1. Criminal and Civil Competence
Chapter 8 1

2. Raising the Issue of Competency in Criminal Proceedings
focus on present mental state, at any given instance
must understand the nature and purposes of the criminal proceeding
based in the 6th Amendment
right to be informed of the nature of the accusation, right to confront witness, and right to assistance of counsel

3. Differences between competency and insanity
Focus on mental state at time of crime versus focus on present
Insanity is a legal defense to a criminal charge whereas competency ensures fairness of the process
Standards are vastly different
Threshold for finding
Insanity requires presence of mental illness
Competency evaluation does not necessitate the defendant to admit guilt

4. Competency to Stand Trial (CST)
Related to notion of defendant being in abstentia
Dusky v. United States (1960)
"sufficient present ability to consult with his attorney with a reasonable degree of rational understanding, and a rational, as well as factual understanding of the proceedings against him”

5. Prevalence of CST 60,000 competency evaluations each year
Most frequently occurring forensic evaluation
Occurs in 2-8% of all felony cases
Attorneys have doubts about their client’s competency in 15% of cases
20% of defendants referred for competency evaluations are found incompetent

6. Procedure for CST Reasons for ensuring competency
A competent defendant increases accuracy of trial
Defendant must be allowed to exercise full rights
Integrity of process could be questioned
Purpose of punishment is not upheld
Competency evaluation, hearing may be scheduled if competency is contested, delay of trial if found incompetent, process continues if found competent
“defendants could not be held more than a reasonable period of time necessary to determine whether there is a substantial probability that they will attain capacity in the foreseeable future” (Jackson v. Indiana, 1972)

7. Competency Evaluations
Significant agreement among experts and judges
No standard approach
Experts split on importance of using psychological testing
Most review past records (police report, mental health records, etc.)

8. Measures of Competence
Competency Screening Test (CST)
Georgia Court Competency Test (GCCT)
The Fitness Interview Test (FIT)
MacArthur Competence Assessment
Tool-Criminal Adjudication (MacCAT- CA)

9. A Comprehensive Approach to Competency Evaluations
Functional - legally relevant psychological abilities
Causal - probable explanation for functional deficits
Interactive - differential abilities required for specific trials
Conclusory - expert’s ultimate opinion
Prescriptive - gather dispositionally relevant information

10. Characteristics of Incompetent Defendants
Psychotic, organic and mental retardation are most prominent diagnoses among incompetent defendants
No clear conclusion regarding demographic variables
Criminal charges are relevant but maybe only as they relate to mental illness 10

11. Other variables related to competence
Professional differences
Forensic psychologists
Use more collateral information
Produce more clinical notes
Complete more useful reports
More frequently use psychological testing
Use more and longer interviews
Spend more time preparing than forensic psychiatrists
Professional setting: outpatient v. inpatient
Outpatient settings are more likely to use psychological testing, take more time, use fewer evaluators, conduct fewer clinical interviews

12. Scope of Practice in Competency Evaluations
Potential confusion by mental health professionals of competency and insanity
May try to address both issues simultaneously
Total reliance of the court on professional opinion
Court and expert opinion agree in 90% of cases

13. Restoration of Competency
Process by which an incompetent defendant becomes competent
Hospitalizations are typically short
Over 75% of all individuals are restored to competency
Small number of failures makes research difficult
Restored individuals were more likely to have a previous criminal history, current violence charge, minor diagnosis, previous mental health contact, previous hospitalization, and prior use of psychotropic medication

14. Competency Restoration Programs
Administration of medication
Involuntary medication
Implementation of traditional treatment combined with psychoeducational interventions
Psychoeducational interventions are effective if defendant is able to pay attention, concentrate, and cooperate
Involuntary treatment can still be beneficial
Incompetent defendants don’t always received specialized treatment

15. Other Criminal Competencies
Competence to be Executed
Ford v. Wainwright (1986)
Competence to Waive Miranda
Competency to confess and waive counsel
Competence to Refuse Insanity Defense
Frendak v. United States (1979) 15

16. Civil Competencies
Core issues are very similar to criminal competencies
Generally focus on ability to make an everyday decision
Competence for Treatment
Real issues is competency to refuse treatment
Competence to Execute a Will
Must often rely on past records because if lack of availability of dead guy/gal
Competence Related to Guardianship
Lack of formal legal standards