Examiner Agreement and Judicial Consensus in Forensic Mental Health Evaluations

The reliability of forensic methods continues to be controversial. Hawaii is unique in utilizing a three-panel system for evaluating criminal defendants for competency to stand trial (CST), not guilty by reason of insanity (NGRI), and postacquittal conditional release (CR). The study examined independent forensic reports with judicial determinations to assess examiner agreement and judicial consensus. Examinees (N = 450) were defendants charged with felony offenses. Three groups of examiners conducted independent forensic mental health evaluations: community-based psychiatrists, community-based psychologists, and psychologists employed by the Courts & Corrections branch of the Hawaii Department of Health. Five classes of reliability estimators were examined in a noncrossed data measurement design. The study examined field reliability of CST, NGRI, and CR as operationalized psycholegal constructs. Overall, findings revealed wide variability in examiner consensus and agreement between examiners and judges, depending on type of examination. Factors associated with examiner disagreement are discussed. Findings are similar to field reliability for other types of complex decision making. Procedural standardization, application of structured professional methods, use for forensic assessment instruments, and de-bias assessment are recommended to improve the quality of forensic mental health opinions.