The Ehrlich case and others like it are examples of the tremendous responsibility psychiatric medical professionals take on when they become involved in criminal psychiatric evaluations for the court system.
If there is a capital punishment issue (crimes that can result in a death penalty), the reason for the psychiatric examination may be to evaluate whether the defendant is competent to be executed. The common notion of the insanity defense is that there is a straightforward question of whether the defendant was responsible at the time of the crime. However, in fact there are many important issues at hand. The defendant could have been responsible at the time, and then became mentally ill because of the police arrest, and hence did not understand the Miranda warnings. The kernel of the issue is what was the mental state of the defendant at the time of the crime.
Let’s take a moment to explore the psychiatric evaluation process and the amount of time spent on each patient. In America we have a multi-layered system which may unfortunately translate into "you get what you pay for." If you are being defended by a public defender (Legal Aid Society), they have limited funds. It is generally believed in the medical community that most doctors will not spend less than 45 minutes at the very minimum on an insanity defense evaluation (described as a psychiatric hour). This is because psychiatrists providing insanity defense evaluations need sufficient time to properly gather information; it also helps the doctor to maintain credibility in court.
Because there are wide discrepancies in how psychiatric evaluations are done, many experts believe the best solution is to look for whether or not there was any other evidence, independent of the defendant’s or police testimony. This additional evidence may help reveal what the defendant’s mental state was at the time of the alleged crime. Were there eyewitnesses? Had the person had other psychiatric help prior to the incident? It is important to mention that this type of evaluation is not confidential once a defendant chooses an insanity defense in a criminal case.