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Quality and Quality Improvement in Forensic Mental Health Evaluations

Dr. Wettstein is Clinical Professor of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. This article is a modified version of the author's President's Address at the Annual Meeting of the American Academy of Psychiatry and the Law, Scottsdale, AZ, October 21, 2004. Address correspondence to: Robert M. Wettstein, MD, University of Pittsburgh School of Medicine, 401 Shady Avenue, Suite B103, Pittsburgh, PA 15206. E-mail: wettsteins{at}aol.com

Despite the growing attention to quality and quality improvement in health care in the United States, forensic psychiatry has yet to incorporate relevant developments and information and make quality an important item on the agenda. This article reviews the empirical research regarding the perceived quality of forensic evaluations, which has primarily examined criminal rather than civil forensic evaluations. Beyond the available research, many important policy and empirical questions must be addressed, including the definition of a quality forensic evaluation, the process used to access quality, the indicators and measures used, the methods that provide incentives for performing quality evaluations, the role of forensic psychiatry training programs, and the role of the American Academy of Psychiatry and the Law (AAPL) or other professional organizations in the quality improvement enterprise.

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