1. What is a Forensic Psychiatrist and can you tell us a bit about your current job?
A forensic psychiatrist is a medical doctor who has then specialised in psychiatry, and further sub-specialised in forensic psychiatry. Forensic psychiatry deals with the assessment and treatment of people with mental health problems and serious criminal offending. My current job is as clinical lead for the Fixated Threat Assessment Centre (FTAC). This is a joint mental health and police team concerned with managing the risk posed by fixated (usually mentally ill) individuals towards particular public figures (mostly, British politicians and Royal Family).
2. Where did you train, and having completed your medical training, what made you want to become a Forensic Psychiatrist?
I studied medicine at Leeds University, and trained in psychiatry at the Maudsley Hospital. I decided to become a forensic psychiatrist after working with Dr Paul Bowden as a trainee. He was the finest clinician I had ever come across, and I wanted to be like him. I also found the work fascinating – trying to help patients make sense of why they had committed the, sometimes horrific, offence that had led them into hospital. Mental illness was generally only a small part of the explanation, and I found the intellectual and human challenge very appealing.
3. What is your particular area of expertise?
I have had a wide variety of different jobs as a consultant psychiatrist, so I guess I have accumulated lots of different areas of interest or expertise along the way. The work of a forensic psychiatrist is often to function as some sort of “expert”. This, in itself, is interesting. I often feel very far from being an “expert” in anything, but the human need in a group of people for someone to be the “expert” in the room is often irresistible, although it is understandable in certain situations. I might lay most claim to expertise in the areas of fixation, stalking, psychiatry in a prison setting and working in partnership with other agencies and services.
4. Can you describe the sort of cases you work on as a Forensic Psychiatrist as part of the Theseus team?
My role is often to make sense of unusually persistent, intrusive, threatening or alarming behaviour, to understand what may be motivating it, and how it might best be managed, and what risks might be involved. When such behaviour presents in a workplace setting, for example, it can be highly disruptive, distressing for individual employees to experience and can persist for months, sometimes years. It can be tempting in such situations – particularly when state of mind appears to be playing a role – to think that nothing can be done.
5. Can you explain the value of having forensic psychiatric input to such cases in risk management terms?
I think forensic clinicians (psychologist, psychiatrists, and others) have a particular expertise and experience in the psychological states associated with a wide range of different sorts of problem behaviours, how to make sense of them, what to do about them, and how to navigate the highly complex systems associated with mental health services and the criminal justice system. We also have lengthy experience with risk assessment.
6. What do you find to be the most rewarding aspect of your job?
I think I most enjoy the uncertainty, and the fact that every case is individual and different. I don’t think you find quite as much of either of those in any other branch of medicine.
7. We understand you had some involvement in the Killing Eve show.
I was involved with two seasons of Killing Eve as a consultant to the show, mainly the writing team, about psychiatric and psychological issues. I was often asked almost impossible questions by the writers, but felt that my role was to support them as experienced writers with the ability to imagine how people might behave in certain situations.
