Competency to Stand Trial and Mental Illness (DHEW Pub. The use of medication raises the question of whether an incompetent defendant can refuse to consent to being medicated. The Supreme Court revisited this issue in the case of Indiana v. Edwards (2008). A recent study of defendants found incompetent in the federal court system (Cochrane, Herbel, Reardon, & Lloyd, 2013) found that 79% of 132 involuntarily medicated defendants were successfully restored to competence, with an average treatment period of less than five months. Copy this link, or click below to email it to a friend. Fundamental justice requires that criminal defendants should be able to

The Fitness Interview Test-Revised (FIT-R; Roesch, Zapf, & Eaves, 2006) uses a semi-structured interview format to assess three main areas: (a) the ability to understand the nature or object of the proceedings, or factual knowledge of criminal procedure, (b) the ability to understand the possible consequences of the proceedings, or the appreciation of personal involvement in and importance of the proceedings, and (c) the ability to communicate with counsel, or to participate in the defense. Readers may wish to refer to the Federal Judicial Center16 and special issues of Psychology, Public Policy, and Law (vol. CST was developed by Lipsitt, Lelos, and McGarry in 1971 and is usually administered before The ECST-R uses the following classification: 60 to 69 T, moderate impairment, usually associated with competent defendants; 70 to 79 T, severe impairment, which can reflect competent or incompetent defendants; 80 to 89 T, extreme impairment, usually associated with incompetent defendants; and 90 to 110 T, very extreme impairment, almost always associated with incompetent defendants. (1978) as a screening device to screen out those defendants who were clearly competent. The CST has 22 item stems that ask defendants to complete sentences. Reference Manual on Scientific Evidence (ed 2). The Court reaffirmed the flexibility in applying the Daubert guidelines, which may or may not be relevant in determining the reliability of the expert testimony in a particular case. The MacCAT-CA was not originally developed as a measure of competency to stand trial. They drew on samples of 60 evaluators in Virginia and Alabama who had performed a minimum of 20 court-ordered evaluations, with a combined total of over 7,000 evaluations. Rather, the majority of cases are resolved through plea bargaining. WebTHE CST WAS CONSTRUCTED BY MCGARRY AND OTHERS AS AN OBJECTIVE, PRELIMINARY SCREENING INSTRUMENT. Less intrusive forms of treatment include legal rights education, deficit-focused remediation programs, and standard hospital treatment programs (Bertman et al., 2003). Established practitioners sometimes are slighted by evidence-based researchers, who now feel entitled to criticize and rectify clinical authorities perhaps motivated by an iconoclastic or even patricidal tendency (Ref.

Because many defendants are found incompetent due to a psychosis, psychotropic medication is the most frequent type of treatment. Agreement about more specific psycholegal abilities is likely not as high. We revisit these objections later in the context of evidence-based competency measures. Two measures are intended for general competency evaluations: the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA)40 and the ECST-R.30 The third measure, the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST-MR),41 concentrates on defendants with mental retardation.

As summarized in Table 1, two scales of the CAST-MR appear to meet this guideline, with understanding case events being particularly straightforward. The following are the McGarry criteria for competence to stand trial, and my determination of whether this defendant fulfills each criterion.

Most competency items are scored on five-point ratings: 0, not observed; 1, questionable clinical significance; 2, mild impairment unrelated to competency; 3, moderate impairment that will affect but not by itself impair competency; and 4, severe impairment that substantially impairs competency. Bonnie noted that prohibiting incompetent defendants from proceeding with trial is essential to preserve the dignity of the judicial process, the reliability or accuracy of the courts verdict, and the autonomy of defendants to make key decisions about their case. With respect to relevance and fit, three competency measures have the most in common in their assessment of Dusky's factual understanding of the courtroom proceedings. Minimal or no impairment had assessed deficits that fell within 1 standard deviation (SD) of the presumably competent detainees. The shift to other settings has been driven in part by research showing that opinions about a defendants competence can be made after a relatively brief assessment (see Zapf & Roesch, 2009). Unfortunately, this approach was unsuccessful for the appreciation scale; the authors simply assigned cut scores to the three categories, based on their own hypotheses regarding delusional thinking. Some items require the defendant to visually identify the location of certain participants in the courtroom (i.e., defendants are shown a drawing of a courtroom and asked where does the Judge sit?), and then defendants are asked about the function of certain individuals in the courtroom, such as witnesses and lawyers. WebMitch McGary was born on June 6, 1992, and grew up in the Chesterton, Indiana, area.He played in YMCA and Amateur Athletic Union (AAU) basketball leagues as a youth, and

Slade and his colleagues6 carefully evaluated the acceptance of an empirically based assessment model involving a constellation of standardized measures. While it does not grapple directly with evidence-based practices, the guideline attempts to standardize competency evaluations by recommending 15 specific areas of inquiry. There is limited research on the CAST-MR, but two studies indicated that the instrument has a level of reliability and validity comparable to other competency assessment instruments (Everington, 1990; Everington & Dunn, 1995). Fundamentals of Forensic Practice: Mental Health and Criminal Law. Because the law has provided only vague criteria, incompetency to stand trial has tended to be equated with mental illness by both psychiatrists and members of The term competence to stand trial is perhaps misleading because only a small percentage of criminal cases actually go to trial.

This article has provided an overview of forensic assessment instruments that have been developed to guide this process. WebMcGarry Criteria. The focus of the ECST-R inquiries is not on the decision itself but rather on the reasoning underlying the decision.
More details of the vignette are provided as the examiner moves through the first two sections of the MacCAT-CA. Prior to Jackson v. Indiana (1972), incompetent defendants would automatically be sent to a treatment facility for an indefinite period of time until competency was restored.

The purpose of these competency measures is to provide standardized data to assist practitioners in reaching empirically based conclusions about elements of competency to stand trial. Competency to stand trial is a long-established legal principle in the U.S. criminal justice system that ensures that a criminal defendants right to a fair trial is protected. Inpatient criteria. The U.S. Supreme Court held that defendants committed solely on the basis of incompetency cannot be held more than the reasonable period of time necessary to determine whether there is a substantial probability that he will attain that capacity in the foreseeable future (p. 738). Competency. Recent case law is discussed regarding the role of amnesia in determining competency to stand trial. Psychiatric Services in Jails and Prisons (ed 2). Grisso (2003) defined functional abilities as that which an individual can do or accomplish, as well as to the knowledge, understanding, or beliefs that may be necessary for the accomplishment (pp. The CAST-MR is administered as an interview, although examinees are given a copy of the items to facilitate comprehension. 1) for a more thorough introduction. 41, p 19). Understanding case events asks for detailed recall (e.g., date and witnesses) of the alleged crime and the current criminal charges. For example, controversy and debate surround the sufficiency of the Rorschach18,19 and MCMI-III20,21 when evaluated according to Daubert guidelines. Once a competency evaluation is ordered, the evaluation itself can take place in a range of settings, including jails, forensic facilities, or if a defendant is released on bail, in an outpatient setting. 41, p 31). Without providing standardized questions, it provides a nuanced statement that Assessing and documenting a defendant's functioning usually requires asking specific questions that systematically explore competency-related abilities (Ref. Instead, the original MacArthur research was intended to assess a much broader construct of decisional competence via a lengthy research measure, the MacArthur Structured Assessment of the Competencies of Criminal Defendants.42 It was subsequently shortened and retrofitted for the evaluation of competency to stand trial. Calculated as the standard error of measurement (SEM), each competency measure produces small SEMs, indicating a high level of accuracy (Table 2). THREE EXPERIMENTS WERE Some variability was due to clinician discipline (psychologists, psychiatrists, and social workers conducted the evaluations), which Murrie et al. 95, suppl. Despite these important contributions to competency assessments, the caution of the AAPL Task Force is well founded; conclusions should not be based only on this source but should reflect a careful integration of multiple sources of data. In reviewing the ECST-R normative data, we did not find a single case of any of the competency scales where this occurred. Although classifications based on the ECST-R evidence a high concordance with legal outcome (88.9%), classifications by ECST-R scales are based on construct validity and the use of normative data. Suicide by Cop and Civil Liability for Police, Polygenic Risk Score Effect on Violent Behavior in Schizophrenia, Effects of Online Distance Learning on Violence Risk Knowledge and Competencies, by The American Academy of Psychiatry and the Law, http://libproxy.library.unt.edu:2055/ehost/detail?vid=3&hid=102&sid=bdf72205-c12f-4c62-aa8f-e6eedlalb8e2%40sessionmgr110&bdata=JnNpdGU9ZWhvc3QtbG12ZSZzY29wZT1zaXR1#db=loh&AN=16093149, Competency Measures and Evidence-Based Practices, American Academy of Psychiatry and the Law. If not based on disciplines, what accounts for this polarization? In addition to psychological tests, there are a number of forensic assessment instruments (FAIs) that may be helpful to evaluators, some of which also provide screens for assessing feigning of mental disorders (Rogers, Sewell, Grandjean, & Tillbrook, 2002). This historical perspective provides an essential insight: the foundation for evidence-based forensic practice was established while the American Academy of Psychiatry and the Law (AAPL) and its counterpart, the American Academy of Forensic Psychologists, were still in their infancies. There was considerable variation in opinions about incompetency, as the rates of incompetency determinations ranged from 0% to 62%. study was their follow-up of the court decisions. The presence of mental illness or intellectual deficit is a key component of a competency evaluation, but mere presence of mental illness or deficit is not sufficient for a determination of incompetence.

The vignette describes a bar fight between two men, Fred and Reggie, that results in an aggravated assault charge against Fred. They differ in that the ECST-R examines how severe psychopathology may affect the defendant's rational abilities. With professional experience and expertise, practitioners can make informed decisions in selecting the appropriate competency measure to evaluate specific competency-related situations.

December 18, 2021. These items are scored on the basis of the reasons that the defendant provides for his or her judgment and whether they are plausible or implausible (i.e., grounded in reality or based on delusional beliefs). Occasionally, a court may request that both evaluations take place at the same time (Chauhan, Warren, Kois, & Wellbeloved-Stone, 2015). We do not capture any email address. Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree?

Your current browser may not support copying via this button. In contrast, Guidelines 2 and 4 were relatively easy to grasp. Representative items are Jack felt that the judge _____ or If the jury finds me guilty _____. Each item is given a score of 2 (competent), 1 (questionable), or 0 (incompetent), and scores below 20 would identify possible incompetent defendants, who would then be referred for further assessment, usually in an inpatient setting. This observation is a likely explanation for the differences in cut scores between the two measures.

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Those defendants who were clearly competent, Public Policy, and Law ( vol determining competency to stand trial functional... 62 mcgarry criteria competency stand trial on a 7.00 rating scale of their representativeness medication raises question! Evidence ( ed 2 ) standardize competency evaluations by recommending 15 specific areas of inquiry components retained average... They seem to stem mostly from apparent confusion over the meaning of an ECST-R rating 3! Levels of reliability and validity ( Nicholson, Robertson, Johnson, & Jensen, )... Interview of Reported Symptoms ( SIRS ) and professional Manual function of certain individuals in the case Indiana! To represent him or herself ( referred to as proceeding pro se ) competent proceed. Determination of whether this defendant fulfills each criterion facilitate comprehension br > < >... The current criminal charges and witnesses ) of the alleged crime and the current criminal charges of... 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Among the broad array of criticisms, researchers have been singled out as motivated by personal and professional gain.5 An alternative view is that traditionalists are equally motivated to avert criticisms of their current clinical practices by researchers. This was the case in Miles v. Stainer (1997), in which a defendant was considered competent but only if he continued to take antipsychotic medication. In their study, they asked two experts to make judgments about competency based on a review of records, reports from hospital evaluators, and evaluations using the Interdisciplinary Fitness Interview (IFI). The issue reached the U.S. Supreme Court in the case of Sell v. United States (2003). Structured Interview of Reported Symptoms (SIRS) and Professional Manual.

These normative data were used for clinical interpretation of information from the jail detainees to establish three categories. Several points should be emphasized: 1. Those components retained an average of 6.10 on a 7.00 rating scale of their representativeness. Research on the GCCT-MSH indicates high levels of reliability and validity (Nicholson, Robertson, Johnson, & Jensen, 1988). There is no explicit prohibition forbidding the offering of an ultimate opinion and, in many ways, a well-written report should make the evaluators opinion obvious even if it is not directly stated. Advokat, Guidry, Burnett, Manuno-Mire, and Thompson (2012) found that about 25% of their sample were considered not restorable, and noted few differences in terms of clinical diagnosis, substance abuse, intellectual capacity, or type of offense, but they also found that the group restored to competency performed better on the Georgia Court Competency Test and Global Assessment of Functioning scale at both initial and final assessments. Moreover, the objectivity of evidence-based researchers has been called into question because they are motivated by payment and publication to produce noteworthy results.4 The acceptance of evidence-based methods within the psychiatric community is clearly influenced by both concerns regarding research design and polarized professional attitudes. Competence is also a consideration when a defendant chooses to represent him or herself (referred to as proceeding pro se).

What are the functional abilities required by defendants to be considered competent to proceed with the legal proceedings?

A third section of the MacCAT-CA focuses on the defendants ability to appreciate his or her own legal circumstances and situation, and explores how they would make decisions in their actual case. Gatowski and her colleagues,17 in a national study of 400 state trial court judges, found that most judges (i.e., ranging from 88% to 93%) believed that the individual Daubert guidelines were useful in deciding the admissibility of scientific evidence.

Legal procedures that protect the rights of criminal defendants have been adopted to ensure that they have the capacity to participate fully in their defense (Youtsey v. United States, 1899; Dusky v. United States, 1960). aaaa. (2002). They seem to stem mostly from apparent confusion over the meaning of an ECST-R rating of 3.

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