A/Prof Leanne Payne1,2, Dr Isabel Wesdorp1, Dr Carrick Anderson1, Dr Mark Barnes1, Dr Simon Burton1, Dr Jonathan Bowers3, Ms Alexandra Green1, Ms Courtney Craig-Jones1, Dr Elissa Waterson1, Prof Ed Heffernan1,2
1Queensland Forensic Mental Health Service, Brisbane, Australia, 2School of Public Health, The University of Queensland, Brisbane, Australia, 3The Park, Centre for Mental Health, Wacol, Australia
Biography:
Substantively the Operations Manager for Queensland Forensic Mental Health Services, Metro North, Alexandra Green is currently in a Project Director role leading strategic service improvement, governance and system redesign initiatives. A social worker by profession, she has extensive experience across forensic mental health, including clinical practice, operational leadership and service development. Alexandra has contributed to research examining the effectiveness of the Queensland Court Liaison Service. She is committed to advancing contemporary forensic mental health services through collaboration, innovation and evidence-informed practice.
Abstract:
Specialist court liaison services provide independent medicolegal recommendations regarding fitness to stand trial and the defence of unsoundness of mind to assist Magistrates in making informed judicial determinations. Despite the central role of these medicolegal recommendations within the criminal justice system, relatively little is known about the characteristics of people referred for assessment or the extent to which judicial determinations align with these recommendations. This presentation reports findings from a five-year retrospective cohort study of all adults referred to the Queensland Court Liaison Service for a medicolegal assessment between July 2018 and June 2023 (2,970 consumers; 3,341 reports). Consumers assessed as unfit for trial were more likely to have cognitive impairment, while those assessed as fit but deprived of statutory capacity relating to unsoundness of mind were more likely to be engaged with public mental health services and to have mood disorders. Aboriginal and Torres Strait Islander consumers had significantly lower adjusted odds of being assessed as deprived of statutory capacity relating to unsoundness of mind. Among cases where judicial outcomes were available, concordance between medicolegal recommendations and judicial determinations was high, particularly for permanent unfitness for trial and recommendations supporting the defence of unsoundness of mind. These findings demonstrate how specialist medicolegal assessment supports fair, evidence-informed decision-making, balancing the rights of individuals experiencing mental illness with the interests of justice and community safety.