Alex Ray is a senior at Bridgewater State University majoring in Psychology.
ABSTRACT
Competency to stand trial has sparked controversy across various disciplines. Like many instances where mental health intersects with law, scholars, mental health practitioners, legal stakeholders, and policymakers struggle to come to a consensus. This piece will detail the basics of competency to stand trial in legal and psychological capacities and contemporary issues concerning the competency crisis. This article also highlights a wider need for compassionate justice service operations and agents that promote hope and healing.
What is Competency to Stand Trial?
Competency to stand trial, also referred to as adjudicative competence and fitness to stand trial, can be defined as the legally determined capacity of a defendant to proceed with criminal adjudication. It refers to a defendant’s ability to participate in legal proceedings associated with an alleged criminal offense.1 In the U.S., a defendant must understand the nature of the charges against them and participate in their legal proceedings. However, impairments to cognition from neurological disorders, intellectual disabilities, or serious psychiatric diagnoses can interfere with one’s ability to understand and participate in legal proceedings. If these impairments are suspected during a defendant’s pretrial, there may be questions about their capacity to proceed. This is when a doctoral-level psychologist or psychiatrist would be consulted by the court to evaluate the defendant’s competency.
These mental health experts are commonly consulted because the conviction of defendants who are found legally incompetent from a comprehensive mental health evaluation violates their due process right to a fair trial.
In contemporary mental health law, this criterion was largely defined in the landmark 1960 Supreme Court decision in Dusky vs. the U.S.2 In the ruling, the court determined that the key test of competency to stand trial is whether the defendant has “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding and whether they a rational as well as factual understanding of the proceedings against them.”3
What Happens When a Defendant is Found Incompetent to Stand Trial?
With the foundational information about competency to stand trial in mind, what if you are found incompetent, lacking both the rational and factual understanding of the proceedings against you? If a defendant is deemed incompetent to stand trial, they essentially begin “legal-limbo.” Due to their current mental state, they are unable to continue with their legal proceedings. However, they are also not allowed to be released into society. Usually, they will be held in a secure facility, whether in a state hospital or a jail.
What is Competency Restoration?
When a defendant is found incompetent, they will be sent to a secure facility to begin competency restoration. Competency restoration is attempting to restore a defendant’s competency so that they may continue with their legal proceedings. This may be done through addressing any medical, substance abuse, or other neuropsychological conditions affecting mental well-being.4 Also, psychoeducational interventions are often used to enhance competency, often in a competency curriculum, including courtroom scenarios and/or mock trials.
Mental Health Law Reform, The Competency Crisis
Much of the theory behind competency to stand trial is a paradox – shedding light on the limits of law and the current consensus on psychiatric care. Recently, more of these discrepancies have been brought into the limelight. The competency crisis began about four years ago because of Covid-19. Because of the lack of hospital capacity, individuals charged with crimes and deemed incompetent to stand trial languished in jails.5 Among many other issues, this resulted in prolonged pretrial detainment and inadequate access to mental health care, which essentially set up defendants for failure – if they ever were able to go through with their proceedings. Consequently, many states were successfully sued in Federal Courts for violation of these individuals’ constitutional rights.6
The competency crisis not only called for a necessary reevaluation of these policies and procedures but also the theories that guide them. As such, the theoretical assumptions that competency to stand trial relies on have been subject to several ethical contemplations. For instance, can a defendant be forced to take medication to enhance their mental status so that they may continue their trial?7 What other criteria can we use to evaluate a defendant’s competency? How can we improve non-invasive competency restoration treatments? These questions continue to guide those working at the intersection of the law and mental health. The hope is that with the example of the competency crisis, we can learn from past failures and improve these systems to reflect a more holistic human experience.
- J.B. Williams, Adjudicative Competence in the Context of a Defendant’s Absence from Trial after a Suicide Attempt, J Am Acad Psychiatry Law (2023). (2023). Adjudicative Competence in the Context of a Defendant’s Absence from Trial after a Suicide Attempt. PubMed, 51(4), 558–565. https://doi.org/10.29158/jaapl.230093-23
↩︎ - Dawes SE, Palmer BW, Jeste, DV. (2008) Adjudicative competence. Curr Opin Psychiatry. 21(5):490-4. 10.1097/YCO.0b013e328308b2ee. PMID: 18650693; PMCID: PMC2570182.
↩︎ - Id. ↩︎
- Id. ↩︎
- Competency to stand trial – Center for Mental Health, Policy, and the Law (CMHPL) (2022). (n.d.). Center for Mental Health, Policy, and the Law (CMHPL). https://cmhpl.psychiatry.uw.edu/education/trainings/competency-to-stand-trial/.
↩︎ - Id. ↩︎
- Brief for the American Psychological Association as Amicus Curiae, Sell v. United States of America, 02-5664 (2003).
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