ABSTRACT

In England and Wales, a finding that a patient is unfit to plead can result in compulsory admission to hospital for treatment under the Mental Health Act (1983) or the Criminal Procedure (Insanity and Unfitness to Plead) Act (1991). It is a statutory requirement that two psychiatrists' opinions are presented to the court as to whether or not the defendant is fit to stand trial once this issue has been raised. However, the clinical assessment of fitness to stand trial can delay the legal process, and it can also consume considerable resources of both the healthcare and criminal justice systems. It is therefore essential that the clinician's evaluation be both a valid and reliable one.