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Mental health evaluation in criminal cases is a complex and challenging task. The purpose of this paper is to highlight the value of semi‐structured interviews for diagnosis, the use of literature review to increase understanding of a case, and the importance of looking “beyond” the criminal offence itself.

The author conducted a forensic mental health assessment of a man who killed his wife and two young daughters. The case is presented in the order in which information reached the psychologist, so her clinical reasoning becomes apparent. Findings from the police file are integrated with psychological test results and a literature review on familicide and uxoricide.

The case analysis illustrates the perpetrator fits a personality profile found in empirical research on male spousal killers, who often suffer from dependent, avoidant and over‐controlled personality pathology. Four mental health experts who previously reported on this case had not agreed on a diagnosis. Using a more structured approach to assessment, the current analysis sheds new light on the relationship between mental disorder and offence.

The use of semi‐structured interviews for psychiatric diagnosis increases diagnostic reliability. Since there is so much at stake for the assessed in a criminal investigation, the importance of reliability and accuracy of diagnosis cannot be overestimated. Forensic mental health experts serve the court best by integrating findings from structured assessment instruments, file information and empirical research on comparable offender types.

This paper can be useful for teaching purposes and provides guidance to both novice and experienced forensic experts.