MODEL OF FORENSIC PSYCIATRY CARE IN LITHUANIA
Until 1991 there were no independent forensic psychiatry institution in Lithuania. Two in patient departments served for forensic inpatient evaluation in two psychiatry hospitals in Naujoji Vilnia and Utena. Outpatient forensic psychiatry evaluation was made by ordinary psychiatrists who had some experience in forensics in different cities. After court judgement forensic psychiatry patients/offenders have been placed and treated in ordinary psychiatric hospitals. This situation was bad for other patients and for staff too.
After liberation in 1991 some changes were made and forensic psychiatry Service was included in Forensic Medicine and Psychiatry center under the Ministry of Justice. Independent Forensic Psychiatry Service was organized by the order of Health Minister in the 1994. In 2019, Lithuanian Forensic Psychiatry Service celebrated its 25th anniversary and during this time became organization with 10 outpatient departments in main cities and one inpatient department in Utena. We also have a specialized Child and Adolescent forensic psychiatry department. There are 21 forensic psychiatry experts and 11 forensic psychology experts working in our Service. Each year about two thousands forensic psychiatry evaluations and about five thousands consultations are made in our Service. All specialists have their primary education on psychiatry or psychology after which they underwent one year special preparation in forensic psychiatry and psychology and took special exam in forensic psychiatry and psychology. So all our specialists have their primary license and additional forensic psychiatry or forensic psychology license. Each five year all specialists undergo additional qualification evaluation.
In Lithuanian Psychiatry Service now we are focused in to diminished responsibility evaluation, civil capacity and diminished civil capacity evaluation. The other actual question is evaluation of malingering which stay very actual in our work. Evaluation of risk assessment of possible future criminal/aggressive behavior is actual for our experts. Also stay actual question about forensic psychiatry evaluations in cases with dual diagnoses. Irresponsibility because of insanity during 20 years (from 1985 till 2004) decreased 1,65 times. So the criminal dangerousness of mental iii persons is much less then have the healthy ones. Insanity formula states that person is not guilty if he or she at the moment of criminal action cannot understand the meaning of his behavior because of mental illness.
The Forensic Psychiatry practice in Lithuania is regulated by Laws: Constitution, Penal and Civil Codes, Health Minister and the Ministry of Justice Orders. The main Law for regulation of all kind of forensic evaluation and also of forensic psychiatry practice is Forensic Expertise Law from 2003. From 2014 the Committee for coordination of forensic expertise practice and ethical questions started to work. This committee includes members from all expertise institutions and coordinates the main principles of different expertise. The Ministry of Justices decree the Codex of professional ethics for forensic experts. Committee for coordination of forensic expertise practice carries supervision of the ethical principles of all experts in all expertise institutions.
Lithuania Forensic Psychiatry Service under the Ministry of Health makes expertise work and also is the center of methodical - scientific research, organizes conferences on forensic psychiatry and tries to keep International professional contacts with forensic psychiatry Services in different countries. We are sure, that despite differences in Law systems and structures of organizations, we have a lot of common points in our professional work- in the forensic psychiatry evaluation field. Today we have a possibility and big interest for professional contacts, scientific research, development of new methodological documents, for exchanging experiences, attitudes and competences.