Quality of criminal responsibility reports submitted to the Hawaii judiciary ☆ Kristen D. Fuger a , Marvin W. Acklin a, ⁎, Annie H. Nguyen a , Lawrie A. Ignacio a , W. Neil Gowensmith b a Argosy University, Hawaii Campus, Honolulu, HI, United States b University of Denver, Denver, CO, United States abstract article info Available online xxxx Keywords: Quality of forensic reports Forensic assessment Forensic mental health evaluations This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was “fair” using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and “fair” inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improve- ment of report quality are proffered, including standardization of procedures and report format and use of foren- sic assessment instruments. © 2013 Elsevier Ltd. All rights reserved. 1. Introduction The insanity defense has been the focus of intense public attention and misperception. Inaccurate knowledge of the insanity defense pre- vails (Golding, Skeem, Roesch, & Zapf, 1999; Hans & Slater, 1983). Common public conceptions view the insanity defense as a loophole allowing the guilty to avoid responsibility for their actions. The public overestimates legal application of the insanity defense; some studies have shown that laypersons believe the insanity defense to be raised in about one-third of all felony cases (Pasewark, McGinley, & Blau, 1989). In reality, criminal responsibility pleas are a relatively rare occur- rence within the criminal justice system, with roughly one percent of criminal cases raising an insanity defense (Melton, Petrila, Poythress, & Slobogin, 2007). An insanity acquittal occurs in about one in four of these cases (Blau, McGinley, & Pasewark, 1993; Murrie & Warren, 2005; Quinsey, 2009; Zapf, Golding, & Roesch, 2006). Warren, Fitch, Dietz, and Rosenfeld (1991) reviewed 894 pre-trial reports for criminal responsibility in Virginia and found that 8% of the defendants were adjudicated not criminally responsible. In Hawaii, the rate of insanity pleas is slightly higher than the national average, with estimates of 1–3% of criminal cases raising an insanity plea, with the courts deter- mining acquittal in about 25% of felony cases raising this defense (Gowensmith, 2008). There are approximately 300 felony criminal re- sponsibility evaluations conducted in Hawaii annually, most of which occur in the First Judicial Circuit (Island of Oahu, Gowensmith, 2008). 1.1. Mental state at the time of the offense evaluations In contrast to a competency to stand trial (CST) evaluation, criminal responsibility assessments require the clinician to conduct a retrospec- tive evaluation of the defendant's mental state at the time of the offense (Acklin, 2007a; Melton et al., 2007; Roesch, Viljoen & Hui, 2004; Simon & Shuman, 2002). “The overriding goal of the insanity evaluation is a comprehensive reconstruction of the defendant's functioning at the time of the offense” (Rogers, 2008, p. 113). Given the retrospective and inferential nature of the examination, assessment of mental state at the time of offense is one of the most challenging forensic assess- ments (Acklin, 2007a; Melton et al., 2007). Retrospectively, the forensic examiner must dissect the offense and examine and integrate the clinical and collateral data (Acklin, 2007a; Melton et al., 2007; Murrie & Warren, 2005; Simon & Shuman, 2002; Warren et al., 2004). This requires reconstruction and evaluation of events leading up to, during, and following the offense, thereby creating International Journal of Law and Psychiatry xxx (2013) xxx–xxx ☆ This report is based in part on the first author's dissertation submitted for partial re- quirements of the doctoral degree in psychology at Argosy University, Hawaii Campus. ⁎ Corresponding author at: 850 W. Hind Drive Suite 203, Honolulu, HI 96821, United States. E-mail address: acklin@hawaii.edu (M.W. Acklin). IJLP-01006; No of Pages 9 0160-2527/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijlp.2013.11.020 Contents lists available at ScienceDirect International Journal of Law and Psychiatry Please cite this article as: Fuger, K.D., et al., Quality of criminal responsibility reports submitted to the Hawaii judiciary, International Journal of Law and Psychiatry (2013), http://dx.doi.org/10.1016/j.ijlp.2013.11.020