Forensic Psychiatry as Public Health: Four Leaders Expanding the Role of Psychiatry
When people hear the words forensic psychiatry, they may think of courtrooms, psychiatric evaluations, or expert testimony. But forensic psychiatry encompasses much more. The American Academy of Psychiatry and the Law (AAPL) defines forensic psychiatry as a medical subspecialty that includes research and clinical practice in the many areas where psychiatry is applied to legal issues.
Public health, meanwhile, takes a broader view. Rather than focusing primarily on diagnosing and treating individuals, public health considers population health, emphasizing prevention, health promotion, and the social and policy conditions that influence well-being.
Where these fields intersect, forensic psychiatry can become a form of public health leadership. Forensic psychiatrists see how mental health intersects with families, schools, healthcare, child welfare, law enforcement, courts, incarceration, and reentry—creating opportunities to prevent harm, improve systems, and inform policy.
What does public health leadership look like in forensic psychiatry? Recently, I had the opportunity to explore this question during a Grand Rounds presentation in the Department of Psychiatry at the University of Nebraska Medical Center. The presentation highlighted three pathways to leadership: prevention, practice, and policy. I also shared the work of four psychiatrists whose careers demonstrate how this broader vision can extend from individual care to families, communities, institutions, and systems. Through their experiences, we can see how prevention, clinical practice, research, and policy can come together to create meaningful change.
These pathways to public health leadership can take many forms. The following four psychiatrists offer distinct examples of how forensic psychiatry can extend beyond the courtroom—from supporting individuals and families to strengthening communities, informing clinical practice and research, and shaping the systems and policies that influence mental health and well-being.
Annie Goldie Steinberg, MD
Clinical Professor, Perelman School of Medicine at the University of Pennsylvania
Forensic expertise as a pathway to justice
For Dr. Annie Goldie Steinberg, public health leadership has included using forensic psychiatric expertise in matters with consequences far beyond an individual case.
Her career has included litigation involving deinstitutionalization, disability rights, special education, sexual abuse of women and minors, foster care, children's rights, exonerations, pardons, and the death penalty.
She describes the impact of this work in terms of both individual lives and broader legal outcomes:
"Advocating for justice by providing competent forensic work can change a life, and sometimes it can change the legal outcome and impact many lives."
Her work illustrates how forensic psychiatry can contribute to public health by bringing psychiatric knowledge into legal decisions that affect individuals, families, and communities.
It also reflects an important principle: the impact of forensic work does not necessarily end when a case ends. The knowledge generated through individual cases can illuminate larger questions about rights, systems, and justice.
Lisa R. Fortuna, MD, MPH, M.Div.
Professor & Chair of Psychiatry and Neuroscience, University of California Riverside
Looking upstream to prevent harm
Dr. Lisa Fortuna describes her work as sitting at the intersection of psychiatry, public health, and law. Her work examines how policies, legal systems, and structural conditions shape the mental health and developmental trajectories of children, families, and communities, with particular attention to immigrant and marginalized populations.
A central idea in her work is the importance of looking upstream—at the places where distress first intersects with institutions.
She identifies schools, healthcare, child welfare, immigration systems, community settings, and first contact with police or courts as important opportunities for intervention and prevention.
She asks:
“What responsibilities do institutions, laws, and societies have for creating—or damaging—the conditions children need to feel safe, belong, develop, and thrive?”
This question reflects a broader vision of psychiatric leadership—one that considers not only what happened to a person, but also what conditions contributed to that experience in the first place.
Dr. Fortuna describes forensic psychiatry as public health leadership that brings clinical knowledge, developmental science, and public health evidence into settings where consequential decisions are made, including courts, policy processes, government institutions, and public discourse.
Her work shows how forensic psychiatry can move beyond documenting harm to help shape systems that promote safety, belonging, development, and well-being.
Kimberly Clawson, MD
Forensic Psychiatry Fellowship Program Director, University of Nebraska Medical Center
Bringing mental health into the legal system
Dr. Kimberly Clawson's work offers another example of public health leadership: working directly within the legal system while advocating for mental health-centered approaches.
One of the most impactful areas of her work has been a mental health treatment court for individuals with felony convictions. The court provides an opportunity for participants to receive mental health treatment, and successful completion of the program can result in felony convictions being removed from their records.
She also serves as legislative chair for the Nebraska Psychiatric Society, where she helps inform the mental health community about proposed policies and provides testimony before the Nebraska legislature.
Her work illustrates how forensic psychiatrists can operate at the intersection of clinical care, courts, and public policy.
As she explains:
"Forensic psychiatrists have specialized knowledge that makes them especially adept at navigating the legal system. As a result, we are in the ideal position to advocate for public health and mental health changes on a systemic level."
Her experience shows that public health leadership can happen within systems themselves—by helping those systems recognize mental health needs and create pathways to treatment and support.
Eraka Bath, MD
Professor of Psychiatry, Assistant Dean of Inclusive Excellence, and Vice Chair of Inclusive Excellence, UCLA
Understanding the structures behind legal-system involvement
Dr. Eraka Bath brings a developmental, community, and structural perspective to her work with young people involved in the legal system. Since 2007, she has served as consulting psychiatrist to Los Angeles County's juvenile mental court, a specialty problem-solving court for youth on probation that centers mental health treatment as a cornerstone of rehabilitation.
Her research also examines commercial sexual exploitation of youth and reproductive justice, particularly the experiences of girls involved in juvenile legal and child welfare systems.
Her My Body, My Choice project uses a youth-centered and youth-co-led participatory framework to advance behavioral and sexual and reproductive health for system-involved youth.
For Dr. Bath, public health leadership requires understanding the larger structures that shape who comes into contact with the legal system.
She describes it this way:
"Forensic psychiatry as public health leadership means thinking about structural intersectionality and being structurally informed about how certain groups experience disproportionate carceral contact."
Her work shows how forensic psychiatry can expand beyond the question, "What is happening with this young person?" to ask:
What systems, environments, and social conditions are shaping this young person's experience?
A Broader Vision of Forensic Psychiatry
Forensic psychiatry is often associated with courtrooms and individual cases, but its potential reaches much further. As these leaders demonstrate, forensic psychiatrists can use their expertise to prevent harm, improve systems, inform policy, and promote mental health at the community level.
No single path leads to public health leadership. It may involve clinical practice, research, treatment courts, policy advocacy, education, or community partnerships. What connects these approaches is looking beyond the individual case to understand how laws, institutions, and social conditions shape mental health and well-being.
Forensic psychiatry and public health invite us to ask not only how we can respond to harm? but also how we can prevent it and create healthier systems.
By bringing psychiatric knowledge into courts, communities, and policy spaces, forensic psychiatrists can help shape the conditions in which individuals, families, and communities can thrive.
Forensic psychiatry is public health leadership in action.