Residency Training Program
in Psychiatry

Forensic Psychiatry: Connecticut Mental Health Center

In the Forensic Consulting area of Law & Psychiatry the division receives requests for insanity defense, pre-sentence, custody, termination of parental rights, civil commitment, independent medical evaluations for insurance purposes, capacity to practice evaluations for licensing boards, and forced medication evaluations. Depending on the residents' interests and abilities, we can focus and direct such evaluations to them. Civil and criminal cases are also referred to faculty, and the residents work with faculty on cases that are deemed educationally useful.

Along with Forensic Consulting, the New Haven Court Clinic represent the "home base" for residents in the Yale University School of Medicine Forensic Residency Program. A placement in this Division affords an opportunity for clinical work, research and teaching. The Court Clinic, within the Law and Psychiatry Division, has full responsibility for all "competency to stand trial" evaluations in the south-central part of Connecticut, involving three judicial districts, amounting to approximately 150-200 evaluations per year. We utilize these evaluations as the initial forensic experience for some psychiatric residents in our program. They are also used for residents who have not had any prior experience testifying in court. The forensic residents do these evaluations individually with supervision, or as part of a forensic team consisting of a physician, a psychologist and a social worker or a psychiatric nurse clinician. This team evaluation is authorized under Connecticut statutes to perform competency evaluations. In our experience these examinations allow the residents a "gentle" introduction to working with attorneys, observing prisoners in jail settings, and testifying under conditions that are relatively routine. The Court Clinic provides one to two evaluations per week of this type under close supervision until there is sufficient mastery in preparation of court reports, testifying and understanding the associated theoretical material, at which time more complicated cases will be assigned.

Supervision for this work is provided in several ways. First, all accepted cases have been screened by Dr. Zonana and/or senior faculty. Second, two seminars are scheduled weekly when all cases currently being evaluated are reviewed and discussed by Division faculty and trainees. As well there are 2 hours of individual supervision weekly. Following the group discussion, a report is drafted with the final report also reviewed by Dr. Zonana and/or other appropriate faculty. For the residents’ early cases, the faculty may accompany the residents to observe evaluations and testimony and provide feedback and supervision. As the trainees become more experienced, they work more independently, although the faculty continues to monitor and review all work and reports.

In the last half of the training year, forensic fellows who have demonstrated mastery in the evaluation and formulations of cases are provided the opportunity to supervise some work of beginning psyvhiatry residents [who participate in competency to stand trial or other cases] and to make contributions to the training seminars. In the latter context, they will be asked to review and present discussions of didactic material to the group.

Seminar for Scholarship & Coursework

Scholarly activities are addressed in research seminars. The purpose of the seminar is to focus on scholarship in forensic psychiatry, providing the members the opportunity to participate in reviews of forensic literature and preparations of scholarly works. The Scholarship Seminar focuses on scholarship and selected forensic topics with a mock trial experience. Fellows are required to publish a case review in the Legal Digest section of the Journal of the American Academy of Psychiatry and Law.

Other coursework and seminars are a part of a fellow’s weekly schedule, including a review of Landmark Cases, a review of important legal cases impacting a mental health; the Law and Psychiatry elective, a selection of relevant and timely topics; and the Competency to Stand Trial Clinic. One of the most popular weekly classes is the Friday Law & Psychiatry Seminar where fellows, students, and faculty gather to discuss cases that are currently being evaluated.

The American Academy of Psychiatry and Law Annual Conference

Each year the L& P division funds the fellows’ attendance at the annual AAPL conference and Board Review Course. Fellows are encouraged to prepare submissions for the AAPL Annual Meeting to occur shortly after completion of the training year.

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