INTERVIEW

'Psychological torture does not work': A forensic psychologist on interrogating a criminal

Investigating a crime also means having to deal with people with PTSD or the mentally ill, says psychologist Dr Gavin Oxburgh.

The pursuit of truth in a legal case often hinges on interviews with victims, witnesses and suspects – some traumatised, some mentally ill. In countries like the United Kingdom forensic psychologists play a major great role in criminal investigations. Psychologists are involved in training members of the police on how to interview victims and suspects of crimes, on how to ask open questions, on how to build rapport with someone who is reluctant to talk, on how to be empathetic with a person to get additional information.

Dr Gavin Oxburgh, a forensic psychologist from Newcastle University in the United Kingdom and founder of the International Investigative Interviewing Research Group that is funded by more than 560 odd members from 35 countries in the world, spoke to Scroll.in on ethical ways of conducting an interviewing in a criminal case, the dangers of coercive techniques and the misconceptions about sexual offenders. Here is an excerpt of the interview.

How do you interview someone who has been traumatised or is vulnerable?
With persons suffering from Post Traumatic Stress Disorder or PTSD [a disorder among people who have been through a shocking, scary and a dangerous event] and mental disorder, the way you interview the person would be very different. In the UK, we have a communication expert in the interviewing room. These people are intermediaries employed by the Ministry of Justice. As a consequence of abuse, people suffering from PTSD may not speak at all and go mute, as we say. The intermediary can then get information by different means such as typing a text on an iPad, or sketches or diagrams. We can still get the same information in a non-conventional manner.

What techniques can be employed to get an effective interrogation? What would be the most ethical way of conducting an interview?
In England, we have a PEACE model, which has been accepted in a lot of countries such as Canada, Norway, Scandinavia. This is has the most ethical manner of interviewing suspects.

Before you do an interview, you need to Plan and prepare what your questions are, and also be ready for what the defences may be. E is for Engage and explain about what the interview is about in an ethical manner. A is to let the interviewee explain or give accounts. We could perhaps even challenge these accounts. C is to close an interview and tell them what will happen after it. E is to evaluate the involvement of the person interviewed.

Credit- UK College of Policing
Credit- UK College of Policing

The questions should always be open ended covering the who, when why, where, what and how. You want them to do all the talking.

If you ask a leading question, the answer may not be correct. If you ask for instance, what happened in a particular bedroom, you are asking a highly suggestive question. That would mean you have already made up your mind. We call it a confirmation bias where the police is only asking questions which confirm their own bias.

Dr Gavin Oxburgh
Dr Gavin Oxburgh

Many suspects in India accuse the police of torture during interrogation. Apart from the violation of human rights, does the technique even work for a crime investigation?
Using psychological torture and beating people, does not work. In fact you may get false information. From the health angle too, it is dangerous. If someone has a mental health disorder or has a disability, using a coercive technique will not work. If the person does not understand anything, he will just say anything or say nothing.

You have interviewed sex offenders. What is the biggest misconception we have about them? What are your impressions about them and how should they be questioned?
Sex offenders and paedophiles are not a homogenous group. One of the beliefs in society is that they are one-eyed monsters. For me, they are everyday individuals who could be lawyers, police officers, they could be people you and me meet. You have to treat them with a little bit empathy and dignity. Especially if you need information from them. You need to be able to convict them if they are the offenders. They would be taken off the streets and they will no longer be able to abuse more children.

How do you manage to convince the police to follow this model? Do they believe in this kind of research?
Some cops do say that this research is rubbish. We give them case examples, and videos on some of the problems and issues related to the conventional way of questioning. They then sit back and say ‘Wow!’ They don’t know what they don’t know. I also tell them that I was a military police officer earlier and changed my ways.

What were the misconceptions you had as a young military officer?
When I was very young, I used to think that nobody would confess to a crime they did not commit. But I was wrong. There are many people who go through psychological torture, or mental health issues, they would confess. They want torture to stop.

You have done a paper on empathetic questioning of witnesses, especially victims.
I knew empathy was not used a lot in police interviews. Was it because police didn’t want to use empathy? We realised that they do not understand the difference between sympathy and empathy. As cops, they don’t want to sympathise with a suspect. But there is nothing wrong with empathising with someone. Empathy would be about trying to help a person out of the ground. Sympathy would be jumping into the hole with them. So it is not about sympathy, but about empathy.

Do you think the way a questioning room or a court looks makes a difference in the way people answer in an interview?
We have realised that in case of vulnerable victims, if the questioning room is laid out as someone’s front room, it is most useful for an interview. A room with comfortable chairs, a coffee table, with the cameras in a corner and not obtrusive, very laid back atmosphere, not oppressive in any shape or form, has an impact in the way a person gives information. How we get answers depends on how that person will feel. If they feel more relaxed and more chilled out, they will give more information and will want to help you more. A (typical) suspect room is not a conducive way of conducting interviews.

Any plans to work with the Indian police?
We would be most willing to help the Indian police and the government to take things forward. I do not think the police do not want to use these techniques, it is because they don’t know. There are about 99 Indian members in my research group. They have some interest in changing things. The question is how do you implement such a change. It took decades for us to change the UK systems. Now using torture is far removed in police practice in the UK. We need to start somewhere

The death penalty clause assume that some people cannot be reformed. What are your views on that.
I think that is fundamentally wrong. People can be reformed. We have proven that through years of treatment in prison and probationary service.

In some countries, like the UK, rehabilitation programmes start the day a person enters prison. We also try give education in prison so that they can equip themselves better. Most persons in prisons are of lower intellect. If we can help educate them, the chances are that they won’t commit those crimes.

We welcome your comments at letters@scroll.in.
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Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

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  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.