Neuropsychiatry / behavioral neurology is the study of emotional and behavioral disorders in which disturbed brain functions are either scientifically established or strongly suggested. Prior to the 80s, the term neuropsychiatry was limited to conditions with identified etiologies, i.e., the depression or mania following a stroke, delirium/dementia associated with hepatic encephalopathy, or the paranoid/religious psychosis of a temporal lobe epileptic?
However, with the rapid advances in the neurosciences, the more serious psychiatric disorders such as schizophrenia, obsessive-compulsive disorder, Tourette’s, ADHD, bipolar disorder, and autism are undeniably recognized as brain disorders. Considerable skepticism is raised in the courts when brain disorders are used to explain away horrific acts or serious antisocial behaviors. Mental health professionals may identify brain damage as a causal mechanism in wrongful behavior without an adequate scientific basis. This may be the result of honest differences in opinion, advocacy, or in some instances (unfortunately) the willingness to provide a desired opinion for the referring party.
Advocacy is counterproductive to the advancement of forensic science.
On the whole, there is little doubt that there are systemic failures in the identification of neuropsychiatry conditions in a forensic setting. The brunt of this failure may be borne, (even to the point of receiving capital punishment), by those who have both psychosocial and neuropsychiatry vulnerabilities.
It is important that legal and mental health professionals develop and maintain sensitivity to the presence of neuropsychiatry conditions, especially among those who are multiply disadvantaged. Professionals also need to recognize the limits of scientific evidence in this area.
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