Background and Objectives: International studies consistently report a high burden of psychiatric disorders among individuals involved in the criminal justice system. In India, however, research has largely focused on prison populations, with limited data on persons referred to hospitals for psychiatric evaluation during legal proceedings. This study described the sociodemographic, clinical, and legal profile of persons in conflict with the law (PCL) referred to a tertiary care teaching hospital in North India. Materials and Methods: This retrospective observational study included 59 consecutive PCL referred to the Department of Psychiatry between 1 January and 30 June 2024 for psychiatric evaluation or management during ongoing legal proceedings. Sociodemographic, clinical (ICD-10 diagnoses, onset of illness, comorbidities), and legal data (charges, referral source) were extracted from medico-legal records and analyzed descriptively using IBM SPSS version 26. Results: The mean age was 30.8 ± 9.2 years. Participants were predominantly male (94.9%), rural (62.7%), married (61.0%), and undertrial (89.1%). Police were the principal referral source (91.4%). Most criminal cases (62.7%) were registered under the Narcotic Drugs and Psychotropic Substances Act. Substance use disorders were the most common psychiatric diagnoses (81.4%), followed by anxiety and stress-related disorders (18.6%). Cluster B personality traits were observed in 75.0% of evaluated participants. Psychiatric illness preceded legal involvement in 75.4% of cases. Conclusion: Persons referred for forensic psychiatric evaluation were predominantly young men involved in drug-related offences, with substance use disorders constituting the major psychiatric burden. The frequent onset of psychiatric illness before legal involvement highlights the importance of early identification and treatment of mental and substance use disorders and stronger collaboration between mental health services and the criminal justice system.
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