11 Forensic psychiatry11.1 Crime and mental disorder
11.1.5 Equality and reasonable adjustments
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Written by Resident Doctor Committee · Published
New in the 2027 syllabus
The College added this topic for exams from January 2027.
The legal framework
The Equality Act 2010 is the main equality law in Great Britain. Northern Ireland has its own discrimination laws, including the Disability Discrimination Act 1995.
The protected characteristics are age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.
What counts as a disability
A disability is a physical or mental impairment that has a substantial, long-term adverse effect on normal day-to-day activities. A diagnosis alone does not decide whether someone meets this definition.
"Long-term" generally means the effect has lasted, or is likely to last, at least 12 months or the rest of the person's life. There are provisions for effects that recur or fluctuate.
Forms of discrimination
Form | What it means |
|---|---|
Direct discrimination | Treating someone less favourably because of a protected characteristic |
Indirect discrimination | A rule applied to everyone puts a protected group at a disadvantage, without enough justification |
Discrimination arising from disability | Treating someone unfavourably because of something that results from their disability, subject to the legal tests |
Harassment | Unwanted conduct that meets the legal test of violating a person's dignity or creating a hostile environment |
Victimisation | Treating someone badly because they did a protected act, such as making a discrimination complaint |
Reasonable adjustments
Reasonable adjustments remove or reduce a substantial disadvantage that disabled people face. The arrangement changes to fit the person, rather than everyone having to use exactly the same one.
For service providers, the duty is anticipatory. Services should think ahead about predictable barriers before a particular disabled person asks for help.
Barrier | Possible adjustment |
|---|---|
A rule or practice | Longer appointments, breaks or a different way of booking |
A physical feature | Accessible rooms and suitable routes into the building |
Need for an auxiliary aid or service | Communication support, information in an accessible format or suitable equipment |
Whether an adjustment is reasonable depends on how effective and practicable it is, what it costs and what resources are available in that setting. Inconvenience alone is not a reason to refuse. The disabled person should not be charged for an adjustment that the duty requires.
Applying this in forensic settings
To take part effectively in proceedings, a person's communication, understanding, attention and sensory needs should be assessed directly. Do not make assumptions from a diagnostic label.
Support may include simpler questions, planned breaks or help from a communication specialist, depending on the person's needs and the court's directions.
Fitness to plead is a separate legal question. Needing adjustments does not, on its own, show that a person is unfit to plead.
The public sector equality duty requires due regard to eliminating unlawful discrimination, advancing equality of opportunity and promoting good relations.
Document the disadvantage, the agreed adjustment, who is responsible and when it will be reviewed, including whether the change worked in practice.