; pp. “John,” a 35-year-old man with a history of schizoaffective disorder, is arrested; he has been treatment nonadherent for several months. Competency to stand trial. B. Weiner & R. K. Otto (Eds. Competency ensures that the criminal defendant can rationally assist in his or her own defense. Federal and state laws require that a defendant must be competent in order to stand trial for a criminal charge. Patricia A. Zapf obtained her Ph.D. in Clinical Forensic Psychology from Simon Fraser University in Canada and currently holds the position of Professor in the Department of Psychology at John Jay College of Criminal Justice, The City University of New York. Because trial competency issues are raised substantially more often than the insanity defense, (2007). In I. It is essential to know what a competency evaluation entails, because this information is directly relevant to the psycholegal assessment questions on the comprehensive exam. In fact, the issue of competency can be raised at any point in the court process. Vitacco, M., Rogers, R., Gabel, J., and Munizza, J. Competency to Stand Trial * Assessment Template This template is designed to be used as a template for completing an evaluation of a . A clear, concise, easy to read guide for anyone who needs to understand competency to stand trial. Approximately 60,000 defendants are evaluated for trial competency annually, making this the most common forensic issue evaluated (Morris & DeYoung, 2012; Pirelli, Gottdiener, & Zapf, 2011). Financial costs associated with competency to stand trial evaluations are vast and increasing every year. The term competence restoration (CR) is used to describe the treatment and education process used to transform the defendants classified as IST to CST (Table 1).1, CST, therefore, is a legal decision made by a judge that determines if a criminal defendant is able to proceed with the legal process. She has published eight books and manuals and more than 85 articles and chapters, mainly on the assessment and conceptualization of criminal competencies. Resolution or resignation: the role of forensic mental health professionals amidst the competency services crisis. Taylor & Francis; 2017. 1. It is the most commonly conducted criminal forensic evaluation in the United States. Base rates of incompetency vary by jurisdiction and setting, but approximately 20% of referred defendants are opined incompetent to stand trial (IST). 6. Licensed clinical social worker Vivian Carr testified that she was on a three-member panel that examined Elder to determine her competency to stand trial. Download Insanity Defense Competency To Stand Trial full book in PDF, EPUB, and Mobi Format, get it for read on your Kindle device, PC, phones or tablets. Callahan L, Pinals DA. Ryba, N. L., & Zapf, P. A. All rights reserved. The legal system in the United States requires that criminal defendants be competent to stand trial. Psychiatrists and psychologists assist courts by evaluating defendants’ CST and, when necessary, providing treatment to restore competency in defendants initially found to be incompetent to stand trial (IST). The aim of this review was to determine which variables were associated with a defendant’s competency to stand trial. Determining whether a defendant meets a jurisdiction’s criteria for competency to stand trial has become a core skill in the field of forensic psychology. A review was done that quantitatively analyzed thirty different studies which compared competent and incompetent criminal defendants. Emptying the “New Asylums”: A Beds Capacity Model to Reduce Mental illness Behind Bars. The competency to stand trial process is designed to protect the rights of people who do not understand the charges against them and are unable to assist in their own defense. Competence is a legal construct, which does not have a distinct or easily identifiable psychological correlate. He tells you that he is interested in accepting a deal, because it will allow him to avoid going to jail. CST is a present tense evaluation, meaning it is an evaluation that determines the current mental state of the defendant, conducted after the alleged criminal incident has occurred. Privacy Policy | Competency Evaluation Report Writing Guidelines (For a pdf version of these guidelines, click here: CST) This checklist is designed as a guideline for completing Competency to Stand Trial Evaluations pursuant to M.G.L. Fundamental justice requires that criminal defendants should be able to understand the charges against them, appreciate the nature and range of penalties, and communicate with their attorney. Evaluators should be aware of the aspects of practice within the evaluating jurisdiction and be thoroughly acquainted with the legal literature to provide the most thorough evaluation. Uniform Crime Report: Crime in the United States, 2018. He ultimately stopped taking his medicines. (a) Definitions. Psychiatric variables typically show the most significant differences between those adjudicated competent and those adjudicated incompetent. (2015). When the court determines an individual is incompetent to stand trial, the law dictates that the individual can’t be … Dr Lee is clinical assistant professor of psychiatry at Brown University, and is the assistant program director of the Forensic Psychiatry Fellowship and assistant director of the forensic service at Slater Hospital, Rhode Island’s only state hospital. Zapf, P. A., & Roesch, R. (2009). That is where psychiatrists come in. ), Law in a therapeutic key: Developments in therapeutic jurisprudence (pp. In determining whether the defendant is competent to stand trial, the court must determine "whether [the defendant] has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding -- and whether he has a rational as well as factual understanding of … (1985). Wall BW, Ash P, Keram E, Pinals DA, Thompson CH. This, paired with the level of ambiguity in the definition of competency, further complicates the evaluation process. An overview of competency tools is beyond the scope of this brief article; however, interested readers are referred to additional sources (Pirelli et al., 2011; Zapf & Roesch, 2009; Zapf, Roesch, & Pirelli, 2014). 2018;46(3):373. AAPL practice resource for the forensic psychiatric evaluation of competence to stand trial. Psycholegal abilities and restoration of competence to stand trial. 2019; 25:1-14. This evaluation aims to provide sufficient information to allow a judge to rule on the competency of the defendant should a motion to that effect be made by either the prosecutor or defense attorney. Dr. Zapf was appointed Fellow of the American Psychological Association and Distinguished Member of the American Psychology-Law Society in 2006 for outstanding contributions to the field of law and psychology for her work in competency evaluation. This includes assessing an understanding of the charges and their potential consequences, an understanding of the trial process, knowledge about the various participants in a trial, and whether the defendant has the ability to help in their own defense and make decisions about their case.7,8. Dr. Zapf is on the Board of Directors for the International Association of Forensic Mental Health Services and is the Past President for the American Psychology-Law Society (AP-LS; Division 41, APA). Concordia University, St. Paul is accredited by the Higher Learning Commission and is a member of the North Central Association. In the 1990s, Winick (1996) estimated that the cost of CST assessments and subsequent treatment in the United States was likely $370-$555 million per year. This requires that all defendants maintain a basic level of competence to proceed (Murrie & Zelle, 2015). After an evaluation, including a clinical evaluation and the CAST-MR, it is clear that he has an understanding of the charges and their potential consequences. Assessment of competency to stand trial in individuals with Mental Retardation. Pirelli, G., Gottdiener, W. H., & Zapf, P. A. Competency to stand trial is a long-established legal principle in the U.S. criminal justice system that ensures that a criminal defendant’s right to a fair trial is protected. Competency to Stand Trial is most simply defined as the defendant’s ability to understand and participate in the court proceedings. At that point, if a second evaluation were ordered, he would likely be found IST and remanded for CR services. defendant’s competency to stand trial. competence, competence to waive right to counsel, etc.). However, given his history of mental illness and his bizarre behavior at the time of the arrest, a CST evaluation was ordered. In contrast, a criminal responsibility evaluation determines the mental state of the defendant at certain point in the past, specifically at the time of the alleged criminal incident. However, in undergoing a thorough CST evaluation, the evaluator would realize that the defendant is paranoid and likely unable to assist in her own defense despite having a strong factual base of knowledge. defendant’s competency to stand trial, to evaluate likelihood defendant will be restored to 1 . Nonetheless, a defendant with schizophrenia can be competent and, similarly, a defendant with intellectual disability can be competent. If the judge determines a defendant is IST, the CR process begins, typically in the form of both treatment of the defendant’s mental illness and competency education (Figure). Dr Wall is a clinical psychiatrist, treating patients in the Providence, Rhode Island area. A defendant's competence to stand trial can come up at any point during the proceedings, before sentencing. Durham, NC: Carolina Academic Press. Tony violates a no contact order, and because of his history of intellectual disability, his competency to stand trial is questioned. Historically, competency was equated with psychosis; however, research has since provided evidence that the presence of psychosis itself is not sufficient for a defendant to be adjudicated incompetent (Zapf et al., 2014). 1282 Concordia Avenue, St. Paul, MN 55104 Although there are no diagnoses that equal IST, psychosis and intellectual disability are the 2 most common clinical reasons that defendants are found incompetent to stand trial. To illustrate this point further, in the 1980s, Winick (1985) calculated that CST assessments and subsequent treatment cost over $185 million in the United States per year. Otto, R. (2006). There are multiple competency assessment instruments that supplement clinical evaluations (Table 2). Since she refuses medication, the treatment team requests the court to medicate despite objection. Click to view or save a PDF of this article. Gowensmith WN. She served on National Judicial College’s Mental Competency—Best Practices Model panel of experts and travels throughout the United States and internationally to train legal and mental health professionals on best practices in forensic evaluation. Psychol Public Policy Law. Assessing competency to stand trial. Murrie, D. C., & Zelle, H. (2015). Evaluators are obligated to address the appropriate range of psycholegal abilities and to effectively tie psychopathological observations to their conclusions regarding competence. Restructuring competency to stand trial. He successfully worked with his attorney on several other misdemeanors, both in family court as a juvenile and in the criminal court system as an adult. Competency to stand trial. “Tony” is a 25-year-old man who has been in and out of the legal system since he was a teenager. 10. Competency to stand trial is legally unrelated to the defendant’s mental state at the time of the alleged crime. This would violate constitutional protections for defendants by denying them the right to a fair trial. It is also called adjudicative competence or fitness to proceed. (2011). Competency to stand trial DOES NOT equal the standard for competency to represent oneself. © 2021 MJH Life Sciences™ and Psychiatric Times. When defendants are IST, the CST-CR system often cannot keep up with demand. That is, between 2% and 8% of all felony defendants are referred for evaluations of competency to stand trial each year. New York: Wiley. Treatment Advocacy Center; 2017.❒, Case-Based Psych Perspectives-Schizophrenia, ADHD: Strategies for Developing a Further Dialogue, Essential Resources in the Treatment of Schizophrenia, https://ucr.fbi.gov/crime-in-the-u.s/2018/crime-in-the-u.s.-2018, Resolution or resignation: the role of forensic mental health professionals amidst the competency services crisis, AAPL practice resource for the forensic psychiatric evaluation of competence to stand trial, Lookin’ for beds in all the wrong places: outpatient competence restoration as a promising approach to modern challenges, Emptying the “New Asylums”: A Beds Capacity Model to Reduce Mental illness Behind Bars. If someone is competent to stand trial, it means that he or she understands the purpose and nature of the proceedings and can assist the defense. Kluwer Academic/ Plenum Studies; 2002. As used in this section: (1) "Attorney for the state" means the attorney general, an authorized assistant attorney general, or other person as may be authorized by law to act as a representative of the state in a criminal proceeding; A defendant’s mental disorder must interfere with relevant, functional abilities in such a way that he or she is left unable to effectively participate in the trial proceedings in order to be opined IST. Zapf, P. A., Roesch, R., & Pirelli, G. (2014). The origins of competency to stand trial can be traced to Babylonian Talmud and early Judeo-Christian texts (Nussbaum, Hancock, Turner, Arrowood & Melodick, 2008) along with English common law that emerged at some point prior to the 14th century (Otto, 2006). Challenges to Reforming the Competence to Stand Trial and Competence Restoration System. 2. Most courts, however, accept the opinion or recommendation of the evaluator, resulting in very high levels of examiner-judge agreement (Zapf et al., 2014). “Jodi,” a 25-year-old law student with a long history of treatment nonadherence, once again stops her medications because they made her thinking “too slow.” She becomes increasingly paranoid. Morris, D. R., & DeYoung, N. J. These instruments range from informal checklists to structured instruments with criterion-based scoring and have minimized the need for lengthy inpatient evaluations. These evaluations are court-ordered the majority of the time and may take place in numerous locations such as jails, community-based outpatient centers, or mental health centers (Vitacco, Rogers, Gabel & Munizza, 2007). (1996). Section 15: Competence to stand trial or criminal responsibility; examination; period of observation; reports; hearing; commitment; delinquents Section 15. Competency involves being able to understand the proceedings and play a role in their defense. The low base rate of defendants adjudicated IST has been highlighted in defining the standards of practice in the competency arena (Pirelli, Gottdiener, & Zapf, 2011). Poythress N, Bonnie R, Monahan J, Otto R. Adjudicative Competence: The MacArthur Studies. Current research indicates that this number has been steadily increasing over time (Zapf, Roesch, & Pirelli, 2014). The police arrive as she is being arrested—she was trying to take a backpack from a passerby, believing a bomb to be inside. Best practices in forensic mental health assessment: Evaluation of competence to stand trial. Prior to 1960, there was not a standardized method for assessing competency. In other words, the issue of competency relates to the defendant’s state of mind during criminal proceedings, not during the commission of the crime. Depending on the jurisdiction, Competency to Stand Trial may also be referred to as Competence To Stand Trial, Competence To Proceed, or … Assessments of competency to stand trial concentrate on several issues including mental and physical health, comprehension of legal proceedings, and capacity to communicate with legal counsel (Chauhan, Warren, Kois & Wellbeloved-Stone, 2015). Plus, as a result of years of experience in the court system, Tony also has a good handle on the trial process. In the decades since Winick’s estimates (1985, 1996), the annual cost of CST assessments and subsequent treatment has likely ballooned (Pirelli, Gottdiener, & Zapf, 2011). What does the population of individuals look like who undergo these evaluations? However, as months passed, the defendant started having difficulty sleeping and became increasingly paranoid. What is the process for conducting such an evaluation? A meta-analytic review of competency to stand trial research. CST evaluations assess basic cognitive processes in relation to the defendant’s present psycholegal abilities such as understanding relevant information, appreciating the situation and its consequences, the ability to use logical thinking and reasoning, being motivated to assist counsel, and the ability to effectively formulate as well as communicate decisions (Murrie & Zelle, 2015). Concordia University, St. Paul has been accredited since 1967, with reaccreditation given in 2018. If a defendant is found to be competent to stand trial, then the criminal proceedings will move forward. He is also a clinical professor at Brown University and provides expert witness consultations for medical-legal purposes. (2012). Therefore, while the law student has a factual understanding of the case (such as case travel, various pleas, etc), the law student’s ability to apply the information to her own case would be impaired, as she does not have a rational understanding of the situation. Some of the more popular screening tools used b… (2011). Amanda plans to continue her studies in a doctoral program after completion of her master’s degree. Psychol Public Policy Law. Forensic evaluators are tasked with describing the degree of congruence or incongruence between the relevant jurisdictional competency standard and the defendant’s current abilities. The American Academy of Psychiatry and the Law estimates that competency evaluations in the U.S. number about 50,000 to 60,000 annually. In fact, competency to stand trial evaluations and subsequent treatment and adjudication require more financial resources than any other venture in forensic psychology (Zapf, Skeem & Golding, 2005). It should reference the court order underlying the evaluation and the statutory authority for the evaluation referenced Psychiatr Serv. 362 US 402; 1960. It is good practice for the evaluator to speak with both the defense and prosecution attorneys to have the best understanding of why the issue of competence was raised. The influence of psychiatric symptoms and cognitive abilities on competence-related abilities. When his defense attorney tried to meet with him, John began muttering under his breath that the lawyer was conspiring with the judge and the police. To complete this task, forensic evaluators must maintain a combination of advanced clinical skills coupled with knowledge about the legal system, competency standards, and their interpretation, as a finding of IST cannot be rendered without sufficient consideration of specific facts regarding the defendant’s current legal case (Murrie & Zelle, 2015; Zapf, Roesch, & Pirelli, 2014). Terms and Conditions, American Institute for the Advancement of Forensic Studies, Forensic Mental Health from Concordia University. Competency to Stand Trial or Fitness to Stand Trial requires that a defendant understands the nature and purpose of the legal proceedings against him and be able to effectively cooperate with counsel in his defense. This is known as “competence.” When a defendant’s mental state restricts the person from understanding or comprehending the charges in their case, the court deems them incompetent to stand trial. 2020;71(7):691-697. It gets right to the point, providing a practical overview of the court system, as well as activities designed to help defendants become competent. Over the past 40 years, no fewer than 12 competency assessment instruments have been developed to address a defendant’s psycholegal abilities (Pirelli et al., 2011). Therefore, he was first recommended as CST. However, it is expected that the evaluator will use his or her clinical judgment based upon the defendant’s presentation in determining how to conduct the evaluation. Concordia University, St. Paul While these formalized checklists and structured interviews can assist evaluators with competency assessments, they do not replace a thorough clinical evaluation. States have been sued for being unable to admit IST defendants for CR services in a timely fashion. In addition to assessing the defendant’s psychiatric, medical, and social histories, the defendant’s competence as it relates to trial-related tasks is evaluated. Fuller DA, Sinclair E, Lamb Human Resources, et al. Additionally, CST trial is moment specific. Once detained, he is restarted on treatment. This has resulted in wait lists for competency-related services for jail detainees. It is important that evaluators appropriately assess a defendant’s mental status in relation to the functional abilities that are relevant to the particular defendant’s legal case. Although not designed to assess competency to stand trial, several instruments developed to measure specific psychological constructs including intelligence (e.g., Wechsler Adult Intelligence Scales) and psychopathology (Minnesota Multiphasic Personality Inventory) are commonly used in competency evaluations (Pirelli, Gottdiener, & Zapf, 2011). She has conducted more than 2,500 forensic evaluations in both the United States and Canada and has served as an witness in a number of cases, including the competency hearing of Jose Padilla. Issues of competency may be raised at any point during the proceedings and, if a bona fide doubt exists regarding competency, the issue must be formally considered, thus requiring a forensic evaluation. Competent to Stand Trial Law and Legal Definition Due process requires that a defendant be competent to stand trial, which includes capacity to assist counsel and to understand the nature of the proceeding sufficiently to participate in and make decisions about rights afforded to defendants. To illustrate how critical the clinical evaluation is in CST evaluations, and that a clinical evaluation cannot be replaced by a competency assessment instrument, consider the following case. There has been a surge in CST evaluation requests in recent years, with current estimates of 160,000 or more evaluation requests annually.2,3 This increase may be due to the criminalization of mental illness, substance abuse, and intellectual disability, all of which often stem from the lack of adequate access to civil treatment in the community. Criminal competencies. Jerrod is also the founder and CEO of the American Institute for the Advancement of Forensic Studies (AIAFS) and lead developer and program director of an online graduate degree program in Forensic Mental Health from Concordia University, St. Paul, Minnesota. Prior experience in the legal system would be an important factor in this case. chapter 123 § 15(b). The competency evaluation of a defendant’s ability to He has never served time, as he always managed to get probation. This includes a grasp of the charges and parties involved. All rights reserved. The most common variables that have been identified as correlates with competency status are ethnicity, sex, employment, marital status, type of current criminal charge, criminal history, and history of psychiatric hospitalization. Currently, public mental health services are inundated with court referrals for CST evaluations. Competency to Stand Trial A defendant cannot be convicted of a crime if they are not mentally competent to stand trial. J Am Acad Psychiatry Law. Dusky v United States. Defense attorneys have concerns regarding their client’s competency in about 8% to 15% of felony prosecutions, and it is estimated that about 20% to 30% of evaluated defendants are found incompetent to stand trial.1 If a judge determines a defendant is CST, the legal case proceeds. P: 1.855.641.2525 | E: onlineinfo@csp.edu, Copyright 2020 Concordia University St. Paul | The Court outlined the basic standards for determining competency. By extrapolation, if the criminal court judge ordered a CST evaluation, she would likely be recommended to the court as IST because she was unable to work with her attorney in civil court due to mental illness symptoms. It is common practice that when the issue of competency is raised, a forensic evaluation is subsequently conducted. In D. B. Wexler & B. J. Winick (Eds. Competency to stand trial evaluations are among the most common forensic evaluation referrals in criminal and juvenile courts nationwide. In the above scenario, the defendant was disorganized during the time of arrest, but by the time the CST evaluation was ordered, he was back on medications and was overall functioning well. Multiple evaluators could agree that the presence of psychosis automatically signifies that a defendant is incompetent, yet previous research has underscored that this is an invalid conclusion (Zapf et al., 2014). Amanda Beltrani is a graduate student in the Forensic Psychology master’s program at John Jay College of Criminal Justice in New York. contextual/functional approach an interpretation of forensic assessments in light of specific demands of the particular legal case or issue Jerrod is currently pursuing his doctoral degree in psychology. Dusky v. United States, 362 U.S. 402 (1960), was a landmark United States Supreme Court case in which the Court affirmed a defendant's right to have a competency evaluation before proceeding to trial. After an evaluation, including a clinical evaluation and the CAST-MR, it is clear that he has an understanding of the charges and their potential consequences. Winick, B. J. Incompetency to proceed in the criminal process: Past, present, and future. Trying a defendant who is unable to assist in their own defense would call into question the dignity of the proceedings and render the adversarial process unfair. SPECIAL REPORT: FORENSIC PSYCHIATRY, PART II, The United States legal system has long recognized that criminal defendants must be competent to stand trial (CST) prior to proceeding with the legal process to allow for fairness for the accused and protect the integrity of the justice system. In such a case, a law student who is knowledgeable about the legal system would do well on scoring instruments. This title provides a review of the most fundamental concepts and methods for performing these evaluations. Zapf, P., Skeem, J., and Golding, S. (2005). Nussbaum, D., Hancock, M., Turner, I., Arrowood, J., and Melodick, S. (2008). There is no “gold standard” instrument for measuring a defendant’s competency (Murrie & Zelle, 2015). I. Competency to stand trial (CST) is a doctrine of jurisprudence that allows for the postponement of criminal proceedings should a defendant be unable to participate in his or her defense on account of mental disorder or intellectual disability. Therefore, a defendant could be initially recommended as CST and later, as the case progresses, may become IST. Adjudicative competence, or competence to stand trial, is a legal construct that usually refers to a crim- inal defendant’s ability to participate in legal pro- ceedings related to an alleged offense. Competency to stand trial is the most common type of criminal forensic evaluation, with approximately 60,000 evaluations conducted annually in the United States. A defendant’s right to a fair trial is one of the core principles of the United States’ criminal justice system, which strives to provide all defendants with objective and dignified proceedings (Pirelli, Gottdiener, & Zapf, 2011). The ultimate decision regarding a defendant’s competence rests with the court, which is not bound by the evaluator’s opinion. To understand the proceedings, a defendant must be able to comprehend the charges against him and the penalties if convicted. John was recommended as CST, which was accepted by the court. As such, it is likely that he would be competent to stand trial, even though he has an intellectual disability. If someone does not … Conclusion: Competent and Incompetent Criminal Defendants. Law Hum Behav. Consider the following case example. Department of Justice, FBI. Trial competence protects the defendant's right to present a defense as guaranteed by the Sixth Amendment and serves to maintain fairness in, and the dignity of, the court. He was not a high school graduate; he dropped out in the middle of tenth grade as he no longer wanted to go to school. Kalbeitzer, R., & Benedetti, R. (2009). If the defense and prosecution attorneys do not accept the opinion of the evaluator, a brief hearing may be held wherein the evaluator is asked to testify; however, this is rarely the case. Tony further explains he would prefer to admit to some form of guilt to be quickly paroled so that he can see his newborn child. The U.S. law regarding trial competency was established in Dusky v. United States (1960) and currently all states use some variant of the Dusky standard, with the exact definition varying by jurisdiction. Better collaboration between the criminal justice and clinical care systems could improve services for persons with serious mental illness in the legal system.4,9,10. Competency means that an accused must understand the nature of the court process. Choose from 226 different sets of competency to stand trial flashcards on Quizlet. During the hearing in mental health court to determine treatment, Jodi, being a law student, starts to question the psychiatrist. , Bonnie RJ, Hoge SK, et al completion of her master ’ s at! Was to determine competency to stand trial evaluations are vast and increasing every...., I., Arrowood, J., and Munizza, J such a case, a defendant be! Of mental illness and addictions criminal charge concerns regarding their client ’ s rests! & Roesch, R., & Pirelli, G., Gottdiener, W. H. &! 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