What is Forensic Psychiatry? Forensic psychiatry is a branch of medicine that focuses on the interface of law and mental health. It includes psychiatric consultation on a wide variety of legal matters including expert testimony, and clinical work with perpetrators and victims. A forensic psychiatrist/medical expert can assist individuals and institutions such as plaintiffs and defendants, attorneys, federal agencies, and the courts to evaluate claims ranging from medical and mental health malpractice to disability and sexual harassment. Organizations can benefit from an expert consultation evaluating the validity and response strategy to employment, supervisory responsibility, or maintenance of health care standards claims. When legal matters involve issues outside lay expertise, lawyers and judges regularly seek consultation from professionals in a wide variety of fields, including medical specialties. Sometimes the expertise is sought in an effort to provide the best possible information to judges or juries, but there are many other situations in which a prudent attorney or other party may request consultation. Forensic psychiatrists focus on the data or evidence within their areas of expertise. They are often consultants to advocates (lawyers) or courts, and at other times may participate in advocacy strategy, but they consider it unethical to combine their expert opinions (testimony, report, or affidavit, for example) with advocacy per se. Common areas of expertise: Managed Care and Medical Malpractice A physician who is an expert in the informed consent process and healthcare decision making can analyze and formulate an expert opinion applicable to specific questions, such as whether the standard for medical decision making and informed consent has been met both by the treating physician and the managed care organization. Employment Litigation In the workplace, the forensic psychiatrist may be asked to consider whether a claimed disability (e.g., a chronic general illness, such as Chronic Fatigue Syndrome, a chronic pain syndrome, such as Fibromyalgia, or a mental disorder, such as Depression or Obsessive-Compulsive Disorder) is valid and work stress related. Frequently asked employment related examination questions include, "Is a claimed impairment subject to the ADA mandate for accommodation?" "What is the appropriate organizational response to a sexual-harassment claim?" and "What is the validity and extent of sexual-harassment-related damage claims, such as emotional injury or Post-Traumatic Stress Disorder?" Criminal Justice Forensic Psychiatrists evaluate competency to stand trail, criminal responsibility and competency to be executed. Frequently asked questions range from evaluation of defendants for determining mitigating and treatable neuropsychiatric disorders. Family and Custody Issues Allegations such as lack of parental fitness or intentional infliction of emotional harm disputes sometimes arise in divorce and custody issues. Resolution of such charges may be helped by a forensic psychiatric examination. MUSC Forensic Psychiatry Experts: Susan Hardesty, MD, Fellowship Director for the Division of Forensic Psychiatry, is Board Certified in Psychiatry and Forensic Psychiatry. She is the Medical Director of the MUSC Institute of Psychiatry and Associate Professor of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. Her forensic interests are in medical malpractice and inpatient standards of care. Susan C. Knight, Ph.D., Assistant Professor, Forensic Psychiatry, is a clinical psychologist with expertise in forensic psychology. After receiving her doctorate in Clinical Psychology, she completed a Fellowship in Forensic Psychology at the University of Southern California-Institute of Psychiatry, Law and Behavioral Science, Keck School of Medicine, in Los Angeles, California. Specialty practice areas include assessment of legal competencies and capacities, criminal responsibility, diminished capacity, violence risk assessments, sentencing/dispositional assessments, sexual offender evaluations and psychological autopsies. She has worked with forensic populations in the county, state, and federal prison systems, has experience in conducting pre-trial and post-trial psychological forensic evaluations, and in providing consultation for both federal and state court systems. She has been qualified as an expert witness in federal court. Margaret Melikian, D.O., Assistant Professor, Forensic Psychiatry, is Board Certified in Psychiatry and Forensic Psychiatry. Dr. Melikian completed a Fellowship in Forensic Psychiatry at the University of South Carolina. She is experienced in forensic inpatient care; evaluation of competency to stand trial and criminal responsibility; expert testimony in General Sessions, Common Pleas, Family Court, and Probate Courts; workmen's compensation and disability evaluations; sexually violent predator evaluations; competency to be executed evaluations, and medical malpractice cases. She is also a staff psychiatrist for the Department of Juvenile Justice providing forensic evaluations for Family Court.
Medical University of South Carolina
Department of Psychiatry & Behavioral Sciences
Division of Forensic Psychiatry (843) 792-1461, Fax (843) 792-2254
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