We integrate multiple domains of psychological science to identify, better understand, and manage the effects of subtle but powerful biases in forensic mental health assessment. This topic is ripe for discussion, as research evidence that challenges our objectivity and credibility garners increased attention both within and outside of psychology. We begin by defining bias and provide rich examples from the judgment and decision making literature as they might apply to forensic assessment tasks. The cognitive biases we review can help us explain common problems in interpretation and judgment that confront forensic examiners. This leads us to ask (and attempt to answer) how we might use what we know about bias in forensic clinicians’ judgment to reduce its negative effects.

We conducted an international survey in which forensic examiners who were members of professional associations described their two most recent forensic evaluations (N=434 experts, 868 cases), focusing on the use of structured assessment tools to aid expert judgment. This study describes:

1. The relative frequency of various forensic referrals.
2. What tools are used globally.
3. Frequency and type of structured tools used.
4. Practitioners’ rationales for using/not using tools.

We provide general descriptive information for various referrals. We found most evaluations used tools (74.2%) and used several (on average 4). We noted the extreme variety in tools used (286 different tools). We discuss the implications of these findings and provide suggestions for improving the reliability and validity of forensic expert judgment methods. We conclude with a call for an assessment approach that seeks structured decision methods to advance greater efficiency in the use and integration of case-relevant information.