• History
  
• Evaluation Services
  
• Training & Research
  
• Family Information
  
• Mission, Vision & Values
  
• Treatment Services
  

Appromixely 3100 diagnostic evaluations are performed each year for the ciminal courts and 250 admissions to the Center processed. The Center is affiliated with the University of Michigan, Department of Psychiatry and other universities (Michigan State and Wayne State) and offers both a Psychiatry Fellowship Program (affiliated with U of M) and a Post- Doctoral Fellowship in Forensic Psychology. The Center staffing currently consist of approximately 525 employees.


Evaluation Services Unit

The Evaluation Unit at the Center for Forensic Psychiatry (CFP) conducts evaluations for all of the district and circuit criminal courts in the State of Michigan's 83 counties. Several thousand defendants are evaluated annually regarding charges ranging from minor misdemeanors to serious felonies. Examinees are typically adults although some adolescents and children are also examined. Evaluation issues often involve questions about competency to stand trial, criminal responsibility and diminished capacity. Less frequently, competency to waive Miranda, competency to be sentenced, juvenile waiver, sentencing and pre-sentencing recommendations, dangerousness and other issues may also be the focus of evaluations.

All evaluations are ordered by the court. Competency examinations may be initiated by any court officer, while criminal responsibility examinations are initiated by defense counsel. Examinations are typically conducted during the morning hours, Monday through Friday at the CFP.

Defendants may be on bond, in which case they are responsible for their own transportation to the CFP. Incarcerated defendants are transported to the CFP by sheriff's deputies. At the conclusion of the examination, incarcerated defendants are returned to jail. Additionally, the Evaluation Unit maintains satellite facilities at the Kent County Correctional Facility, Marquette County Sheriff's Department and the Grand Traverse County Sheriff s Department for evaluation of defendants from near those areas. Once court orders have been received by the CFP, scheduling is done by the CFP Forensic Services Department. Forensic Services also arranges for foreign language and deaf interpreter services when these are needed.

The Evaluation Unit is staffed by 21 doctoral-level psychologists and 2 psychiatrists. Other psychiatrists, psychologists and social workers are available for consultation. Two masters-level psychologists are also assigned to the Evaluation Unit with responsibility for administering psychological testing. Neuropsychological assessment services are provided as needed by doctoral-level neuropsychologists. An examination typically consists of an interview of two hours or more, followed by psychological testing as needed. Examinees are routinely administered the Minnesota Multiphasic Personality Inventory - 2 (MMPI-2). Examinees are expected to discuss their criminal charges, their backgrounds and their current functioning. Persons with histories of psychiatric treatment are asked to provide releases of information so their psychiatric records can be obtained.

For a more complete description of Evaluation Unit services see: Benedek, E. (Ed.) (I 966). New directions for mental health services: Emerging issues in forensic Psychiatry: From the clinic to the courthouse. 69, Spring 1996, Jossey-Bass Publishers.


Training & Research

The training of clinical staff at the Center for Forensic Psychiatry is accomplished through a collaborative effort of the discipline directors including social work, psychology, psychiatry, security, activity services, staff medical library, nursing and the facility director and the director of training and research. The core curriculum for all center employees is determined through the Training and Research Committee chaired by the Training and Research Department Director.

Training and Research Committee surveys the staff for educational program recommendations and plans training opportunities as appropriate. The Center for Forensic Psychiatry Training and Research Department is accreditated by the Michigan Medical Society and is responsible for scheduling Continuing Medical Education programs in compliance with the Michigan Medical Society requirements.

The Center for Forensic Psychiatry is mandated to provide research in various aspects of mental illness and the law. All research projects must be approved through the Training and Research Department and meet CFP standards and policy for conducting research and maintaining confidentiality.

The Training and Research Department maintains a Staff Medical/Legal Library in support of informational, educational, research-related needs, and administrative services.

The Training and Research Department oversees the Forensic Psychiatry Residence Program in affiliation with the University of Michigan Medical School.

THE CENTER FOR FORENSIC PSYCHIATRY AND THE UNIVERSITY OF MICHIGAN DEPARTMENT OF PSYCHIATRY FORENSIC PSYCHIATRY RESIDENCY PROGRAM

Stephen C Cook, M.D., Training Director

Program Description

The Psychiatry Residency Program in forensic psychiatry is a one-year, post-residency training program for psychiatrists planning careers in forensic or correctional psychiatry. The program is accredited by the Accreditation Council of Graduate Medical Education. Board certified (American Board of Psychiatry and neurology) general psychiatrists in good standing who complete this program are qualified to sit for the sub-specialty examination in forensic psychiatry.

Clinical Rotations

Residents receive clinical training at three major sites in four major settings: Inpatient treatment units at the Center for Forensic Psychiatry; Evaluation Services unit of the Center for Forensic Psychiatry; The University of Michigan Medical Center; and the Scott Correctional facility, a state prison for women located about 20 minutes from the medical center.

Center for Forensic Psychiatry --- Inpatient

Most inpatients at the Center have been found not guilty by reason of insanity or incompetent to stand trial. Residents function both as treating psychiatrists for their own patients, and as forensic examiners for the patients of other clinicians. They receive ongoing supervision in the management of forensic patients with particular emphasis on clinical problems such as suicide, malingering, amnesia, self-injurious behavior, violence, psychosis, substance abuse, and antisocial behavior. Residents prepare psychiatric reports and provide testimony for the courts, particularly competency to-stand-trial evaluations and clinical certificates for continued, involuntary hospitalization. Other important forensic issues encountered on inpatient units include the right to treatment, the right to refuse treatment, informed consent, and confidentiality/privilege. Typical case loads of 2-3 patients are carefully monitored to provide exposure to a variety of diagnostic groups, legal issues, and offenses.

Center for Forensic Psychiatry --- Evaluation Services Unit

In order to obtain certification as consulting Forensic Examiners under Michigan Law, residents observe at least five competency to stand trial evaluations and five criminal responsibility evaluations in the Evaluation Services Unit. They then conduct five supervised competency evaluations and five criminal responsibility evaluations; the final evaluation regarding each issues is supervised by the Director of Training and Research. Residents observe court testimony, participate in a mock trial, and provide testimony when required in cases they have examined. Other forensic issues arising in the evaluation services unit include Miranda rights, competency to be sentenced, juvenile waiver, and pre-sentencing recommendations.

University of Michigan Health System -- Legal Regulation and Civil Forensic Psychiatry

The University of Michigan Health System and the practices of faculty forensic psychiatrists on staff serve as the venues for this rotation. Residents consult to a general psychiatric service on issues related to the legal regulation of psychiatric practice, such as civil commitment, confidentiality, refusal of treatment and the ‘right to die", emergency treatment, decision-making competency, guardianship and conservatorship, etc. They gain experience in psychiatric aspects of civil litigation such as malpractice, disability, sexual harassment, psychic injury related to trauma, and child custody, and in administrative aspects of forensic psychiatry. The rotation includes three major components. First, residents attend a monthly conference including faculty from the forensic psychiatry program and from the consultation-liaison service of the University of Michigan Department of Psychiatry, where cases and questions pertaining to the law/psychiatry interface represented for consultation and educational purposes. Second, residents meet regularly with the hospital attorney of the University of Michigan Health System to discuss matters relating to the legal regulation of psychiatry, with particular reference to active problems, law suits, and policy issues at the hospital. Third, residents observe and assist experienced forensic psychiatrists, both in private practice and at the Child and Adolescent Psychiatric Hospital, engaged in the full range of civil controversies.

Scott Correctional Facility/Corrections Mental Health Program

Scott Correctional Facility is a state prison for women, housing convicts at all security levels. It is a modern correctional structure, clean, attractive, and well maintained. Psychiatric services at Scott include a "Residential Treatment Program", the major venue for the first three months of the rotating; and an "outpatient" clinic, serving inmates from the general prisoner population, to which residents rotate for an additional three months. Major clinical and forensic issues include mental health screening at reception; suicide risk assessment; self-mutilation; malingering; somatization; psychopathy; involuntary treatment; consultation with custodial staff; disposition of prisoners; violence risk assessment; and institutional policies governing mentally ill prisoners, such as the use of segregation. Residents also have opportunities to visit mental health programs at other state prisons and to participate in administrative activities at the Bureau of Forensic Mental Health Services, with offices near the Center for Forensic psychiatry.

DIDACTIC PROGRAM

Mastery of forensic psychiatry requires immersion in a knowledge base and a style of thinking that are foreign to most clinicians. Didactic are therefore given a high priority, and assigned a full day each week at the Center, along with sequences at the Scott Correctional Facility and at the University of Michigan Law School.

Legal aspects of Forensic Psychiatry (Core Curriculum I)

Professor M. Guyer, JD, reviews major legal systems and principles of law critical for the practice of forensic psychiatry. The Landmark Cases of forensic psychiatry provide source material for the study of the underpinnings of criminal and civil law, including criminal responsibility, pre- and post-adjudication disposition of defendants, criminal procedure, evidence, personal injury/malpractice, patient and prisoner rights, family law, disability law, and expert testimony, as practiced in federal and state courts. The cases presented also provide a thorough introduction to legal principles that enable the forensic resident to understand the legal literature and appreciate the significance of developing case law.

Clinical Aspects of Forensic Psychiatry (Core Curriculum II)

Faculty lead discussions on all aspects of forensic psychiatry, emphasizing a practitioner's perspective. The traditional subject matter of law and psychiatry is covered, including many of the topics addressed in professor Guyer's course, but here the emphasis is less on the underlying principles and more on their practical application. Clinical topics in forensic psychiatry include seminars on conducting forensic assessments and writing forensic reports; serving as an expert witness; rendering forensic consultation to mental health practitioners; risk assessment in forensic and civil populations; malingering; assessment techniques (e.g., hypnosis, polygraphy, amobarbital interview, plethysmography); special populations and behavior (antisocial personality, psychopathy, sexual offenders); and treatment approaches employed in forensic settings.

University of Michigan Law School

Trainees may elect to take courses in criminal law, mental health law, child mental health or other subjects at the University of Michigan Law School.

Continuing Medical Education psychiatry Seminar (Friday Conference)

Visiting speakers, center Staff, and University of Michigan faculty present selected topics in general and forensic psychiatry, varying from year to year, but emphasizing newly developing knowledge and treatments.

Correctional Psychiatry Seminar

This course is held at the Scott Prison as an integral part of the clinical rotation in correctional psychiatry. Topics include the following: roles and ethical problems in correctional mental health; legal regulation of psychiatric care in prisons; landmark cases in correctional psychiatry; prisons; epidemiology and causes of crime and criminality; classification/nosology of crime; sex offenders; sexual homicide, serial killers; and mass murderers; mental illness and criminality/violence; mentally ill prisoner; common syndromes in prison populations (psychopathy and antisocial personality disorder; malingering; somatization; self-injury and suicide; substance abuse in prisons; attention deficit hyperactivity disorder; post-traumatic stress and acute stress disorders; psychoses associated with isolation/segregation); risk appraisal and dangerousness; death row and executions; juvenile delinquency and young offenders; use of testing and formal quantitative instruments in assessment of psychopathology and risk (PCL-R; HCR-20; VRAG; ASSESS-LIST; MMPI-II, etc).

FACULTY

The faculty comprise a large and diverse group including psychiatrists, psychologists, attorneys, social workers, and a criminologist. Collectively they have produced hundreds of publications covering most major topics in psychiatry and the law. We have one of the largest cohorts of forensically certified psychiatrists in the nation (at least 13 at last count, including 9 who are full-time at the Center for forensic Psychiatry)

APPLICATION PROCEDURE

Interested persons should call or write:
Stephen C Cook, M.D.
Director of Training and Research
Center for Forensic Psychiatry
P O Box 2060
Ann Arbor, MI 48106
734/429-0862, ext 352

E-mail: cooks2@michigan.gov

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On the second Saturday of each month, the Forensic Center offers an educational supportive program for family members and significant others of our patient population. We know that having a relative or friend receiving treatment at the Forensic Center can often be confusing and at times frustrating. Some of you may have experienced feelings of helplessness and uncertainty about what you can do to help your family member. We have designed this program to assist in clarifying some of your confusions and answer some of your questions. This is an on going program that meets once a month to assist families in understanding general treatment concepts for the mentally ill, gain knowledge about mental illness and what you can do to help your family member and yourself.

The program will meet once each month for two and a half hours (21/2) on the second Saturday morning (10:30 to 1:00 p.m.) of the month. The program will have two areas of focus. The first is to provide you with information about mental illness, the courts, and the Forensic Center. The second is to set up a system that allows you to get needed support with the difficulties of having a mentally ill family member or significant other. We hope that the support part of the program will allow you to talk with other families that share the same frustration fears and confusions that you have. By sharing your experiences you may be able to develop different coping strategies for dealing with your mentally ill family member.

Topics that will be addressed in this group will include: mental illness, what it is and how it is treated, substance abuse, how it impacts the family and the mentally ill individual, how the Forensic Center provides treatment for mental illness, information about visitation and other therapy programs. We will accomplish these goals with the use of invited speakers, such as, psychiatrist, social workers, security staff, nurses and others.

The program time is from 10:30 a.m. to 1:00 p.m. the ending time is designed for you to have an opportunity to visit your family member or significant other after the program ends. Patients will not be present during the program. You will be able visits during the regular visiting times in the visiting area.

The Forensic Center offers a monthly program for families, designed to help families understand mental illness and the system that your family member is committed to. We meet in the Administration building, which is located in the building next to the visiting area, on the second Saturday of each month. The program provides support, education and understanding. This is a place that you can come to share your feelings about the changes in your family system, and know that you will be accepted and understood.

The Group Meets From 10:30 a.m. until 1:00 p.m.

Co-facilitators: Eugenia Ramon ext. 355
- Byron Randolph Ext. 377
- Brent Hurber Ext. 377
- Betty Ellerson Ext. 223

If you have guestions or concerns please feel free to contact any one of us. We look forward to meeting with you.

Visiting. Regular visiting hours at the Forensic Center are 1:00 - 3:00 p.m. Friday, Saturday Sunday and holidays, year around, in a supervised visiting area. Visitors and patients are separated by a glass barrier, and personal contact is not allowed during regular visits. Picture identification is required for all visitors over 16 years of age. Children under 12 are not to be left unattended in the visiting lobby. Other visiting rules are posted in the lobby, or may be obtained by contacting the Center.

Barrier-free visits with family members may be possible after a patient has been hospitalized at the Center for at least six months if arrangements are made through the patient's chief clinician and approved by the treatment team. Barrier-free visits are monitored by security staff and are granted under the following conditions:

• Such visits are limited to one hour in duration.
• Only two visitors will be allowed in the visiting room at one time; exceptions are possible with prior approval.
• Patients and family members may embrace, hold hands, and briefly kiss during the visit. A visit may be ended for security or safety reasons, or if physical contact becomes sexually inappropriate.
• Food or pets are not allowed.
• All visitors must be approved prior to the visit.

Family Therapy. Family Therapy sessions involving the patient, family members and the chief clinician can be arranged when needed by contacting the chief clinician.

Personal Property. Space permitting, residents are allowed to keep their own clothes and personal items that are not specifically prohibited. Each resident is responsible for his or her own property and is provided limited, locked storage space on the unit. Additional storage is provided for valuable, prohibited, or excess items, which are stored in central property labeled with the patient's name.

Because of security requirements at the Center, some personal items are not permitted on the inpatient units because a patient might used an item to harm oneself, another resident or staff. For example, ball point pens, tools of any type, matches, scissors, mirrors, and products containing alcohol are all prohibited. Space does not allow listing them all here, so family members should check with a patient's chief clinician or a security staff member if they have questions about a particular item before bringing the item to the patient. Residents may have small portable radios or tape players if the recording function has been disabled, but personal television sets are not allowed.

Phone Privileges. Each inpatient unit has one or more telephones which residents can use to place or receive calls between 8:00 a.m. and 10:00 p.m. Collect calls can be placed to others, but not received. Family and friends can call the Forensic Center at 734/429-2531, and ask to be connected to the appropriate inpatient unit.

Patients without funds may be allowed to call their attorney or family members at no cost if such a call is approved by the treatment team.

Mail. Patients may send and receive mail without restriction. However, all incoming mail addressed to the patient will be opened in the presence of staff to insure that prohibited items are not enclosed.

The Center for Forensic Psychiatry’s mission is to provide quality forensic mental health services to individuals and the Michigan court system.

Vision Statement

The Center for Forensic Psychiatry will provide high quality forensic mental health services. The Center will strive to develop, monitor, and enhance programs which will help individuals with mental disorders, as well as their families and advocates, to understand, manage and cope with the physical, mental, emotional and social problems associated with their particular disorder. The Center will also assist the Michigan Court System in the adjudication and disposition of forensic cases.

Organization

The Center for Forensic Psychiatry will use available resources in the most efficient and effective manner necessary to accomplish its mission.

Staff

The Center for Forensic Psychiatry will maintain competent staff who are motivated to deliver high quality services to its patients, the court system, and the community. The Center will establish mechanisms to ensure that staff members practice within the scope of their competency, and consistent with generally accepted standards of practice. The Center will promote continuous staff development of knowledge and skills.

The Center for Forensic Psychiatry will facilitate communication between and among its staff members, its various departments, and the community it serves, so that the mission, values and goals of the Center will be understood, supported and implemented.

Professional Training

The Center for Forensic Psychiatry will develop and maintain accredited training programs which prepare mental health professionals for practice in clinical and forensic areas.

Research

The Center for Forensic Psychiatry will provide research opportunities and encourage staff and students to participate.

Community

The Center for Forensic Psychiatry will create and maintain a positive relationship with the community. The Center will promote an exchange of information which considers community needs and encourages community involvement.

Customer Satisfaction

The Center for Forensic Psychiatry will involve recipients, their support systems and the court system in developing and shaping service delivery. The Center will regularly assess satisfaction with services provided and will make improvements based on the feedback.

Improvement

The Center for Forensic Psychiatry will promote continuous quality improvement. The Center will maintain mechanisms to monitor and improve services delivered.

Values Statement

1. The Center for Forensic Psychiatry values human dignity and believes that the consumer is entitled to accessible, coordinated, and timely quality services.

2. The Center for Forensic Psychiatry values and provides services in a safe, humane, and secure environment.

3. The Center for Forensic Psychiatry values and provides individualized treatment which is designed to help its patients manage their mental disorders, and which promotes treatment in the most appropriate setting.

4. The Center for Forensic Psychiatry values autonomy, diversity, and privacy, and respects the rights of consumers and staff.

5. The Center for Forensic Psychiatry values and encourages patients and their advocates to participate in treatment planning and implementation.

6. The Center for Forensic Psychiatry values continuity of care and collaborates with support systems and other health care providers to assure that transition occurs with minimal disruptions in service.

7. The Center for Forensic Psychiatry values and promotes scientific integrity in its work with the court system.

8. The Center for Forensic Psychiatry values and promotes research as a tool for increasing knowledge and understanding of mental disorders as they relate to treatment and legal issues.

9. The Center for Forensic Psychiatry values and promotes training opportunities for providers of forensic mental health services.

10. The Center for Forensic Psychiatry values and promotes staff competency and skill development.

11. The Center for Forensic Psychiatry values and promotes fiscally responsible planning and use of available resources.

The Treatment Services Division provides treatment and/or diagnostic services for individuals who have been found either Incompetent to Stand Trial (IST) or Not Guilty by Reason of Insanity (NGRI). Treatment Services consists of seven (7) inpatient units and is authorized to provide treatment for 225 patients. At present, there are two admission units, one for men and one for women, and five (5) intensive treatment, male units, one of which has been designated for higher functioning patients with a more ambitious level of programming than the other four. Each unit is staffed with psychiatrists, psychologists, social workers, a recreational or occupational therapist, registered nurses, forensic security aides, and a security supervisor. Most patient programming is provided within each unit due to security issues, although some programs may be available for select patients from different units to avoid unnecessary duplication of programming, such as Dual Diagnosis (Substance Abuse & Mentally Illness).

Occasionally, individuals who have been committed to another state hospital for psychiatric treatment under Chapter 4 of the Michigan Mental Health Code may be transferred to the Forensic Center for treatment. Such persons are transferred here because they present specialized management problems in the lesser restrictive setting. In very rare instances, prisoners from the Department of Corrections may be transferred to the Center for treatment.