Examining the written word: An audit of psychiatric medical reports in the general hospital setting

Dr KC Soh1

1Department of Psychological Medicine, Khoo Teck Puat Hospital,  , Singapore

Introduction

The focus of psychiatric services in the general hospital setting is clinical care for the community-based population. This represents a departure from the subspecialized role of evaluating mental health and state of mind in the criminal context. Nevertheless, hospital patients still run into encounters with various aspects of the law, both civil and criminal. This presents an avenue for the psychiatrist to provide meaningful input, in order to advise the Court and facilitate legal proceedings. An audit of the medical reports would serve to provide useful information about the current service load and help to chart the direction ahead.

Aim

This audit serves to quantify the department’s service load, determine what proportion of these reports pertain to legal matters, and delineate the areas of demand.

Methods

Hard-copy of the medical reports produced over the 2017 calendar year were physically reviewed by the author. Information captured included the requesting party, rationale for requesting the report, and the patients’ diagnosis.

Results

A total of 310 psychiatric medical reports were produced over the 2017 calendar year. Behind employers, lawyers formed the second-largest group of addressees with 78 reports (25.2%) written to them. Police had requested for 28 reports (9.0%). Reports pertaining to legal matters constituted the largest segment, with 116 reports (37.4%) written. The top 3 requests were for assessment of mental capacity (such as testamentary capacity, handling financial transactions and understanding court proceedings), trauma-related psychiatric conditions and criminal matters.

Conclusion

Report-writing is an important means of conveying medical information towards serving the needs of the Court. This audit has highlighted that a substantial portion of the psychiatric medical reports produced by the author’s department does have a forensic role beyond routine clinical care.


Biography:

Dr Soh KC received his medical education in Singapore, having obtained specialist qualifications as a Psychiatrist not long ago in 2017. He has a keen interest in the workings of the legal system, and how mental health professionals can provide meaningful input in their duty to the Court. His line of work in the general hospital setting presents an interface with a departure from the usual thrust of criminal forensic work, with emphasis on civil forensic matters. He hopes that his background and exposure at work would allow him to offer congress participants a unique perspective.