Home › Guides › Psychiatric assessment for a report—what to expect
If you have been told that a medico-legal psychiatric assessment has been arranged for you, you may have questions about what it involves, what will happen to the report, and how it differs from an NHS appointment with your doctor. Understanding the process in advance can help reduce anxiety and ensure you are prepared to engage fully in the assessment.
Who arranges the assessment and why
A medico-legal psychiatric assessment is commissioned by a solicitor (or, in some cases, the court) to provide an expert opinion for legal proceedings. It might be ordered in a personal injury claim to assess whether an incident caused psychiatric harm, in a clinical negligence case to evaluate injury from medical malpractice, in family proceedings to assess your parenting capacity or mental health, in criminal proceedings to inform sentencing or fitness to plead, or in an employment dispute about psychiatric loss.
The solicitor will identify a psychiatrist with expertise in medico-legal work and contact them with a “letter of instruction” that outlines the case, the legal issues, and the specific questions the expert needs to address in the report. The solicitor will confirm your details and ask the psychiatrist to contact you to arrange an appointment.
Before the appointment: preparing yourself
The psychiatrist’s letter will explain the date, time, location (usually in-person), what to bring (identification, medication list, medical records), and how long to set aside—a thorough psychiatric interview takes appreciably longer than a routine GP appointment. You can bring a support person but not your solicitor, as that could compromise independence.
Gather your own medical records—GP letters, hospital discharge summaries, treatment records, prescription details. The expert will review these as part of their assessment.
The interview and assessment
The psychiatrist will invite you to sit in a private, confidential room. The atmosphere is professional but not clinical in the NHS sense—you are not being “treated”; you are being assessed for a legal opinion.
The psychiatrist will typically:
- Take a detailed history: Your background, family history, education, employment, significant life events, and how you have coped with stress or trauma. This is thorough and may take 30 minutes or more.
- Explore the specific incident or issue relevant to the case: If you are claiming psychiatric injury from an accident, they will ask detailed questions about the incident, what you witnessed, how it affected you, and your symptoms since. If the assessment concerns parenting or family matters, they will ask about your relationships, your care of the child, and any mental health difficulties.
- Conduct a mental state examination: The psychiatrist will observe your mood, thinking, concentration, memory, and any signs of psychosis, anxiety, or depression. They are not being critical; they are gathering objective clinical information.
- Ask about current mental health: Any symptoms of depression, anxiety, sleep problems, substance use, or other concerns.
- Administer standardized assessment tools: They may use questionnaires or psychological rating scales—for example, the Patient Health Questionnaire (PHQ-9) for depression or the Generalized Anxiety Disorder Scale (GAD-7) for anxiety—to quantify your symptoms objectively.
- Clarify your medications and medical history: Current and past treatments, effectiveness, side effects, and any other medical conditions affecting your mental health.
The psychiatrist will take notes and may ask follow-up questions. Be honest and detailed; the expert cannot form a fair opinion without accurate information.
What the psychiatrist will not do
It is crucial to understand that this is not treatment. The psychiatrist will not:
- Prescribe medication or adjust your current prescriptions.
- Provide therapy or counselling.
- Offer an ongoing therapeutic relationship.
- Take your “side” or advocate for any particular outcome in the case.
- Commit to confidentiality in the way your treating doctor does (see below).
This can be a relief in some ways—you are not expected to form a therapeutic alliance, and the psychiatrist is not judging your choices. But it is also important to understand the limits of the relationship.
Confidentiality and disclosure of the report
The medico-legal assessment is not confidential in the way NHS care is. The psychiatrist will produce a written report that will be disclosed to:
- All parties’ solicitors in the case.
- The court (if the case goes to hearing).
- The other side’s legal team and potentially their own experts, who may ask questions or request a meeting with your psychiatrist.
The report will be shown to you first (through your solicitor) so you can check for factual accuracy and discuss it with your legal team. You will have an opportunity to comment or ask for corrections if there are errors.
However, you should assume that anything you tell the psychiatrist during the assessment may appear in the report and may eventually be seen by the court. Do not tell the psychiatrist anything you would not want a judge to read. If there are matters you feel are too private, discuss this with your solicitor before the assessment—they may be able to advise you.
After the assessment: what happens next
The psychiatrist will write the report within the timescale agreed with the instructing solicitor (often set by the court timetable in family and care cases), summarizing your background, findings from the interview and tests, expert opinion on the case questions, and a statement confirming duty to the court.
Your solicitor will explain the report to you. If it supports your case, it becomes key evidence. If not, your solicitor will discuss options—sometimes mixed views show genuine uncertainty or agreement with the other side.
Questions under CPR Part 35
Once the report is disclosed, the other side has a right to put written questions to the psychiatrist about the report, for the purpose of clarification, within 28 days of the report being served (under Civil Procedure Rules Part 35.6). These questions are usually straightforward clarifications or requests for the expert to explain reasoning, and the expert’s answers are then treated as part of the report itself. You will not be directly involved, but your solicitor will see the questions and the expert’s replies.
Expert discussions and joint statements
If there are experts instructed by both sides, the court may direct them to meet and discuss areas of agreement and disagreement. This might be in person or by written exchange. The aim is to narrow issues and avoid duplication of evidence at trial. You will not attend these discussions—they are between the experts—but your solicitor will brief you on the outcome.
How medico-legal assessment differs from NHS assessment
An NHS psychiatric assessment aims to diagnose your condition and plan treatment. It is part of your ongoing care. Records are kept confidential (with limited exceptions). The psychiatrist is your doctor and has a duty of care to you.
A medico-legal psychiatric assessment is a one-off evaluation to answer specific legal questions. It is not treatment. The report will be disclosed. The psychiatrist’s primary duty is to the court, not to you. The tone is objective and analytical rather than therapeutic.
Both can involve similar clinical techniques—interviews, mental state examination, psychological tests—but the purpose and context are fundamentally different. If you are simultaneously receiving NHS mental health care and undergoing a medico-legal assessment, your treating NHS psychiatrist will not usually conduct the medico-legal assessment, as that would create a conflict of interest.
Key points
- Medico-legal assessments are thorough interviews conducted to provide expert opinion for legal proceedings, not treatment.
- The psychiatrist will take a detailed history, conduct a mental state examination, and may administer psychological measures.
- The assessment is not confidential; the report will be disclosed to all parties and the court.
- Be honest and detailed; the expert cannot form a fair opinion without accurate information.
- After the assessment, the psychiatrist will write a report setting out findings and expert opinion.
- The other side may ask written questions about the report under CPR Part 35.
- Medico-legal assessment differs from NHS assessment in purpose, confidentiality, and the expert’s duty to the court rather than to you as a patient.
Related: Find a medico-legal expert