At any point in criminal proceedings that a defendant shows signs of mental illness, his competence to proceed to stand trial may be questioned (Winick, 2002). The issue may be brought up when he pleads guilty, waives certain constitutional rights, at sentencing hearing or when administering punishment, including capital punishment. Either the defense or prosecution or the court itself may raise the issue, even if the defendant himself objects to it. But mental illness alone, even schizophrenia, does not automatically produce a finding of incompetence. Rather, it is based on the degree of functional damage produced by the illness. Two conditions must be satisfied in order to be adjudged incompetent to stand trial. It focuses on the defendant's mental state during trial. It is differentiated from the legal insanity defense, which is based on the defendant's mental state at the time of the criminal act (Winick).
Research reveals that many defendants inappropriately seek and gain competency evaluation and as part of a delaying strategy (Winick, 2002). Either side resorts to this strategy. Prosecutors seek it to avoid bail or an insanity acquittal, or hospitalization if available by law. Defense attorneys seek it to secure mental health recommendations as part of an insanity defense, plea bargaining or sentencing (Winick).
Several studies conclude that the vast majority of defendants are referred inappropriately for competency evaluation and have suggested that the competency process often is invoked for strategic purposes (Winick, 2002). The issue may be raised by both sides to obtain delay, by prosecutors to avoid bail or an expected insanity acquittal, or to bring about hospitalization that might not otherwise be available under the state's civil commitment statute, or by defense attorneys to obtain mental health recommendations for use in making an insanity defense, in plea bargaining, or in sentencing (Winick)
Thirty studies were conducted to compare 8,170 competent and incompetent criminal defendants to determine the characteristics, which related to incompetency ((Nicholson & Kugler, 1991). These were poor performance in psychological tests or interviews on defendants' legally relevant functional capabilities; a psychotic diagnosis, and psychiatric symptoms, indicating severe psychopathology. Lesser characteristics were traditional psychological tests, previous psychiatric hospitalization, previous legal involvement, marital resources, and demographic characteristics (Nicholson & Kugler).
This describes how psychiatrists should evaluate criminal defendants' competence to stand trial (Mossman et al., 2007). It specifies standards of practice and principles and an analysis of an individual defendant's case in the light of applicable laws in the jurisdiction. Recommendations reflect and are limited by evolving case law, statutory requirements, legal publications and current psychiatric knowledge. The review of psychiatric diagnoses is drawn from general trends. Reviewing psychiatrists should remain aware of the jurisdiction's interpretation of laws. They use their expertise in the direction of providing assurance about the defendant's mental state. Before allowing him to face criminal prosecution and possible punishment, the courts must receive assurance to come from careful and expert individualized evaluation on his mental capacity for a defense. The psychiatrist's opinion should come from an understanding of jurisdictional standard and how the defendant's mental condition affect his competence. The psychiatrist's report should describe this opinion and the reasoning that leads to it. The psychiatrist should provide the courts with the information needed to assure them that the defendant can sufficiently defend and protect himself (Mossman et al.).
The competence of a defendant to stand trial was determined by the conclusion of the case, Dusky v. United States (Felthous, 2001). Later referred to as the Dusky Standard, it established the two elements of competency. First, the defendant must possess rational and factual understanding of the charges and the associated penalties. Second, he must possess the capability cooperate with an attorney for this defense. The Court found this formulation an appropriate test of competency throughout the criminal process and as a bare constitutional requirement. It emphasizes the importance of cognitive capability to understand and the behavioral ability to consult and coordinate with a lawyer. It does not require the defendant to engage in any rational decision-making (Felthous).
This Standard is explicit in the requirement of rational understanding for determining a defendant's competence to stand trial (Felthous, 2001). Most courts do not. After the Dusky decision, court disposition has remained ambiguous about it. This Standard requires that the defendant's understanding be explicitly and uniformly rational in criminal responsibility and execution. This Standard safeguards the accuracy of criminal adjudications, guarantees a fair trial, preserves the integrity and dignity of legal processes, and insures that the defendant knows and understands why he is being punished for being found guilty (Felthous).
Medication to Restore Competency
The Supreme Court ruled in Washington v Harper of 1990 that the Due Process Clause allowed prisoners to refuse to take antipsychotic medicines unless and until set preconditions are met (Paul & Noffsinger 2008). It found that involuntary medication does not infringe this Clause if he is a danger to himself or others and the treatment will benefit hi. The Supreme Court, in Sell v. U.S., decided that involuntary medication was permissible in some circumstances for an incompetent defendant on trial for a serious but nonviolent crime. It directed lower courts to consider four criteria, known as Sell criteria, in making this determination. First, important government interests must be threatened. Second, involuntary medication must substantially enhance such government interests. Third, involuntary medication must be necessary to enhance government interests. And fourth, the administering of the drugs should be medically correct and warranted (Paul & Noffsinger).
This means that a non-dangerous prisoner found incompetent to stand trial at pre-trial but competently refuses to take medication should be appraised, using the Sell criteria (Paul & Noffsinger, 2008). This is to determine if his involuntary taking medicines would restore his or her competency is justified. It is in the government's interest to put him in trial, whatever the consequences. The importance lies in the maximum possible penalty if convicted and the dangerousness of the offense. If the defendant is suffering from schizophrenia, there is no other option but to administer antipsychotic medication. If he argues that the side effects of the medication may damage his ability to help in his defense, the side effects should be assessed to determine if they are likely to be so convincingly severe as to impair his ability to stand trial. It should also be assessed if these side effects may be lessened (Paul & Noffsinger).
Disposition of the Incompetent Defendant
A number of situations and dispositions are proposed. If the director of the treatment facility finds and concludes that the defendant is likely to remain incompetent in the foreseeable future, he shall report this to the court (Justia, 2006). His report shall recommend that the defendant be released, committed or certified if found unrestorably incompetent. Based on the report, the court shall make a competency determination. If it finds the defendant incompetent and likely to remain so in the foreseeable future, he shall be ordered released, committed, reviewed for commitment or certified pursuant. But if the court finds him incompetent but restorable, he may be ordered treated until 6 months from the date of his admission. At the end of 6 months and the director determines that the defendant remains incompetent, the former shall report this to the court with appropriate recommendation. The court will conduct a hearing on this report. If it finds the defendant unrestorably incompetent, it shall order one of the 4 dispositions. If found incompetent but restorable to competency, it may order the defendant's treatment for another 6 months and a hearing held at the end of that period if the defendant remains incompetent but restorable to competency in some foreseeable future (Justia).
Charges against an unrestorably incompetent defendant shall be dismissed on the date his sentence shall have expired if convicted the maximum sentence or 5 days from the date of arrest, whichever is sooner (Justia, 2006). If the court orders a review for commitment, an attorney shall be ordered to conduct it in the jurisdiction of the charge. The defendant shall be turned over to the custody of the Department of Mental Health, Mental Retardation and Substance Abuse Service for confinement and treatment until the review and any hearing are completed. If the incompetent defendant is charged with capital punishment, the charge shall not be dismissed. The court with jurisdiction may order continued treatment for additional 6-month periods without limit, provided that a hearing held at the end of each period, the defendant remains incompetent, the court determines the continued medical treatment as appropriate and the defendant is a danger to himself or others. The attorney may file the dismissed charges against the defendant if and when he is restored to competency (Justia).
The first is the Dusky Standard, which is the basis for every other standard on competency to stand trial in any State (Zapf & Roesch, 2000). It is also considered the minimum constitutional requirement. Secondly, the only way to test the validity of competency…