Center for Forensic Psychiatry

Acting Director: Carol E. Holden, Ph.D.
P.O. Box 2060
Ann Arbor, MI 48106
Phone: (734)429-2531
Fax: (734)944-0802

• History
• Evaluation Services
• Training & Research
• Family Information
• Mission, Vision & Values
• Treatment Services
• Commitment To Quality Care and Patient Safety
  

Brief History of the Center for Forensic Psychiatry

In 1966, responding to the recommendations of a special Department of Mental Health task force, legislative changes in the Michigan Mental Health Code were enacted that established the Center for Forensic Psychiatry.  Act 266 of 1966 was passed and updated in August, 1974, with the passage of Act 258 and the new Mental Health Code.  The Code states in Section 128 "The department shall maintain under its jurisdiction an entity to be known as the Center for Forensic Psychiatry.  The Center shall perform such services as are required by law and may, with the approval of the Director of the Department, perform any other services or activity, including research that pertains to mental health and criminal law."  

In July, 1967, Dr. Ames Robey of Massachusetts was hired to implement and direct the formation of the Center for Forensic Psychiatry (CFP), which was to be located on the grounds of the Ypsilanti Regional Psychiatric Hospital.  From 1967 to the summer of 1969, staff was recruited and trained, plans made and implemented and the CFP brought into being.  Approximately 65 staff members were on the payroll on September 8, 1969, when the first four patients from Ionia State Hospital were transferred to the CFP.

Today, under the direction of Carol E. Holden, Ph.D., the Center is a 210 bed psychiatric facility that provides both diagnostic services to the criminal justice system and psychiatric treatment for criminal defendants adjudicated incompetent to stand trial and/or acquitted by reason of insanity.

Approximately 4,000 diagnostic evaluations are performed each year for the criminal courts and 250 court-ordered admissions to the CFP are processed. The CFP is affiliated with the University of Michigan Department of Psychiatry, Michigan State University, and Wayne State and offers both a Psychiatry Fellowship Program (affiliated with the University of Michigan) and, when funding is available, a Post-Doctoral Fellowship in Forensic Psychology.  In addition, the CFP offers a psychology doctoral student practicum, medical student rotations, social work internships, nursing student clinicals, and undergraduate training and research experiences to students from a number of Michigan colleges and universities. CFP staffing currently consists of approximately 500 employees.

Steve J Kenzie, MPA                            Kathryn J Ednie, M.D.
Administrative Officer                            Clinical Director
kenzie@michigan.gov                       edniek@michigan.gov                         

Evaluation Services Unit  

George Watson, Jr., Ph.D.
Acting Director of Evaluation Services                                                                                 
watsongeo@michigan.gov
( 734) 295-4508

The Evaluation Unit at the Center for Forensic Psychiatry (CFP), the State's sole certified forensic facility, conducts evaluations for all of the district and circuit criminal courts in the State of Michigan's 83 counties pursuant to statutory requirements in Michigan law. Approximately 2,500 defendants are evaluated annually regarding charges ranging from minor misdemeanors to serious felonies fulfilling a total of 4,000 court-ordered evaluations. Examinees are typically adults, although some minors charged as adults are also examined. Evaluation issues most often involve questions about competency to stand trial and criminal responsibility. Less frequently, competency to waive Miranda, competency to be sentenced, dangerousness, and other issues may be the focus of special diagnostic evaluations.  Examiners can be summoned to court to testify regarding evaluations.

All evaluations are ordered by the court. Competency examinations may be initiated by any court officer; whereas criminal responsibility examinations are initiated by defense counsel. Examinations are typically conducted during the morning hours, Monday through Friday at the CFP.

Defendants are responsible for their own transportation to and from the CFP, if they are not incarcerated; that is, if they are on bond. Sheriff's deputies transport incarcerated defendants to the CFP. At the conclusion of the examination, incarcerated defendants are returned to jail. Additionally, the Evaluation Unit maintains satellite facilities at the Kent County Correctional Facility, Marquette County and Grand Traverse County Sheriff's Department where defendants who reside near those areas are evaluated. Once court orders have been received by the CFP, scheduling is done by the CFP Forensic Services Department, which serves as the liaison between the courts and the CFP. Forensic Services also arranges for foreign language and deaf interpreter services, when these are needed.

The Evaluation Unit is staffed by 35 doctoral-level psychologists and 2 master's-level psychologists.  Other psychiatrists, psychologists and social workers, including those from Treatment Services, are available for consultation and occasional evaluations. Two master's-level psychologists assigned to the Evaluation Unit are responsible for administering psychological testing. Neuropsychological assessment services, when needed, are provided by doctoral-level neuropsychologists. An examination typically consists of a clinical interview of two hours or more, in addition to psychological testing as needed. Defendants are expected to discuss their criminal charges, their backgrounds, and their current functioning. Defendants are asked to give written permission for release of medical, school, or other pertinent records as needed.

For a more complete description of Evaluation Unit services see: Benedek, E. (Ed.) (1996). New directions for mental health services: Emerging issues in forensic Psychiatry: From the clinic to the courthouse. 69, Spring 1996, Jossey-Bass Publishers.

Training & Research

Craig A. Lemmen, M.D.
Training  & Research Director 
lemmenc@michigan.gov
(734)295-4301

The training of clinical staff at the Center for Forensic Psychiatry is accomplished through a collaborative effort of the discipline directors including social work, psychology, psychiatry, security, activity services, staff medical library, nursing, the facility director, and the director of training and research. The core curriculum for all center employees is determined through the Training and Research Committee chaired by the Training and Research Department Director.

The Training and Research Committee surveys the staff for educational program recommendations and plans training opportunities as appropriate. The Center for Forensic Psychiatry Training and Research Department is accredited by the Michigan Medical Society and is responsible for scheduling Continuing Medical Education programs in compliance with Michigan Medical Society requirements.

The Center for Forensic Psychiatry is mandated to provide research in various aspects of mental illness and the law. All research projects must be approved through the Training and Research Department and meet CFP standards and policy for conducting research and maintaining confidentiality.

The Center for Forensic Psychiatry maintains a Medical Library staffed by a Master's Degree Librarian in support of clinical and administrative decision-making through authoritative, up-to-date print and non-print resources.

 The Training and Research Department oversees the Forensic Psychiatry Residency Program in affiliation with the University of Michigan Medical School.

The Center for Forensic Psychiatry and The University of Michigan Department of Psychiatry Forensic Psychiatry Residency Program

University of Michigan Forensic Psychiatry Fellowship

Program Description

The Psychiatry Residency Program in forensic psychiatry is a one-year, post-residency training program for psychiatrists planning careers in forensic or correctional psychiatry. The Accreditation Council of Graduate Medical Education accredits the program. Board certified (American Board of Psychiatry and Neurology) general psychiatrists in good standing who complete this program are qualified to sit for the sub-specialty examination in forensic psychiatry.

Clinical Rotations

Residents receive clinical training at three major sites in four major settings: Inpatient Treatment Units at the Center for Forensic Psychiatry; Evaluation Services Unit of the Center for Forensic Psychiatry; The University of Michigan Medical Center; and Huron Valley Complex (HVC) Correctional Facility, a state prison for women located next to the CFP.

Center for Forensic Psychiatry --- Inpatient

Most inpatients at the CFP have been found not guilty by reason of insanity or incompetent to stand trial. Residents function both as treating psychiatrists for their own patients and as forensic examiners for the patients of other clinicians. They receive ongoing supervision in the management of forensic patients with particular emphasis on clinical problems such as suicide, malingering, amnesia, self-injurious behavior, violence, psychosis, substance abuse, and antisocial behavior. Residents prepare psychiatric reports and provide testimony for the courts, particularly competency to-stand-trial evaluations and clinical certificates for continued, involuntary hospitalization. Other important forensic issues encountered on inpatient units include the right to treatment, the right to refuse treatment, informed consent, and confidentiality/privilege. A typical caseload of 2-3 patients is carefully monitored to provide exposure to a variety of diagnostic groups, legal issues, and offenses.

Center for Forensic Psychiatry --- Evaluation Services Unit

In order to obtain certification as Consulting Forensic Examiners under Michigan Law, residents observe at least five competency to-stand-trial evaluations and five criminal responsibility evaluations in the Evaluation Services Unit. They then conduct five supervised competency evaluations and five supervised criminal responsibility evaluations; the final evaluation regarding each issue is supervised by the Director of Training and Research. Residents observe court testimony, participate in a mock trial, and provide testimony, when required, in cases they have examined. Other forensic issues arising in the evaluation services unit include Miranda rights and competency to be sentenced.

University of Michigan Health System --- Legal Regulation and Civil Forensic Psychiatry

The University of Michigan Health System and the practices of faculty forensic psychiatrists on staff serve as the venues for this rotation. Residents consult to a general psychiatric service on issues related to the legal regulation of psychiatric practice (such as civil commitment, confidentiality, refusal of treatment and the ‘right to die," emergency treatment, decision-making competency, guardianship and conservatorship, etc.). They gain experience in psychiatric aspects of civil litigation (such as malpractice, disability, sexual harassment, psychic injury related to trauma, and child custody) and in administrative aspects of forensic psychiatry. The rotation includes three major components. Initially, residents attend a monthly conference including faculty from the forensic psychiatry program and from the consultation-liaison service of the University of Michigan Department of Psychiatry, where cases and questions pertaining to the law/psychiatry interface are represented for consultation and educational purposes. Second, residents meet regularly with the hospital attorney of the University of Michigan Health System to discuss matters relating to the legal regulation of psychiatry, with particular reference to active problems, lawsuits, and policy issues at the hospital. Third, residents observe and assist experienced forensic psychiatrists, both in private practice and at the Child and Adolescent Psychiatric Hospital, engaged in the full range of civil controversies.

Huron V alley Complex /Corrections Mental Health Program

Huron Valley Complex (HVC) is a state prison for women, housing convicts at all security levels. It is a modern correctional structure, clean, attractive, and well maintained. Psychiatric services at HVC include a "Residential Treatment Program," the major venue for the first three months of the rotation; and an "outpatient" clinic, serving inmates from the general prisoner population, to which residents rotate for an additional three months. Major clinical and forensic issues include mental health screening at reception; suicide risk assessment; self-mutilation; malingering; somatization; psychopathy; involuntary treatment; consultation with custodial staff; disposition of prisoners; violence risk assessment; and institutional policies governing mentally ill prisoners, such as the use of segregation. Residents also have opportunities to visit mental health programs at other state prisons.

Didactic Program

Mastery of forensic psychiatry requires immersion in a knowledge base and style of thinking that may be foreign to many clinicians. Didactics are, therefore, given a high priority and assigned a full day each week at the CFP, along with sequences at the Huron Valley Complex and at the University of Michigan Law School.

Legal Aspects of Forensic Psychiatry (Core Curriculum I)

This curriculum provides a review of major legal systems and principles of law critical for the practice of forensic psychiatry. The Landmark Cases of forensic psychiatry provide source material for the study of the underpinnings of criminal and civil law, including criminal responsibility, pre- and post-adjudication disposition of defendants, criminal procedure, evidence, personal injury/malpractice, patient and prisoner rights, family law, disability law, and expert testimony, as practiced in federal and state courts. The cases presented also provide a thorough introduction to legal principles that enable the forensic resident to understand the legal literature and appreciate the significance of developing case law.

Clinical Aspects of Forensic Psychiatry (Core Curriculum II)

Faculty members lead discussions on all aspects of forensic psychiatry, emphasizing a practitioner's perspective. The traditional subject matter of law and psychiatry is covered, including many of the topics, but here the emphasis is less on the underlying principles and more on their practical application. Clinical topics in forensic psychiatry include seminars on conducting forensic assessments and writing forensic reports; serving as an expert witness; rendering forensic consultation to mental health practitioners; risk assessment in forensic and civil populations; malingering; assessment techniques (e.g., hypnosis, polygraph, amobarbital interview, plethysmography); special populations and behavior (antisocial personality, psychopathy, sexual offenders); and treatment approaches employed in forensic settings.

University of Michigan Law School

Trainees may elect to take courses in criminal law, mental health law, child mental health or other subjects at the University of Michigan Law School.

Continuing Medical Education Psychiatry Seminar (Friday Conference)

Visiting speakers, CFP staff, and University of Michigan faculty present selected topics in general and forensic psychiatry, varying from year to year, but emphasizing newly developing knowledge and treatments.

Correctional Psychiatry Seminar

This course is held at the Huron Valley Complex as an integral part of the clinical rotation in correctional psychiatry. Topics include the following: roles and ethical problems in correctional mental health; legal regulation of psychiatric care in prisons; landmark cases in correctional psychiatry; prisons; epidemiology and causes of crime and criminality; classification/nosology of crime; sex offenders; sexual homicide, serial killers, and mass murderers; mental illness and criminality/violence; mentally ill prisoners; common syndromes in prison populations (psychopathy and antisocial personality disorder, malingering, somatization, self-injury and suicide, substance abuse in prisons, attention deficit hyperactivity disorder, post-traumatic stress and acute stress disorders, psychoses associated with isolation/segregation); risk appraisal and dangerousness; death row and executions; juvenile delinquency and young offenders; use of testing and formal quantitative instruments in assessment of psychopathology and risk (PCL-R; HCR-20; VRAG; ASSESS-LIST; MMPI-II, etc).

Faculty

The faculty comprises a diverse group including the disciplines of psychiatry, psychology, law, and social work. Collectively, they have produced hundreds of publications covering most major topics in psychiatry and the law. We have one of the largest cohorts of forensically-certified psychiatrists in the nation (at least 13 at last count, including 9 who are full-time at the Center for Forensic Psychiatry)

Application Procedure

Interested persons should call or write:

Craig A Lemmen, M.D.
Training and Research Director                                                                
Center for Forensic Psychiatry
P.O. Box 2060
Ann Arbor, MI 48106
(734)295-4301
lemmenc@michigan.gov

Family Information

Click here for our handbook for patients & families

Invitation to Join Our Support Group

The second Saturday of each month the Forensic Center offers an educational supportive program for family members and significant others of our patient population. We know that having a relative or friend receiving treatment at the Forensic Center can often be confusing and at times frustrating. Some of you may have experienced feelings of helplessness and uncertainty about what you can do to help your family member. We have designed this program to assist in clarifying some of your confusions and answering some of your questions.

This is an ongoing program that meets once a month to assist families in understanding general treatment concepts for the mentally ill, gaining knowledge about mental illness and what you can do to help your family member and yourself, and understanding the system that your family member is committed to. This is a place that you can come to share your feelings about the changes in your family system, and know that you will be accepted and understood.

The program meets on the second Saturday of each month, from  10:30 a.m. - 1:00 p.m. The program has two areas of focus. The first is to provide you with information about mental illness, the courts, and the Forensic Center. The second is to set up a system that allows you to get needed support with the difficulties of having a mentally ill family member or significant other. We hope that the support part of the program will allow you to talk with other families that share the same frustration, fears, and confusions that you have. By sharing your experiences, you may be able to develop different coping strategies for dealing with your mentally ill family member.

Topics that will be addressed in this program will include: mental illness, what it is and how it is treated; substance abuse, how it impacts the family and the mentally ill individual; how the Forensic Center provides treatment for mental illness; and information about visitation and other therapy programs. We will accomplish these goals with the use of invited speakers, such as psychiatrists, social workers, security staff, nursing staff, and others.

The ending time of the program (1:00 p.m.) is designed for you to have an opportunity to visit your family member or significant other after the program ends. Patients will not be present during the program. You will be able to visit during the regular visiting times in the visiting area.

Coordinators:  

    - Eugenia Ramon (734)295-4327
       ramone@michigan.gov

    - Paul Schneider (734)295-4220
       schniederp@michigan.gov

    - Brent Huber (743)429-2531
       Huberb@michigan.gov

If you have questions or concerns, please feel free to contact us. We look forward to meeting with you.

Family Education Calendar for 2009

Visiting 

Regular visiting hours at the Forensic Center are 1:00 - 3:00 p.m., on Friday, Saturday Sunday and holidays, year round, in a supervised visiting area. A glass barrier separates visitors and patients, and personal contact is not allowed during regular visits. Picture identification is required for all visitors over 16 years of age. Children under 12 are not to be left unattended in the visiting lobby. Other visiting rules are posted in the lobby, or may be obtained by contacting the CFP.

Barrier-free visits with family members may be possible after a patient has been hospitalized at the CFP for at least six months, if arrangements are made through the patient's chief clinician and approved by the treatment team. Barrier-free visits are monitored by nursing/security staff and are granted under the following conditions:

• Such visits are limited to one hour in duration.
• Only two visitors will be allowed in the visiting room at one time; exceptions are possible with prior approval.
• Patients and family members may embrace, hold hands, and briefly kiss during the visit. A visit may be ended for security or safety reasons, or if physical contact becomes sexually inappropriate.
• Food or pets are not allowed.
• All visitors must be approved prior to the visit.

Family Therapy:  Family therapy sessions involving the patient, family members and the chief clinician can be arranged, when needed, by contacting the chief clinician.

Personal Property:  Space permitting, residents are allowed to keep their own clothes and personal items that are not specifically prohibited. Each resident is responsible for his or her own property and is provided limited, locked storage space on the unit. Additional storage is provided for valuable, prohibited, or excess items.  These items are stored in central property, labeled with the patient's name.

Because of security requirements at the CFP, some personal items are not permitted on the inpatient units because a patient might use an item to harm oneself, another resident or staff. For example, ballpoint pens, tools of any type, matches, scissors, mirrors, and products containing alcohol are all prohibited. Space does not allow listing all items here, so family members should check with a patient's chief clinician or a nursing staff member, if they have questions about a particular item, before bringing the item to the patient. Residents may have small portable radios or tape players if the recording function has been disabled, but personal television sets are not allowed.

Phone Privileges:  Each inpatient unit has one or more telephones, which residents can use to place or receive calls between 8:00 a.m. - 9:00 a.m. and between 11:15 a.m. and 10:00 p.m., Monday through Friday, and between 8:00 a.m. - 10:00 p.m., Saturday and Sunday.  (Telephone calls from patients' attorneys are accepted at all times.) Collect calls can be placed to others, but not received. Family and friends can call the Forensic Center at (734)429-2531, and ask to be connected to the appropriate inpatient unit.

Patients without funds may be allowed to call their attorney or family members at no cost, if the treatment team approves such a call.

Mail:  Patients may send and receive mail without restriction. However, all incoming mail addressed to the patient will be opened in the presence of staff to insure that prohibited items are not enclosed.

Mission, Vision & Values

Mission  Statement

The Center for Forensic Psychiatry's mission is to provide quality forensic mental health services to individuals and the Michigan court system.

Vision Statement

The Center for Forensic Psychiatry will provide high quality forensic mental health services. The CFP will strive to develop, monitor, and enhance programs which will help individuals with mental disorders, as well as their families and advocates, to understand, manage, and cope with the physical, mental, emotional, and social problems associated with their particular disorder. The CFP will also assist the Michigan Court System in the adjudication and disposition of forensic cases.

Organization

The Center for Forensic Psychiatry will use available resources in the most efficient and effective manner necessary to accomplish its mission.

Staff

The Center for Forensic Psychiatry will maintain competent staff that is motivated to deliver high quality services to its patients, the court system, and the community. The CFP will establish mechanisms to ensure that staff members practice within the scope of their competency, and consistent with generally accepted standards of practice. The CFP will promote continuous staff development of knowledge and skills.

The Center for Forensic Psychiatry will facilitate communication between and among its staff members, its various departments, and the community it serves, so that the mission, values and goals of the CFP will be understood, supported and implemented.

Professional Training

The Center for Forensic Psychiatry will develop and maintain accredited training programs, which prepare mental health professionals for practice in clinical and forensic areas.

Research

The Center for Forensic Psychiatry will provide research opportunities and encourage staff and students to participate.

Community

The Center for Forensic Psychiatry will create and maintain a positive relationship with the community. The CFP will promote an exchange of information that considers community needs and encourages community involvement.

Customer Satisfaction

The Center for Forensic Psychiatry will involve recipients, their support systems, and the court system in developing and shaping service delivery. The CFP will regularly assess satisfaction with services provided and will make improvements based on the feedback.

Improvement

The Center for Forensic Psychiatry will promote continuous quality improvement. The Center will maintain mechanisms to monitor and improve services delivered.

Values Statement

1. The Center for Forensic Psychiatry values human dignity and believes that the consumer is entitled to accessible, coordinated, and timely quality services.

2. The Center for Forensic Psychiatry values and provides services in a safe, humane, and secure environment.

3. The Center for Forensic Psychiatry values and provides individualized treatment which is designed to help its patients manage their mental disorders, and which promotes treatment in the most appropriate setting.

4. The Center for Forensic Psychiatry values autonomy, diversity, and privacy, and respects the rights of consumers and staff.

5. The Center for Forensic Psychiatry values and encourages patients and their advocates to participate in treatment planning and implementation.

6. The Center for Forensic Psychiatry values continuity of care and collaborates with support systems and other health care providers to assure that transition occurs with minimal disruptions in service.

7. The Center for Forensic Psychiatry values and promotes scientific integrity in its work with the court system.

8. The Center for Forensic Psychiatry values and promotes research as a tool for increasing knowledge and understanding of mental disorders as they relate to treatment and legal issues.

9. The Center for Forensic Psychiatry values and promotes training opportunities for providers of forensic mental health services.

10. The Center for Forensic Psychiatry values and promotes staff competency and skill development.

11. The Center for Forensic Psychiatry values and promotes fiscally responsible planning and use of available resources.

Treatment Services

Diane E. Heisel, M.D.
Treatment Services Director                                                                                          
heiseld@michigan.gov 
(734)295-4228

The Treatment Services Division provides treatment and/or diagnostic services for individuals who have been found either Incompetent to Stand Trial (IST) or Not Guilty by Reason of Insanity (NGRI). Treatment Services consists of seven (7) inpatient units and has a target census of 210 patients. There are three admission units, two for men and one for women, and five (5) intensive treatment male units, one of which has been designated for higher functioning patients with a more ambitious level of programming than the other four units. Each unit is staffed with psychiatrists, psychologists, social workers, recreational, occupational or music therapists, registered nurses, forensic security assistants, and a unit supervisor. Using "Person-Centered Planning," the patient and the treatment team work together to develop an individualized plan of services, resulting in an individualized treatment plan.

The Psychosocial Rehabilitation programs take place within the units and on Main Street.  Main Street is the CFP's common area for activities and therapeutic programs.  Program areas include: the patients' library, gym, fitness room, kitchen, activity rooms, a multipurpose room/chapel, music therapy, horticulture therapy and greenhouse. 

Occasionally, individuals who have been committed to another state hospital for psychiatric treatment under Chapter 4 of the Michigan Mental Health Code may be transferred to the Forensic Center for treatment. Such persons are transferred here because they present special management problems in the lesser restrictive setting. In very rare instances, prisoners from the Department of Corrections may be transferred to the CFP for treatment.

Commitment to Quality Care and Patient Safety

Commitment to Quality Care and Patient Safety

The Center for Forensic Psychiatry is a Joint Commission accredited hospital with a commitment to quality care and patient safety.

• If anyone (staff, patient, family or visitor) has concerns about patient safety, that person is encouraged to contact the Center for Forensic Psychiatry Nursing Shift Supervisor right a way.  The phone number is 734-295-4400.
• If an individual does not believe that the concern was addressed by the hospital, a report can be made to the Joint Commission.
• To contact the Joint Commission's Office of Quality Monitoring to report any concerns or register complaints about a Joint Commission accredited health care organization:

Telephone: 1-800-994-6610

Facsimile: 1-630-792-5636

Mail: One Renaissance Boulevard;  Oakbrook Terrace, Illinois 60181

Or

Email: complaint@jointcommission.org