by Gene Deisinger, Ph.D.
Q: What is the role of a forensic psychologist/psychiatrist -- as an independent examiner -- in supplementing an effective threat assessment / management process?
A: There is some confusion about the role and purpose (and limitations) of a forensic psychologist/psychiatrist as an independent examiner in conducting "Direct Threat" and/or Fitness for Duty evaluations. These evaluations are often useful in supplementing an effective threat assessment and management process. We have found independent forensic examinations both to be over-used (e.g., being mandated when it would not be lawful to do so) -- and also under-used (e.g. when such expertise could inform a threat assessment team’s perspective on managing a case).
A psychological evaluation of this sort is appropriate under the following conditions:
- when there is a reasonable belief that a person of concern (i.e., a student or employee) may pose a direct threat (as defined by law) to the campus/workplace/others
AND
- that such potential threat may (reasonably) be due to a psychological/psychiatric/medical condition or disability.
The fundamental question for an examination of this sort is whether the subject of the evaluation poses a direct threat due to a mental disorder or disability; and/or whether, due to a medical condition or disability, there is evidence that the subject cannot safely and effectively perform the essential functions of their position.
If the examination finds that psychological conditions are causing/contributing to the threat posed by the subject, then consideration is given to mental health interventions to ameliorate symptoms and mitigate risk, and (to where appropriate), what accommodations the workplace may consider for the person to continue enrollment/employment. Note that these issues and outcomes of a forensic psychological or psychiatric examination are not to be equated with the threat management process, which is an operational, problem-solving approach to preventing and mitigating risk (rather than predicting risk). An effective threat management strategy is multi-dimensional in nature, and is not solely focused on mental health issues or interventions.
Finding a Qualified Examiner
Independent evaluations (for Direct Threat, Fitness for Duty, or forensic purposes) are highly specialized areas of practice and go well beyond administration of a standardized psychological test and a brief interview. Board certification (e.g., ABPP) in forensic psychology would be good evidence of expertise, but it is not the only consideration. As with all determinations of expertise, one must consider the relevant education, training, and experience of the professional in conducting these evaluations. The American Pychology-Law Society and the American Psychological Association Council of Representatives have developed and approved recognized specialty guidelines for forensic psychologists (see: www.apa.org/practice/guidelines/forensic-psychology.pdf).
Professionals with experience in conducting pre-employment and/or fitness for duty evaluations MAY have relevant experience but those evaluations are not fully the same as a forensic/direct threat evaluation. There are differing aspects of law and research that inform the different (but related) fields. A former law enforcement officer, or physician or generalist psychologist is NOT competent to perform such evaluations. However, each of those persons may have skills that may supplement a threat assessment/management process.
For educational institutions and for employers, we recommend that, before the need arises in a particular case, it is helpful to have already identified professionals with demonstrated expertise in this area and to have established referral arrangements with professionals. In some areas of the country, these professionals may be few and far between so it will be important to seek out such resources before a critical need arises. Where possible, it is helpful to have a couple of qualified experts available to the institution, so that if one is not available in a timely manner, or has a conflict of interest, the other is available to provide the evaluation.
It is preferable to have these evaluations conducted by persons external to your organization, both to minimize perceptions of bias, and because few campuses have clinical services that are staffed with persons that are qualified to conduct the evaluations. Even where an institutions may have qualified experts on staff (e.g., with a university hospital/clinic, medical school or graduate program) there is significant value in utilizing an external evaluator to provide an objective and independent assessment of the case. This greatly minimizes the potential for a conflict of interest, or any dual relationships that may have otherwise arisen.
Finally, the issues involved with forensic/direct threat evaluations are many and varied, and there are significant aspects of law and professional standards that impact on ethical and lawful practice with such evaluations. We recommend consulting with legal counsel (who has knowledge and experience of those issues) when considering such evaluations, to ensure compliance with relevant employment and educational laws and policies.
