Child psychiatry and child protection litigation
Julia Brophy
What do the courts require of a
clinical expert in child and adolescent psychiatry?
How can clinical expert opinion be developed to improve family
justice?
In the decade following the Children
Act 1989 two issues have emerged as indisputable. First, care
proceedings are a multi-disciplinary exercise and second, child and
adolescent psychiatrists are key players providing the majority of
expert evidence. This book is based upon a study that is the first
to analyse and digest the views and practice of these clinicians
after more than a decade's experience with the Children Act.
The text examines the Act itself and
what courts require of experts; the institutional and contractual
base from which these clinicians approach medico-legal work; their
own views of their added value to proceedings; and how this field
of work should be taken forward, both by the family justice system
and by the clinical community.
In a policy environment in which
multi-disciplinary and multi-agency approaches to child abuse and
neglect are vital and where evidence-based practice increasingly
dictates clinical approaches, this book provides vital information
for setting a new agenda for current practice and future policy
developments. It addresses complex and controversial issues in this
field and the text will be central to future education and training
initiatives for:
- new and established child and adolescent psychiatrists
- lawyers, and academics in law, social work and socio-legal
studies
- judges, magistrates and court clerks
- guardians and court welfare officers in CAFCASS
- social workers, team managers and heads of children and
families services in local authorities.
Features of this volume
include:
- a thorough examination of the Children Act 1989
- detailed discussion of what the courts require of a clinical
expert
- discussion of how clinical opinion can be developed to improve
family justice
Contents
- List of tables, boxes and
figures
- Foreword
- Preface
- Acknowledgements
- Introduction
Background • The sample • The structure of
the book
1. The Children
Act 1989: a new landscape for the work of expert
witnesses
The Act – a
milestone in family proceedings • The principles that guide the
courts • A new court structure for family proceedings • Local
authority support for children and families • Proceedings for care
and supervision applications • A new landscape for experts • The
use of experts following the Children Act
1989
2. NHS structures
and contracts: the context in which child psychiatrists meet the
needs set by care proceedings
Introduction • From welfare state to welfare markets?
Medico-legal work during the NHS reforms at the beginning of the
1990s • Custom and practice or contractual obligation? The work of
the child psychiatrist in child protection litigation • Waiting
lists for medico-legal work • Working practices: working alone or
in a multi-disciplinary team • Ethical dilemmas: doctor to the
family and an adviser to the court? • Numbers of cases, numbers of
appointments and length of experience in clinical and legal arenas
• Conclusions
3. The bearers of
gifts? What do child psychiatrists consider they bring to child
care proceedings?
Introduction
• Presenting problems • What do parties generally want from child
psychiatrists? • Ethical dilemmas: making recommendations as to
children’s future therapeutic needs • The risk assessment – a
multi-professional exercise • Social work assessments • ‘Added
value’: what do child psychiatrists consider they bring to the task
of assessing families that is different from that of a social
worker? • Underpinning theoretical perspectives and techniques •
Assessing children and parents from Black and other ethnic minority
households • ‘Gilding the lily’: using psychiatrists to add status
and power • More ‘added values’ from child psychiatrists •
Conclusions
4. The new legal
agenda: those ‘on the receiving end’
Introduction • ‘On the receiving end’: letters of
instruction after the Act • Joint letters of instruction – time for
clinicians to debate? •Writing reports for courts • The content of
reports and the language of recommendations • Using research in
court reports – ‘evidence-based practice’ and strategic planning •
‘On the receiving end’: improvements to the work of experts
following the 1989 Children Act
5. A new clinical
agenda: challenges for child protection
litigation
Introduction • The
‘forensic’ exercise and children’s future therapeutic needs: a need
for debate • Competing expert opinions • The ‘texture’ of expert
evidence • The failures of the 1989 Children Act •
Conclusions
6. Child psychiatrists and the family
justice system: a multi-disciplinary, multi-agency
agenda
Introduction • Service
provision for the twenty-first century • The tasks of the child
psychiatrist: legal and welfare discourses
- Appendix
The sampling procedure
- References
- Index