Why Evidence Matters More Than Opinion in Psychiatric Medicolegal Work

This is part of a three-part series examining how psychiatrists in medicolegal practice can effectively bridge the gap between clinical complexity and legal clarity.

Lawyers often want clear, definite answers. Psychiatrists, however, live in a world of nuance. In medicolegal work — especially in historical abuse cases — the challenge is to bridge those two worlds with integrity. Evidence and opinion both matter, but evidence must always take the lead.

A psychiatric opinion, no matter how well written, won’t stand up in court if it isn’t grounded in evidence. That means going beyond the claimant’s narrative and thoroughly examining the supporting documents — past assessments, treatment records, and any contemporaneous notes. Getting the names, dates, and references right might seem tedious, but months or even years later, when you’re asked to give evidence in court, those details become your anchor. You’ll know exactly why you reached your conclusions — and where the inconsistencies lay.

Evidence isn’t just documentary. It also means referencing high-quality research. Citing credible studies strengthens your opinion and reassures the court that your conclusions align with the broader psychiatric evidence base, not personal belief. A prime example is the Australian Child Maltreatment Study (Mathews et al., 2023) — an invaluable and contemporary resource demonstrating the lifelong mental health and other effects of all forms of childhood abuse and neglect. Applying the research findings from this landmark study to a case involving incidents of historical child abuse and sequelae of outcomes, including the development of psychiatric illness will explain to the referring lawyer and the Court why you have formed your opinion. We should be drawing on this research more often to substantiate our opinions, rather than relying solely on case experience or intuition.

Ultimately, the legal system depends on experts who can explain complex psychiatric issues with clarity and evidence. When we provide opinions that are transparent, defensible, and research-informed, we don’t just help the court — we elevate the standard of medicolegal psychiatry as a whole.

If you work in this space, start building your “evidence library.” Reference it. Revisit it. And let your expertise rest on something more solid than opinion alone.