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Criminal Justice > Criminal Psychology > Forensic Assessment Of Offenders > Competency to Stand Trial

Competency to Stand Trial




The issue of competency to stand trial refers to a defendant’s current mental functioning at the time of his or her trial: Those who are unable to understand the court proceedings or unable to assist counsel in their defense as a result of mental disorder or cognitive deficit are considered incompetent to stand trial. The incompetency doctrine attempts to ensure that all defendants have an opportunity to be mentally present and to participate in their own defense, thereby upholding the dignity and reliability of court proceedings and assuaging the public’s confidence in the fairness of the criminal justice system. Although competency to stand trial is a legal term, it comprises several psycholegal abilities, which are evaluated by psychologists and other mental health professionals. The evaluations conducted by these professionals form the basis for an opinion regarding the defendant-in-question’s psycholegal capacities. Defendants found to be incompetent to stand trial have their proceedings postponed until they have been restored to competency at which point the legal proceedings typically resume.




Background

With an estimated 60,000 evaluations conducted each year in the United States, competency to stand trial is a commonly conducted psychological evaluation for the criminal justice system. In general, competency to stand trial pertains to a defendant’s ability to understand the charges against him or her and the general legal process, requiring the defendant to have the ability to understand and function in that context in order to assist with his or her case. It is important to understand that competency to stand trial involves the evaluation of a defendant’s current mental functioning and not mental functioning at the time of the offense (this is referred to as criminal responsibility or insanity and is a different issue from that of competence). The issue of competency can be raised at any point during trial before a verdict is rendered. Typically, a mental health professional conducts the competency evaluation, and depending upon jurisdictional protocols, more than one evaluator may be involved. Competency to stand trial falls under the larger umbrella term of adjudicative competency, which encompasses several distinct criminal competencies (e.g., competency to waive Miranda rights, competency to plead guilty, and competency to be sentenced). The constitutional minimum standard for each of these distinct criminal competencies was set out in Dusky v. United States (1960) and elaborated in Godinez v. Moran (1993).

Legal Standard

The legal standard for competency to stand trial was established in Dusky v. United States (1960), where it was held that in order to be deemed competent, a defendant must have “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding” and a “rational as well as factual understanding of the proceedings against him” (p. 402). In other words, a rational understanding means that the defendant must be able to understand the charges and the trial process in relation to himself or herself as the defendant. A factual understanding means that the defendant must have knowledge about the people and proceedings relevant to a trial. Since Dusky was established in 1960, each state has adopted some variation of this standard.

All civil and criminal defendants are presumed to be competent; therefore, if competency is a concern, it must be formally raised. The question of competency can be raised either by legal party or by the court, though most often it is raised by the defense. To warrant a competency to stand trial evaluation, a bona fide doubt must exist, representing a fairly low legal threshold and making it relatively easy to request an evaluation, likely contributing to the high frequency of these assessments. Evaluations of competence to stand trial are conducted on either an inpatient basis or an outpatient basis, with many states moving toward a least restrictive setting protocol for competency evaluation. In addition, jail-based competency evaluations are increasing in frequency as more states implement strategies to reduce the wait-list for these evaluations. Each state has its own statutes and procedures for how these evaluations are to be conducted, by whom, and within what time frames.

Evaluation of Competency to Stand Trial

A qualified mental health professional may perform a competency to stand trial evaluation. Generally, the evaluating professional must establish the presence or absence of a mental disease or defect that impairs the defendant’s current mental functioning as it affects his or her ability to meet criteria for competency to stand trial in the respective jurisdiction. Several forensic assessment instruments exist to assist evaluators in formulating their opinions regarding competency. Among the more recent are the Fitness Interview Test–Revised, the MacArthur Competence Assessment Tool– Criminal Adjudication, and the Evaluation of Competency to Stand Trial–Revised. Using data from interview and forensic assessment instruments, the evaluator must then come to an opinion about the degree to which the defendant is impaired with respect to the abilities required to proceed. The characteristics of the defendant and the context of his or her case must be taken into consideration in arriving at an opinion regarding a defendant’s competence. Evaluations are typically conducted with a focus on functional abilities, that is, extrapolating the defendant’s ability to function at trial on the basis of his or her functioning during the evaluation.

Only about one in five of those referred for a competency to stand trial evaluation are deemed incompetent, although this rate varies by jurisdiction. When a competency to stand trial evaluation is ordered by the court, the evaluating mental health professional must submit a report to the court detailing his or her findings. In a small number of cases, a competency hearing may be held to determine the issue of competency. Most of the time the judge’s decision is in accordance with the opinion of the evaluator. In fact, research indicates an agreement with the evaluator in more than 95% of cases—an extremely high concordance rate. There tends to be a good agreement between mental health professionals regarding ultimate opinions of competency to stand trial (80% or more); however, disagreement occurs more often regarding the defendant’s functioning on the specific psycholegal abilities that constitute competency to stand trial.

Incompetent Defendants

There has been a plenty of research on the topic of competency to stand trial, with convergence on the characteristics and psychological symptoms and conditions typically found among incompetent persons. A 2011 meta-analysis by Gianni Pirelli, William H. Gottdiener, and Patricia A. Zapf synthesized this research in order to capture the major differences between those found to be competent versus incompetent. Typically, incompetent defendants tend to be older, on average, than those found to be competent. The slight majority of incompetent defendants are non-White, and more often, they are male, unemployed, and unmarried. Regarding psychological functioning, most incompetent defendants have a diagnosed psychotic disorder (e.g., schizophrenia, psychosis), and relatively few are diagnosed with personality disorders. Mental retardation, organic brain disorders, and mood disorders have also been associated with incompetence. In addition, those deemed incompetent are more likely to have had prior contact with the criminal justice system and a history of psychiatric hospitalization compared with their competent counterparts.

In 2007, Douglas Mossman identified psychosis and cognitive impairment as the two conditions under which a defendant is most likely to be found incompetent to stand trial. Psychosis refers to a broad category of disorders that are characterized by an inability to remain in touch with reality. Symptoms typically involve bizarre behavior, hallucinations, and delusions. If psychotic symptoms are severe enough to diminish one’s ability to meet the standard for competency to stand trial, a defendant may be found incompetent. Similarly, cognitive impairment is a broad term for various cognitive deficits that may coincide with mental, developmental, or medical disorders. Intellectual dysfunction may also serve as a threshold condition for a finding of incompetence, but evaluators and legal decision-makers must be careful to establish that the cognitive deficits contribute to an inability to meet the specific standard for competency to stand trial.

It is important to note that a psychiatric diagnosis does not necessarily mean a defendant will be found incompetent to stand trial. In 2011, Pirelli and colleagues observed that, of those referred for a competency to stand trial evaluation and found to be competent to stand trial, 22.2% were diagnosed with a psychotic disorder and 27.9% were diagnosed with a personality disorder. The distinction between those adjudicated competent versus incompetent, therefore, is that the presence of a mental disease or defect significantly impairs an incompetent defendant’s rational and factual understanding of the proceedings or his or her ability to participate in the defense. Conversely, those adjudicated competent may certainly have a mental disease or defect, but this does not impair their ability to factually or rationally understand or participate in the proceedings.

Restoration to Competence

When a defendant is found to be incompetent to stand trial, he or she will likely undergo court-ordered treatment for restoration. Although this typically occurs in an inpatient setting, many jurisdictions have moved toward a least restrictive alternative policy, wherein outpatient treatment is to be used whenever possible. In addition, there has been a recent move toward providing competence restoration services in jail facilities.

Most incompetent defendants can be restored within 12 months (or fewer) and, once restored, will proceed with trial. Most jurisdictions require a periodic review of defendants undergoing treatment for restoration and have procedures in place to find a defendant unrestorably incompetent if restoration attempts have been unsuccessful after some period of time (defined by each jurisdiction). Defendants who are deemed unrestorable will typically have their charges dismissed.

The length of time for which an incompetent defendant can be detained varies by jurisdiction, with each state required to have statutes regarding restoration procedures and time lines as a result of the Supreme Court’s decision in Jackson v. Indiana (1972). Prior to this, defendants who were detained for restoration were often confined indefinitely. In Jackson v. Indiana, the Supreme Court decided that incompetent defendants could not be detained for “more than a reasonable period of time necessary to determine whether there is a substantial probability” that they will regain competency in the foreseeable future (p. 738). Although seemingly unspecific, many states have adopted the exact language of Jackson, and others have included a more specific time frame in their statutes.

As far as treatment, restoration typically involves the administration of psychotropic medication to control symptoms of mental illness and education about court proceedings. But what about when a defendant refuses to take psychotropic medication? A series of Supreme Court cases have indicated that incompetent defendants may be forcibly medicated if it is justifiable and medically appropriate (Riggins v. Nevada, 1992) and necessary for the safety of the defendant or others (Washington v. Harper, 1990), or it is likely to restore competency with minimal side effects and less intrusive methods are not possible (Sell v. United States, 2003).

Although the vast majority of defendants who undergo treatment for restoration are restored to competence within 6–12 months, there are two groups of defendants that are particularly difficult to restore. Defendants with chronic severe mental disorders with a history of multiple inpatient admissions, such as those with schizophrenia, are difficult to restore to competence, as are those with severe intellectual disabilities (formerly called mental retardation).

Specific treatment programs have been developed for defendants with intellectual disabilities (e.g., the Slater Method), and the available research indicates that although these programs show success in comparison with treatment as usual for this population, they are resource-intensive, and restoration often takes upward of 2 years.

References:

  1. Melton, G. B., Petrila, J., Poythress, N. G., & Slogobin, C. (1997). Psychological evaluations for the courts: A handbook for mental health professionals and lawyers (2nd ed.). New York, NY: Guilford.
  2. Mossman, D. (2007). Predicting restorability of incompetent criminal defendants. Journal of the American Academy of Psychiatry and the Law, 35(1), 34–43.
  3. Murrie, D. C., & Zelle, H. (2015). Criminal competencies. In B. L. Cutler & P. A. Zapf (Eds.), APA handbook of forensic psychology, Vol. 1: Individual and situational influences in criminal and civil contexts (pp. 115–157). Washington, DC: American Psychological Association. doi:10.1037/14461-005
  4. Pirelli, G., Gottdiener, W. H., & Zapf, P. A. (2011). A meta-analytic review of competency to stand trial research. Psychology, Public Policy, and Law, 17(1), 1–53. doi:10.1037/a0021713
  5. Roesch, R., Zapf, P. A., Golding, S. L., & Skeem, J. L. (1999). Defining and assessing competency to stand trial. In A. K. Hess & I. B. Weiner (Eds.), The handbook of forensic psychology (2nd ed., pp. 327–349). Hoboken, NJ: Wiley.
  6. Zapf, P. A., & Roesch, R. (2011). Future directions in the restoration of competency to stand trial. Current Directions in Psychological Science, 20(1), 43–47. doi:10.1177/0963721410396798
  7. Zapf, P. A., & Roesch, R. (2013). Evaluation of competence to stand trial in adults. In R. Roesch & P. A. Zapf (Eds.), Forensic assessments in criminal and civil law: A handbook for lawyers (pp. 17–22). New York, NY: Oxford University Press.
  8. Zapf, P. A., Roesch, R., & Pirelli, G. (2014). Assessing competency to stand trial. In I. B. Weiner & R. K. Otto (Eds.), The handbook of forensic psychology (4th ed., pp. 281–314). New York, NY: Wiley.

Court Cases

  1. Dusky v. United States, 362 U.S. 402 (1960).
  2. Godinez v. Moran, 509 U.S. 389 (1993). Jackson v. Indiana, 406 U.S. 715 (1972).
  3. Riggins v. Nevada, 504 U.S. 127 (1992).
  4. Sell v. United States, 539 U.S. 166 (2003).
  5. Washington v. Harper, 494 U.S. 210 (1990).