychiatrists. Section 12 (2) approved since 2006 and an Approved Clinician since 2010

The Devereux Centre Barton Road. Tewkesbury Gloucestershire GL20 5GJ 07785 785 647 osunsanmi@doctors.org.uk enquiries@edcapelimited.co.uk www.edcapelimited.co.uk

info@drrozhalari.co.uk | 01424 444130www.drrozhalari.co.uk | www.drrozhalari.co.uk

Consultant Clinical (Neuro) Psychologist I have experience of providing medico-legal reports in personal injury, capacity, accident trauma, PTSD, anxiety, depression, (neuro)psychological rehabilitation, work related stress, occupational injury, effects of medical negligence, and disability discrimination.

I specialize in neuropsychological assessment of cognitive, emotional and behavioral consequences of acquired brain injury in adults following road traffic accidents, assaults and assessment and diagnosis of ADHD and Aspergers and personality and risk assessments.

I undertake full educational assessments including assessment of such conditions as dyslexia and cognitive ability.

I have experience of preparing reports for family proceedings. My experience Includes: conducting psychological assessments, assessments of parenting, attachment, cognitive function, and risk (e.g. drugs and alcohol, domestic violence).

Specialists groups I work with include: Adolescents, Adults and older adults, adolescents, in patients and out patients, immigration and asylum.

I undertake risk assessments (HCR20 Version 3, START Assessments).

I have acted for both claimants and defendants and as a single and single joint expert.

Professional Skills •

Sept 2005 - Sept 2008: Doctorate in Clinical Psychology, Royal Holloway, University of London • July 2004 - July 2005: Diploma Clinical Hypnotherapy, British College of Clinical Hypnosis, London • Oct 1999 - Feb 2004: Doctor of Philosophy, Institute of Psychiatry, Kings College London • 1998 - 1999: MSc in Neuroscience, Institute of Psychiatry, Kings College, University of London

Membership of Professional Organisations Health Professions Council British Psychological Society • British Neuroscience Association • British Society of Clinical Hypnotherapy • Member of the Division of Clinical Psychology • The Federation of Forensic and Expert Witnesses •

Consulting at: Twickenham TW1 1EU 21 wimple street London W1G 8GG cardinal clinic in Windsor

•

Also

EXPERT IN MIND Astec House Sedlescombe Road South St Leonards on Sea East Sussex TN38 0TA

General Adult Psychiatrist Dr Elena Daniela Herescu is a Consultant Psychiatrist based in Kent.

She currently works with the community mental health team in reviewing patients in the community; formalising treatment and management plans and assessing their risk and needs. She is on the S136 rota and attends daily screening meetings and reviews referrals from primary care.

Dr Herescu also has experience as a Consultant in Intellectual Disabilities on a low secure forensic unit for people with intellectual disabilities and mental health problems.

Dr Herescu is Section 12 approved, and is fluent in English and Romanian.

Expertise in:

General Adult Psychiatry | Complex Mental Health Problems | Assessments Adult Learning Disabilities | Alcohol Misuse | Depression | Anxiety | Personality Disorders Behavioural issues | Addictions | Forensic Psychiatry | Intellectual Disabilities Conflict Resolution | Conflict Management | Emotional Intelligence

Membership:

On the Specialist Register in the United Kingdom since March 2012, Registered with a Licence to Practice with the General Medical Council (reg. no. 7069812,) Member of the Royal College of Psychiatrists, Approved under Section 12(2) of the Mental Health Act 1983 (amended 2007), Member of the British Medical Association, Responsible Office for Cambian Group since September 2017

Contact and instruct Dr Daniela Herescu:General Adult Psychiatrist T: 07990 575153 | E: daniela_herescu@yahoo.com

Dr Marta De Madariaga Lopez BSc, MSc, DClinPsy CPsych AFBPsS HCPC registered

Consultant Chartered Clinical Psychologist MSc in cognitve neuropsychology.

Doctorate in Clinical Psychology.

BSc (Hons) Psychology with Computing Science

W

orking with Harmonia Psychology Solutions, Dr de Madariaga Lopez, Consultant Chartered Psychologist, specialises in conducting psychological and neuropsychological assessments, formulations and treatments of individuals and families nationwide.

She has extensive experience in the assessment and treatment of vulnerable adults in community and hospital settings. We receive instructions from solicitors, and provide specialist and comprehensive court reports and expert evidence.

Expertise:

* Dementia * Acquired Brain Injury * Chronic Pain * Trauma * Emotional Health (e.g. anxiety, depression, stress, bereavement, etc.)

Family Court Personal injury • Capacity • Differential diagnosis • Post-traumatic conditions • Cognition •

•

Cases:

Memberships include:

•

• Associate Fellow of the Br Psychological Soc (AFBPsS); Div of Clinical Psychology and Faculty for the Psychology of Older People of the BPS; BABCP; • BPS Dir Chartered Psychologists; • Health Professionals Council; • The Federation of Forensic and Expert Witnesses;

O3301330072 07941 993 762 info@harmoniasolutions.co.uk www.harmoniasolutions.co.uk

Ms Mair Edwards B.A., B.Sc (Anrh/Hon), D. Clin.Psy, HCPC

Chartered Clinical Psychologist Dr Mair Edwards is a Doctor of Clinical Psychology who has specialised in the area of parental mental health, child behaviour problems, and parenting skills.

She received specialist training at the University of Tennessee in the observation, coding, and assessment of parent-child interactions, and specialist training in the assessment and therapy of child behaviour problems at the Bangor Child Behaviour Project, University of Wales, Bangor.

Until September 2001, she was employed as a Clinical Psychologist within NHS Child and Adolescent Mental Health teams in the North Wales area. Concurrently, from 1999 until September 2003, she held an academic appointment as Teaching Fellow in the School of Psychology, Bangor University, where she remains an Honorary Lecturer. She is often called upon to comment on psychological issues in the media.

Dr Edwards provides psychological assessments, training, and consultation to a wide range of private and public sector organisations and authorities, and accepts instructions for psychological reports in proceedings relating to children and young people and their parents. She also provides therapeutic services to children, young people, and adults.

All services can be offered in Welsh and/or English.

Membership: • Associate Fellow of the British Psychological Society (BPS), • Member of the Division of Clinical Psychology and Faculty for Children, Young People, and their Families • Registered with the Health and Care Professions Council (HCPC)

01248 715005 | post@cathcyf.co.uk | mairedwards@btinternet.com | www.cathcyf.co.uk

Dr Alfred White MD MBBS LRCP MRCS DPM FRCPsych Consultant Psychiatrist r Alfred White has over 35 years' experience acting as an expert witness including extensive court experience. He undertakes approximately 200 cases per year, taking instructions on behalf of both claimant and defendant and as a Single Joint Expert.

D

Dr White prepares reports on most aspects of psychiatry (excluding learning disability and child psychiatry) but specialises in:

• Trauma (personal injury) • Medical Negligence • Employment issues • Brain injury • Medically unexplained symptoms • Liaison Psychiatry (Hospital Conditions) His interest in trauma began with a research project in burns and other accidents (MD 1981) followed by research on the Birmingham pub bombings. His wide ranging experience also includes eating disorders, brain injury rehabilitation and liaison psychiatry.

Dr White is an examiner for the royal college of psychiatrists.

Dr Alfred White MD MBBS LRCP MRCS DPM FRCPsych Consultant Psychiatrist 17 Portland Road Edgbaston B16 9HN T: 0121 454 2217 07985 882 603 F: 0121 454 2217

Dr Tinnevely Ananthanarayanan MBBS FRCPsych DPM(Lond) DPM(RCSI)

Consultant Psychiatrist Dr Ananthanarayanan is a Consultant Psychiatrist with extensive experience in the NHS, treating various types of mental illnesses for 22 years, from 1981 to 2003. He was a Specialist Medical Visitor for the Lord Chancellor's Department from 2003 until June 2014. This work mainly involved Mental Capacity, Cognitive Assessment, Memory problems etc. due to organic brain conditions, such as Alzheimer's and other dementias, head injury and alcohol related brain damage. He was also a Medical Member of the Mental Health Tribunal from 1998 until June 2015, where he performed Mental Capacity Assessments and Mental Health Act Assessments during this period.

Over the years Dr Ananthanarayanan has given Independent Psychiatric Reports on Mental Capacity for the Court of Protection and other bodies, including giving opinion on patients’ fitness to plead in court. His experience has involved, mainly Mental Health Act Assessment for detained patients, also assessment of patients' Mental Capacity, to appear before the Tribunal, and understand the proceedings. Mostly he deals with civil cases involving capacity.

Dr Ananthanarayanan also appears in criminal cases, both for defence and prosecution in which mental capacity is an issue. In addition to this he attends court to provide expert evidence in criminal cases both defence and prosecution.

He has extensive experience in clinical and medico-legal aspects of Mental Health and given frequent independent psychiatric reports on patients appearing before for the Mental Health Tribunal. Special expertise in Mental Capacity, Cognitive Assessment, and memory problems, primarly due to organic and functional mental disorders.

Training Dr Ananthanarayanan has attended various courses over the years, as part of his continuing professional development and continues to do so. These courses were organised by the NHS, Royal College of Psychiatrists, British Medical Association (BMA), Court of Protection, Mental Health Tribunal and various other bodies. Throughout the year Dr Ananthanarayanan also attends medico legal courses which keep him up to date with relevant issues.

Membership He is a member of the British Medical Association, Royal College of Psychiatrists, Royal Society of Medicine and was a Medical Member of the Mental Health Tribunal for sixteen years, until June 2015.

He is a member of the expert witness panel for the Medical Protection Society.

15 De Burgh Gardens, Tadworth. Surrey. KT20 5LU. 07921 299110

Dr Sue O’Rourke

AFBPsS

Consultant Clinical Psychologist

Specialist in Deafness High quality and timely reports with 20 + years of experience of: • Criminal Cases: Fitness to plead • Personal injury: Specialist in trauma/historical abuse - EMDR trained • Family Proceedings: Assessment of adults in proceedings.

• Mental HealthReview Tribunals: Assessment of risk • Mental Capacity Assessments

07875 358574 | sueorourke@btinternet.com | www.deafexpert.co.uk

DR. DAWN BAILHAM

MSc Forensic Psychology, DClinpsych (Doctorate in Clinical Psychology), BSc (Hons) Psychology, AFBPS, CAT Practitioner

Dr. Dawn Bailham is able to draw on her background in forensic mental health, in which she has assessed and treated adults and children, together with her extensive academic training, to provide a highly professional, independent service as a Consultant Clinical Psychologist & Expert Witness.

A trained DBT therapist and qualified Cognitive Analytical Therapist (CAT Practitioner), Dr. Bailham has been a qualified Clinical Psychologist now for 14 years, working in a variety of settings dealing with people with complex mental health needs, as Dr. Bailham outlined in a recent interview: “My experience of working in the NHS within Child and Adolescent Mental Health Services (CAMHS), in Looked after Children’s Services, and adult Forensic Mental Health Inpatient Services has given me great insight in mental health issues. The insight and knowledge I have gained I have applied to Child and Family Law cases to gain an understanding of how they impact on parenting capacity, child development, and the emotional wellbeing of children.

Beginning working in forensic mental health has given me great insight into mental health issues within a legal framework and how they contribute to offending in Criminal Law and impact on parenting capacity and insight in family law cases. I feel an important aspect of my role in Expert Witness cases has been sharing psychological formulations to inform the Court, and to assist the Court in making sense of issues regarding parenting, child protection, and the future risk of offending, or victimisation of vulnerable adults and children.

I currently work in a residential care service on a part-time basis with young people aged 16 - 25 years with complex mental health problems and emerging personality disorders. I have recent experience of working with young adults with histories of sexually harmful behaviour some of which have had offending histories.

My role involves management, assessment and intervention to address clinical needs e.g. Cognitive Behavioural Therapy, Dialectical Behavior Therapy and Cognitive Analytical Therapy. I also have experience of developing and managing the running of a sex offender treatment programme. Prior to my role working in the forensic inpatient service I worked in an NHS community Child Adolescent and Mental Health Service (CAMHS) delivering DBT to adolescents with histories of self-harm, attempted suicide, and emerging personality disorders, some of which also had offending histories and were known to the Youth Offending Service. I have had previous experiences of developing and managing the delivery of a sex offender.

Consultant Clinical Psychologist & Expert Witness

A sign of Dr. Bailham’s commitment to further develop her knowledge-base is evident in that she has also obtained the Cardiff University Bond Solon certificate in Criminal Law. Offering her services as an Expert Witness for both the prosecution and defence, as a single or joint Expert, Dr. Bailham has attended court on numerous occasions to give expert evidence for cases relating to Family Law and more recently Criminal Law. Her key areas of interest are the development of personality disorders, post traumatic stress disorder, juvenile sex offending and applications of Cognitive Analytical Therapy (CAT).

“More recently I have been instructed by Local Authorities in pre-care proceeding cases to give my opinion in Child and Family cases particularly where there are child protection concerns,” Dr. Bailham told us, “The value of this as an Expert has been to guide Local Authorities in terms of appropriate psychological interventions for parents to sometimes prevent care proceedings, as well as provide a psychological understanding of why issues within families have developed. This can assist professionals in understanding parenting concerns, their communication with parents, and to be more empathic about how parenting difficulties have arisen.

In criminal cases as an Expert Witness I have been asked to give an opinion at the early stages of a case as to whether a perpetrator or victim has the capacity to instruct a solicitor, which has been helpful to inform the Courts especially with vulnerable adults who come into contact with the Criminal Justice Services.”

As you would expect of such a consummate professional, Dr. Bailham is an Associate Fellow of the British Psychological Society (BPS), a Practitioner Psychologist with the Health & Care Professions Council (HCPC), as well as being a Member of the National Organisation for Treatment of Sexual Abusers (NOTA).

Below you will find typical examples of the types of cases undertaken

by Dr. Bailham in her capacity as an Expert Witness: I have been instructed on a number of cases where domestic violence has been an issue in the family, and I have been asked my opinion on a parents‘ insight into these risks, their ability to protect their children, and the psychological impact on children. In terms of Child and Family Law I am often asked to assess parents where there may be personality difficulties, mental health problems, and/or substance misuse issues. More recently I have been asked to assess parents insight and ability to protect their children from adults with a sex offending history, this could be a parent with a history of this type of offence, or parents who associate with adults with this history.

I am often asked to assess children where the child has a history of sexually harmful behaviour, or young people who come into contact with the Criminal Justice Services for other offences.

With Criminal Law cases I am often instructed to assess vulnerable adults, or children who have been victims of crime; to assess the psychological impact on them, and their ability to instruct a solicitor. At other times I have been instructed to assess young people who come into contact with the Criminal Justice Services in terms of their mental health functioning, the presence of learning disabilities, and capacity to instruct and understand Court proceedings.

Mobile Tel: 07801 266 010 / Email: dawnbailhan@icloud.com

Dr Krishma Jethwa MBChB | MRCPsych | MMedSc | LLM (Mental Health Law

Psychiatric Reports I aim to provide prompt psychiatric reports to the highest professional standards for both Criminal and Civil Courts. I can assess clients nationwide including at my offices in Birmingham, solicitors offices throughout the country, prisons or at psychiatric hospitals.

Criminal Cases

Within criminal cases I can prepare reports in order to assess for the presence of mental disorders such as depression, bipolar affective disorder, schizophrenia, personality disorder as well as other conditions including co-morbid alcohol and substance misuse disorders. I can assist with the assessment of fitness to plead and stand trial, psychiatric defences, risk assessment and sentencing recommendations. I also have experience of providing oral evidence within Court. Within criminal cases I would require a letter of instruction, charge sheet / indictment, witness statements, copy of relevant exhibits, PNC print and any other relevant documents or reports already prepared as well as a copy of the patients GP/ Health Records.

Civil Cases

I am happy to prepare psychiatric reports within civil cases where there is a need to assess for the presence, severity and effects of mental disorder following traumatic events such as a road traffic accident or personal injury. In order to prepare a psychiatric report within such cases I would require a letter of instruction which could be from either party or jointly, relevant case papers and a copy of the patients GP / Health records.

CONSULTANT PSYCHIATRIST

I have co-authored the following publicatons: • Diminished Responsibilty and Alcohol. Advances in Psychiatric Treatment. (2010) • Letter about European Community Driving License published in the 30: 36. Psychiatric Bulletin. (2006).

• Admission physical examinations performed within the settings of the medium security. 9: 15. British Journal of Forensic Practice (2007).

• The effects of a crisis resolution and home based treatment team upon inpatient admissions. 31: 170-172.

Psychiatric Bulletin (2007).

• Careers in Forensic Psychiatry, 133-134, 7th. BMJ Careers. (2006).

• Teaching Forensic Psychiatry with Problem Based Learning. 29: 283. Medical Teacher (2007).

• Community Treatment Orders. 337: a613. British Medical Journal (2008).

Contact and instruct now at: 38 Harborne Road Edgbaston Birmingham B15 3HE

07702 088 878 krishmajethwa@gmail.com www.krishmajethwa.com

Phil has been director of Psychologica Ltd for over 20 years. He is a Chartered Occupational Psychologist with considerable experience addressing a range of human factors, within organizations of all types and sizes.

These include issues such as: • bullying in the workplace; • stress management, • leadership coaching and development; • staff assessment and selection; • and facilitation of organizational change.

Phil has been Managing Director of both large and small commercial companies before developing an interest in Organizational Development. Gaining a PhD in Psychology and Marketing – in the area of Service Quality and Leadership Style.

He is actively involved in research, and has published various articles and papers in respected journals and presented findings at international conferences, relating to the unique Psychologica Model™ which forms a basis for much of his work.

Psychologica works with both commercial organizations and private individuals, focusing on maximising effectiveness and well being in the workplace. The company offers a range of tools and services and have the capacity to manage projects of all sizes, using our partners and associates and drawing on the Psychologica Practitioner network and their diverse range of professional skills and expertise.

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Coaching Stress Management Bullying & Harassment Staff Selection Leadership Development Research Expert Witness work and reports GDPR Compliant

Dr Phil Bardzil “Over the years the Psychologica ModelTM and associated tools and techniques, have been used in a wide range of organizations of all kinds”

0161 883 2879 info@psychologica.co.uk www.psychologica.co.uk 26 Albert Street Ramsbottom Bury Lancs BL0 9EL