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Forensic Psychiatric Evaluation in NYC Criminal Courts

Stephan M. Carlson, MD, MBA, FAPA · Correctional Mental Health

A defendant in a New York City jail can generate two parallel psychiatric records that answer different questions: the clinicians managing care in custody, and the court-appointed examiner answering a statutory legal question. Treating those records as interchangeable is how a competency opinion quietly loses its footing. Two psychiatric roles, one defendant When a person held at Rikers raises a court question about mental state, the psychiatric activity around that defendant splits into roles that are easy to conflate. NYC Health + Hospitals Correctional Health Services delivers the in-custody treatment; the court-appointed examiner conducts a discrete, non-treating evaluation directed at a

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