Forensic psychiatry is concerned with the assessment and treatment of mentally disordered offenders, the management and supervision of patients who represent a high risk of harm to others, and the provision of psychiatric expertise to the criminal justice system, in particular the Courts. Forensic psychiatrists practice in a variety of settings, including in-patient units of varying levels of security, community teams, and prisons. Multi-agency working, and liaison between different services, is an important part of the role.

Forensic psychiatry is based on detailed assessment and understanding of patients, their mental disorders, and their behaviour. Caseloads are generally smaller than in general psychiatry, with relatively few admissions and discharges, but work is more intensive, and length of treatment both in hospital and in the community is greater. It appeals to psychiatrists who prefer to work in depth with the same group of patients over a prolonged period. Forensic psychiatrists often work in settings where the medical perspective may be overridden by other considerations. in these cases, the ability to understand that other agencies often have the final decision-making authority, and to work effectively in situations where the Consultant's ability to determine the course of treatment may be very limited, without becoming unduly frustrated, is important. Working constructively with other agencies and accepting that, at times, the Consultant Psychiatrist may have only a subordinate role to play is vital.

Forensic psychiatrists are often expected to present psychiatric evidence and opinions to non-medical audiences such as Courts, juries, or the Home Office. This requires the ability to express complex technical issues in understandable ways, while still ensuring that the complexities of the psychiatric assessment are retained. First-rate communication skills, both written and verbal, are essential. Forensic psychiatrists also need to develop a good working knowledge of the legal system and of the law, particularly criminal , mental health and personal injury . Issues of responsibility and causation are never far away, and there are often moral and ethical dilemmas to resolve. Forensic psychiatry appeals to people who enjoy this interplay between medical, legal, and philosophical issues.

Forensic training in the Eastern Deanery is based at two medium secure units, one in Norwich (Norvic Clinic) and one at Runwell Hospital near Basildon. There are additional placements available at low secure units in Cambridge (George Mackenzie House) and Great Yarmouth (Coastlands), and a possible future placement in Luton (Orchard Clinic). Trainees will be expected to rotate between one of the medium secure units, which will normally be the first placement, and one of the low secure units, but rotation between the two medium secure units is not required.

Each placement offers a combination of in-patient and community work, with the opportunity to carry out assessments and to provide forensic opinions to other agencies. Regular sessions are undertaken in local prisons, and a range of prison facilities (remand, long-term, specialist, young offender, female) are accessible locally. One of two national pilot sites for the treatment of Dangerous and Severe Personality Disorder (DSPD) within the Prison Service is based in this region and linked to the Norvic Clinic, which may in future be available for training placements.

Additional experience of high-secure care, adolescent forensic psychiatry and learning disability forensic psychiatry, is arranged by shorter placements in other areas, subject to the needs of the trainee. Additional experience, including psychotherapy, addiction psychiatry, multi-agency working, sex-offender treatment and neuropsychiatry are also available.

Further details of the training scheme, academic programme, and research opportunities are available from Dr Christopher Jones, Programme Director