02_Competence to stand trial

Question 1

What is Competence to Stand Trial (CST)?

Answer 1

¥ A legal judgment (determined by judge) about the ability of a defendant to
¥ Understand the legal proceedings
¥ Instruct, consult, and work with counsel in their own defense (i.e., participate in their defense)
¥ Focus on present mental state, at any time during trial (or multiple times)
¥ Based in the 6th Amendment

Question 2

Why Do We Care?

Answer 2

¥ Fairness, dignity, accuracy, and integrity of the legal system
¥ Requires participation of people who can exercise their full rights and defend themselves
¥ Punishment only morally acceptable if the person understands why they’re being punished

Question 3

MENTAL ILLNESS DOES NOT AUTOMATICALLY MAKE A PERSON _____?

Answer 3

INCOMPETENT

Question 4

What is CST Standard?

Answer 4

Sufficient present ability to consult with one’s attorney with a reasonable degree of rational understanding, and a rational as well as factual understanding of the proceedings against him.
(Dusky v. United States, 1960)

Question 5

What is Evaluation of CST?

Answer 5

¥ Mental health expert retained by the state, defense (adversarial) or appointed by the court (neutral)
¥ Conducts the evaluation & submits a recommendation to the court, with their expert opinion
¥ Written report & testimony
Focus on functional abilities
Neutral ? = who knows

Question 6

What to Evaluate?

Do they understand ?

Answer 6

¥	Functions of courtroom personnel
¥	Understanding court procedures
¥	Understanding of charges
¥	Appraisal of defenses
¥	Appreciation of penalties
¥	Ability & willingness to work with attorney
¥	Planning of legal strategies (e.g., plea bargain)
Etc

Question 7

Most Common
Forensic Evaluations
What is the typical outcome?

Answer 7

¥ 70-80% of those referred for CST assessments are found COMPETENT
¥ Judges rank clinician’s opinion on competence to be in the top 3 pieces of info they use to make their decision
¥ Court & expert opinion in CST hearings agree in >90% of cases

Question 8

What is Malingering?

Answer 8

¥ Production of false/exaggerated symptoms
¥ Important aspect of any competency evaluation (and any forensic evaluation)
¥ We have excellent tools to figure out when someone is faking.

Question 9

Forensic Evaluation of CST?

Competency Evaluations?

Answer 9

• No standard approach
• Experts split on importance of using psychological testing
  Most review past records (police report, mental health records, etc

Question 10

What are Forensic Assessment Instruments (FAI) for CST?

Answer 10

1. MacArthur Competence Assessment
   Tool-Criminal Adjudication (MacCAT- CA)
2. The Evaluation to Stand Trial-Revised (ECST-R)
3. The Fitness Interview Test (FIT) (cnada)

Question 11

What is MacCAT-CA?

Answer 11

• MacArthur Competence Assessment
  Tool-Criminal Adjudication

¥ 22 items
¥ Presents a hypothetical vignette
¥ First 16 questions are about vignette
¥ Last 6 items about defendant’s own case
¥ Assesses general understanding of the legal system
Reasoning related to legal situations

Question 12

What is ECST-R?

Answer 12

¥ Semi-structured interview developed using Dusky criteria
¥ Assesses factual understanding, rational understanding, and consulting with counsel
¥ Focuses on their case – not hypotheticals
¥ A malingering scale built in

Question 13

What happens when defendants are deemed Incompetent to Stand Trial (IST)?
What are Characteristics of Incompetent Defendants?

Answer 13

¥ Psychotic disorders and intellectual disability are most prominent diagnoses
¥ Pirelli & Zapf 2011 meta-analysis: psychotic d’s 8x more likely to be IST than non-psychotic
¥ Incompetence due to psychosis is easier to treat than intellectual disability

Question 14

Restoration of Competency?

Answer 14

¥ Process by which an incompetent defendant becomes competent
¥ Hospitalizations are typically short
¥ Most are restored within 6 months
¥ Over 75% of all individuals are restored to competency
¥ Mostly it is antipsychotic medication therapy
¥ Once restored, trial resumes

Question 15

¥ What if someone can’t be restored (not responding to medication, too intellectually disabled to ever understand/help)?

Answer 15

¥ Can they be forever deprived of their liberty without due process?
¥ What if they committed a really minor crime?

Question 16

Jackson v. Indiana (1972) CASE

Answer 16

¥ Jackson charged with petty theft for stealing a pair of shoes from a store.
¥ He was deaf and mute – could not read, write, or communicate.
¥ Found permanently incompetent to stand trial (IST), committed indefinitely to state hospital.
¥ Essentially a “life sentence” even though he had not been convicted of a crime.
¥ SCOTUS ruled that defendants cannot be held for “more than a reasonable period of time”
¥ Placed a limit on how long IST defendants can be held – all states.
¥ E.g., can’t be held longer than sentence they would get if convicted
¥ E.g., in some states, can’t be held longer than ½ the sentence they would get if convicted
¥ If permanently IST but dangerous, can be civilly committed

Question 17

Competency Restoration?

Answer 17

Two factors that can lead to IST
- Administration of medication**
Involuntary medication

• Psychoeducational interventions to restore (or attain) competency
  Effective if defendant is able to pay attention, concentrate, and cooperate

Question 18

What are Other Criminal Competencies?

Answer 18

¥ Competency to waive Miranda warnings
¥ Competency to confess
¥ Competency to waive counsel (go pro se)
¥ Competency to plead guilty
¥ Competency to waive right to trial by jury
¥ Competency to be sentenced
¥ Competency to be executed
Competency to refuse the insanity defense

Question 19

A Uniform Criminal Competency Standard ?

Answer 19

¥ Despite research, legal cases, and scholarly debates about the contextual nature of competencies, SCOTUS decided context was irrelevant.
¥ Godinez v. Moran (1993) = the standard for all types of criminal competencies are the same (basically Dusky).
¥ No higher standard is needed to represent oneself.

Question 20

Is CST enough to waive right to counsel and go pro se?

Indiana v. Edwards (2008) CASE

Answer 20

¥ SCOTUS revisited the issue of contextual competencies
¥ Pro se competence is higher than CST - right to pro se is qualified by functional abilities
¥ To preserve “courtroom decorum” and effective practice of law
¥ “A right of self-representation at trial will not affirm the dignity of a defendant who lacks the mental capacity to conduct his defense without the assistance of counsel.”