The Uses and Misuses of the DSM in Forensic Settings

The purpose of this paper is to present in broad summary our views—gained through experiences interacting in the legal system—concerning some of the more significant issues that trouble the legal/psychiatric interface. Even when a psychiatric diagnosis is the reliable and accurate result of appropriate evaluation methods and proper documentation, it may not be helpful in answering the questions posed to mental health professionals by the legal system. The Diagnostic and Statistical Manual provides explicit cautions that its clinical descriptions of mental disorder do not always map well with legal concepts of mental illness or abnormality. This is an inherent tension that accurate psychiatric diagnosis can reduce, but not eliminate. The relationship between psychiatry and the law continues to evolve and we hope will improve with greater understanding of the possible misunderstandings.