The current debate over suppression orders on mental health grounds turns on an important but often overlooked question: what, exactly, can psychiatric evidence reliably establish?
As a psychiatrist, I do not wish to lessen the importance of mental illness. Courts should keep the authority to safeguard genuinely vulnerable individuals in exceptional cases. However, I am worried that psychiatric reports might be asked to answer questions that psychiatry is not well-equipped to answer with confidence.
A psychiatrist can assess a person’s current mental state with reasonable skill. We can diagnose depression, anxiety, psychosis, substance misuse, and general vulnerability to stress. What we cannot do with the same degree of confidence is predict the exact impact of a particular event within a much larger and already distressing legal process.
That distinction is crucial. The core issue in these applications is not simply whether an accused person is distressed or mentally unwell. It is whether publication of their name is likely to cause such harm that the principle of open justice should be displaced. That is a much narrower, and much more speculative, question.
How can any psychiatrist confidently separate the effect of publication from the effect of being accused, charged, discussed within one’s family or community, exposed to gossip or social media, brought before a court, or ultimately tried and convicted? These experiences overlap and interact. In many cases, they may be impossible to disentangle with scientific precision. A psychiatrist may reasonably conclude that a person is vulnerable. It is far harder to say that naming them, rather than the prosecution itself, is the decisive additional factor.
This is not a criticism of psychiatrists. It is simply a recognition of the limits of the discipline. Psychiatry is much better at describing current illness and identifying broad risk factors than at making fine-grained predictions about what will happen if one specific event occurs.
There is also the question of independence. Many of these reports are prepared in an adversarial setting, commissioned and paid for by lawyers acting for the accused. That does not make the opinions improper, but the conflict is obvious. The report is obtained for a forensic purpose, on a tightly framed legal question, and that context matters. Even where the author is a treating psychiatrist, the difficulty remains. A long-term clinician may know the patient well, but still cannot confidently isolate the mental health effect of publication from the broader burden of accusation and trial.
A further problem is that psychiatrists are not reliable lie detectors. We can assess plausibility, consistency, and corroboration, but we cannot confidently determine whether symptoms are being exaggerated for personal advantage. That limitation becomes especially relevant in a forensic context where the stakes are high.
For these reasons, psychiatric reports should inform courts, but they should be treated cautiously and tested rigorously. If suppression is sought on mental health grounds, the court should ask not merely whether a person is unwell, but what evidence shows that publication creates a distinct and substantial risk beyond the ordinary burdens of prosecution.
Mental illness deserves respect. So does open justice. Courts should be slow to set aside one on the basis of psychiatric predictions that are far less exact than they may appear.