UH Forensic Psychiatrist Wins National Award, Honored for Contributions to the Field

UH Clinical Update | December 2023

School shootings, intimate partner violence and the complicated connection between mental illness and family homicide are some of the most challenging issues confronting modern society. Forensic psychiatrist Susan Hatters-Friedman, MD, Director of the Division of Forensic Psychiatry at UH Cleveland Medical Center, is at the forefront on all of them – and many more.

Susan Hatters-Friedman, MD

Working at the nexus of mental health and the law, Dr. Hatters-Friedman leads a team at UH providing invaluable assistance to prosecutors, defense attorneys, judges, law enforcement and other members of the justice system to help support the judicial process, offering evaluations of both defendants and victims in both civil and criminal cases.

“Our team provides high-quality forensic psychiatry evaluations to assist finders-of-fact deciding complicated legal issues,” she says. “Some of the services we provide include evaluation for criminal responsibility, competency to stand trial, malingering, fitness for duty and suicide and violence risk assessments.”

Relevant work: Hot-button issues are naturally her stock in trade. Take the issue of guns and mental health, which many turn to as an explanation for school shootings.

“Being acutely, mentally unwell can increase your risk of violence in general, of course,” Dr. Hatters-Friedman says. “But it’s untrue that it’s the sole explanation. Overwhelmingly no.”

Intimate partner violence is another area rife with misconceptions – even among healthcare providers, she says.

“IPV should be something that psychiatrists and other physicians are asking about and thinking about in terms of prevention,” she says. “Oftentimes we see it before people are charged, when we're treating somebody, either a victim or a perpetrator or a potential perpetrator. And then we in forensics also see cases after horrible violence has occurred, within the family as well. Thinking about prevention of partner violence is such an important thing. Doctors should be seen as approachable for a person who’s being victimized.”

Achievements gain acclaim: When she is not seeing patients or supervising forensic psychiatry fellows at the Northcoast Behavioral Healthcare forensic hospital in Northfield or the Justice Center’s psychiatry clinic in Cleveland, Dr. Hatters-Friedman is also an active researcher and prolific writer. She is the author of more than 350 research articles, academic reviews, op-eds, book reviews, movie reviews and more. In recognition of her contributions, the leading organization in forensic psychiatry -- the American Academy of Psychiatry and the Law -- recently named Dr. Hatters-Friedman the 2023 winner of its Seymour J. Pollack Distinguished Achievement Award.

Maternal mental health: Though forensic psychiatry is her main focus and passion, Dr. Hatters-Friedman is also trained as a reproductive psychiatrist and treats new moms through UH MacDonald Women’s Hospital one day a week and supervises residents there. She also continues work that began almost 20 years ago to provide mental health treatment to parents who had a baby in the NICU.

“There's so much need being in the NICU,” she says. “It's such a stressful situation. Mom may have had a traumatic delivery and then worries about whether her baby is going to live or die or be disabled. These moms and dads are on a roller coaster on a daily basis, so it's especially important that there are mental health services available.”

Because a new mom is not a NICU patient and therefore can’t be billed that way for insurance purposes, Dr. Hatters-Friedman and her colleagues have had to be creative over the years securing grants to fund this important work. But it’s well worth it, she says. To provide further support to NICU families, Dr. Hatters-Friedman and her team give monthly sessions for NICU staff on what they can do to help.

Popular culture as vehicle: With all of this work, the subjects are often difficult. Crime and mental illness are both stigmatizing and poorly understood. To accommodate this reality, Dr. Hatters-Friedman says it’s important to stay grounded in the everyday and speak about the sometimes-difficult mental health subjects of forensic psychiatry in ways the public can understand – or even that the residents and fellows she’s training in the discipline can understand. Iconic characters from the Star Wars movies, for example, are a favorite teaching tool. The motley cast of characters, she says, can demonstrate everything from borderline and narcissistic personality traits, to psychopathy, PTSD and partner violence risk.

“It’s partially tongue in cheek, but also it's quite memorable for learners,” she says.

Dr. Hatters-Friedman also uses her skill as a writer to dispel misconceptions about mental health that are such a prominent feature of American movies, especially in the horror genre. She regularly contributes movie reviews to her field’s journals to provide colleagues with new and innovative ways to approach the material. And she recently completed a crime novel as part of a master’s degree in crime fiction and thriller writing from the U.K.’s prestigious University of Cambridge.

She’s come a long way from the little girl who enjoyed reading about the adventures of girl detective Cam Janson – who had a photographic memory – and Nancy Drew. But that desire to solve mysteries – both in crimes themselves and in the workings of the human mind behind them – persists even all these years later.

“I took my first forensic psychiatry class because I loved reading mysteries and thought it seemed like an interesting subject,” she says. “I’m still awestruck that it’s a real job I can do.”