What Questions Should Solicitors Ask a Psychiatric Expert?

Introduction

The usefulness of a psychiatric report is shaped as much by the instruction as by the assessment itself. Well-framed questions help the expert stay focused on the live issues, make assumptions explicit, and present reasoning in a way the court can apply. Poor questions—overbroad, legally framed, or unclear on purpose—often lead to delay, additional cost, and the need for clarification or addenda.

This page provides a structured set of questions solicitors can adapt for letters of instruction. It is offered for general information only and does not constitute legal advice. For common instruction-stage errors that cause rework, see Common Pitfalls When Instructing a Psychiatric Expert.

First Principles: Ask Clinical Questions, Not Legal Ones

Psychiatric experts assist the court on matters within clinical expertise—diagnosis, symptomatology, functional impact, prognosis, and clinically framed causation or contribution. The expert does not decide the law, and should not be asked to make findings of fact or to determine credibility. Where facts are disputed, the report is often most useful when the expert is asked to state the assumptions used and (where appropriate) give opinions on alternative factual scenarios.

If you want a clear explanation of what properly falls within psychiatric expertise (and what does not), see Scope and Limits of Psychiatric Expert Evidence. For the expert’s overriding duty and how it shapes report writing, see The Psychiatrist’s Duty to the Court.

Core Questions (Copy/Paste Checklist)

In many cases, these core questions—kept neutral and clinically framed—will cover what the court is likely to need:

• What diagnoses (if any) are supported, and what clinical features support them?
• What is the severity, course, and current presentation, and how does it affect day-to-day functioning?
• What materials were reviewed (records, collateral information), and how do they support or contradict the history given?
• What is the clinical formulation (including pre-existing vulnerabilities, maintaining factors, and comorbidity)?
• On the balance of probabilities, is the condition attributable to the alleged events, and if not wholly attributable, what is the likely contribution of other factors?
• Are there plausible alternative explanations, and how are they accounted for in the formulation?
• What is the prognosis (with treatment and without), and what factors may materially alter it?
• What treatment is indicated, what is the likely duration, and how practical is it in context?
• Are there any limitations, uncertainties, assumptions, or missing records that affect confidence in the opinion?
• If facts are disputed, can the expert provide opinions on alternative factual scenarios (clearly stated)?

For civil proceedings, CPR Part 35 compliance also matters to weight and admissibility. For a practical overview, see CPR Part 35 Compliant Psychiatric Reports.

Question Bank by Purpose

Diagnosis and Clinical Picture

Use these where diagnosis, symptom profile, or differential diagnosis is central:

• What diagnoses are supported, and what is the differential diagnosis (including comorbidity)?
• What are the key symptoms, their onset, course, and fluctuation over time?
• What is the relevance of pre-existing mental health history (if any) and any periods of remission or relapse?
• What is the impact of medication, substance use, physical health conditions, or psychosocial stressors on presentation?
• Are there features suggesting exaggeration, minimisation, or inconsistency that should be interpreted clinically (without the expert making a credibility finding)?

Functional Impact

Courts and tribunals generally find concrete descriptions of functional impact more useful than diagnostic labels alone:

• How does the condition affect activities of daily living, sleep, concentration, motivation, and social functioning?
• What is the impact on work capacity, attendance, performance, and workplace interaction (where relevant)?
• What adjustments or supports (if any) are clinically indicated, and what are their likely benefits and limits?
• Is the reported impact consistent with the clinical findings and the documentary record?

Causation and Attribution (Clinically Framed)

Where causation or contribution is disputed, clarity on assumptions and timeline is key:

• What is the temporal relationship between the alleged events and symptom onset or deterioration?
• On the balance of probabilities, is the condition caused by, or materially contributed to by, the alleged events?
• What role do pre-existing vulnerabilities, concurrent stressors, or subsequent events play in the presentation?
• Are alternative explanations plausible, and what clinical features or records support or weaken them?
• Where there are disputed facts, can the expert provide opinions on alternative scenarios (clearly specified)?

If you want to understand what makes psychiatric evidence more persuasive in court—records engagement, reasoning, and transparency—see How Courts Evaluate Psychiatric Evidence.

Prognosis and Future Impact

Prognosis is inherently uncertain; the best opinions explain confidence and contingencies:

• What is the likely trajectory over the next 6–24 months, and beyond, with appropriate treatment?
• What is the likely trajectory without treatment or with limited engagement?
• What factors are most likely to improve outcome (protective factors), and what factors may worsen it (risk or maintaining factors)?
• Is a range of outcomes more appropriate than a single prediction—and why?

Treatment and Recommendations

Recommendations should be practical and proportionate:

• What treatments are clinically indicated (medication, therapy, social interventions), and what is the expected duration?
• What is the likely benefit of treatment, and what are the limits or uncertainties?
• Are there service-access constraints that may affect practical implementation, and what realistic alternatives exist?
• Where risk is relevant, what risk management measures are appropriate and proportionate?

Capacity-Focused Instructions (Where Relevant)

Where capacity is in issue, the most common problem is failing to specify the decision and relevant timeframe. Consider asking:

• What is the relevant impairment or disturbance of mind or brain, and how does it affect decision-making abilities?
• Can the person understand, retain, use or weigh the relevant information, and communicate a decision (with support where appropriate)?
• Is capacity fluctuating, and if so, what triggers fluctuation and what practical supports may assist?
• Are there limitations in the evidence base (for example retrospective assessment) that affect the confidence of the opinion?

Mini Templates by Case Type (Short, Practical Sets)

Personal Injury and Civil Claims

• What is the primary diagnosis and severity, and how is it supported by clinical findings and records?
• Is the presentation consistent with the alleged mechanism and timeline?
• On the balance of probabilities, what is attributable to the index event, and what is attributable to other factors?
• What is the prognosis and expected time to resolution or plateau with treatment?
• What treatment is indicated and proportionate, and what barriers exist to engagement?

Workplace Stress, Bullying, or Harassment Allegations

• What is the diagnosis and functional impact, particularly in occupational functioning?
• How does the timeline of symptoms relate to the alleged workplace events and to any non-work stressors?
• What role do pre-existing vulnerabilities play, and how does that affect attribution?
• What is the expected prognosis with support, and what steps are likely to be helpful in recovery?
• If facts are disputed, can the expert provide opinions on alternative scenarios?

Family Proceedings (Where Psychiatric Issues Affect Welfare)

• What is the diagnosis and current stability, and what impact does it have on parenting capacity in practical terms?
• What treatment or support is indicated, and how likely is engagement?
• Are there risks relevant to welfare, and what factors mitigate or increase risk?
• What is the likely course over the next 6–12 months with and without treatment?

Instruction Hygiene: What to Provide With the Questions

Even well-drafted questions can produce weak evidence if the expert does not have the right materials. In many cases it is helpful to provide:

• a clear summary of the issues the report must address (and the jurisdiction/procedural framework)
• a chronology and key documents (pleadings where relevant)
• contemporaneous medical records and any relevant therapy notes
• occupational/educational records where functional impact is in issue
• any specific assumptions the expert should apply (especially where facts are disputed)
• deadlines, hearing dates, and whether court attendance is possible

For a practical step-by-step on what we require when you instruct, see Instructing Us.

Conclusion

The most persuasive psychiatric evidence is built from neutral, clinically framed questions that are aligned to the issues in dispute, grounded in records, and transparent about assumptions and limitations. Thoughtful scoping at the outset reduces delay and produces reports that genuinely assist the tribunal of fact.

This page is provided for general informational purposes only and does not constitute legal advice. Procedural requirements vary by jurisdiction and case type, and solicitors should apply their own professional judgement to the circumstances of each instruction.