In this chapter we will look at the medicolegal connotations of PTI. Where there is a need specifically to address legal practice, the focus will be quite clearly upon the interaction of PTI and law in England and Wales. Aspects of American law have been addressed widely elsewhere, for example by Sparr (Sparr and Boehnlein, 1990) and others. Indeed, almost all of the work concerning PTI and criminal law, as well as much of that concerning civil law, comes from America. There are a number of useful books and pamphlets which specifically address the legal side of the psychiatric injury issues (Napier and Wheat, 1995) (Law Commission 1995) in England and Wales, or in areas with similar basis of law (Mullany and Handford, 1993). An attempt will be made in this chapter to examine both criminal and civil legal issues from the point of view of the expert clinician.

Probably more than any other form of mental illness, PTI is associated with medicolegal issues. It seems that in almost every case of PTI, be it PTSD or another condition, there is at least the potential for some form of legal or quasilegal consequence. There are a number of obvious areas of possible concern:

• PTI may be presented as a defence or mitigating factor in criminal cases

• PTI may be a consequence of criminal behaviour

• PTI may be a consequence of a civil wrong.