Forensic psychiatric examinations have been carried out in Finland since the 19th century. A central concept of justice is that persons with severe psychiatric illnesses should not be subject to retributory sentences, but that their illness should be treated by medical authorities. By virtue of the Code of Judicial Procedure (Chapter 17, Section 45) a court may order the mental state of a person charged with an offence to be examined. The Finnish Institute for Health and Welfare (THL) orders where the mental examination is to be carried out. The examination is usually carried out at a hospital; the physician responsible for the examination issues a statement on the examination and delivers it THL, which then issues its own independent statement on the mental state of the accused to the court.
In international comparison the Finnish practice of these court-ordered mental examinations stands out as being very thorough. Background information concerning persons undergoing mental examination is obtained from the persons themselves and from a wide array of public institutions and organizations, such as health care units in charge of previous treatment, social services, schools and the police. In addition, with the consent of the examinee, information is obtained from family members, friends and employers. During the mental examination the person undergoes extensive psychiatric evaluation and standardised psychological tests, is monitored in a mental hospital or other examination facility by staff for a period of ca. two months, and is also subjected to a physical health examination. Possible structural abnormalities of the brain may also be examined using imaging methods. Although the extensive examination practice is time-consuming and expensive, the data obtained through the use of this method are reliable by international standards, and therefore support the legal protection of the person being examined.
With regard to the reliability of forensic psychiatric mental examinations, it is important that mental examinations in Finland are carried out at the request of a court. Finnish forensic psychiatrists are obligated to present an independent, objective opinion on the mental health of the examinee at the time of the accused offence and the mental examination, regardless of whether the observations made during the mental examination provide evidence to support the view of the prosecution or the defence. Considering the impartiality of the physician carrying out mental examinations, it is of paramount importance that the s/he is not an expert in the service of either the prosecution nor defence. In contrast, for example in the United States the standard practice is that both the defence and prosecution can present the views of their respective forensic psychiatrists regarding the mental state of the person being examined. The risk inherent in such a practice is that both parties only present facts providing support for their own viewpoint. Finnish judges have expressed their satisfaction with the information obtained from mental examinations. Courts have deemed the information obtained from mental examinations to be reliable in over 90 percent of cases.
Mental examinations at Niuvanniemi Hospital are carried out on closed wards, which means that the wards have the preparedness and facilities required for isolation in accordance with the Mental Health Act, which is also applicable to examinees. As a rule, examinees reside on the ward with treatment patients, sharing rooms and recreational facilities with them; no-one is isolated without the appropriate grounds as provided by the Mental Health Act. Examinees may have the opportunity to meet their family, based on case-by-case assessment. During the examination examinees are not allowed hospital leave. After the examination has been completed, THL grants leave to discharge the examinee. The examinee referred for treatment will wait for the decision of THL at the hospital.
Located at Niuvanniemi Hospital, the department of Forensic Psychiatry of the University of Eastern Finland has carried out a wealth of epidemiological research on, for example, the risk of violent crime offenders reoffending. Information gained from research in forensic psychiatry also serves the court-ordered psychiatric examinations.