A study of forensic psychiatric screening reports and their relationship to full psychiatric reports

In Norway the prosecuting authorities can request a forensic psychiatric screening report in order to determine whether a full forensic psychiatric report is required. This study explores three research questions. Are such screening reports considered relevant by the prosecution authorities? To what extent are their recommendations followed? What is the concordance of the conclusions of the screening reports and the full reports? This study analysed the screening reports issued on 419 defendants by Oslo Police District's Office for Forensic Psychiatry in 2002-2005, and the 91 (22%) full reports issued on these defendants. All reports were evaluated using a structured rating form. Of the 118 screening reports that recommended a full report, 50% were followed up by the prosecution authorities. In contrast, non-recommendation of a full report was almost always followed, while 16% of open recommendations resulted in a full report. Instigation of a full report was significantly associated with major crimes, and with positive recommendation compared to open recommendation. The concordance between screening and full reports was 46% regarding psychosis, 78% regarding unconsciousness, and 94% regarding mental retardation. Based on these findings, the value of the system of screening reports seems to lie primarily in negative recommendations. Low concordance between screening and full reports, and the limited follow-up of expert recommendations for full reports, indicate that the system has questionable validity.