论受审能力的恢复

受审能力评定越来越引起重视的情况下,对于无受审能力者,受审能力的恢复也是一项值得大家关注的问题,受审能力恢复的培训程序包括相关精神障碍治疗、法律知识培训、综合住院治疗;而个别程序的专门培训可能是受审能力最大程度恢复的必要措施。受审能力恢复评定的标准更多的参照于经典的Bennett标准。虽然有关受审能力恢复的研究还存在一些挑战,但为我国相关受审能力恢复的研究指明了道路,提供了很好的参考依据和措施。     

The Effect of Competency Restoration Training on Defendants with Mental Retardation Found Not Competent to Proceed

The present investigation focused on the reevaluations of competency to stand trial (CST) of 75 criminal defendants with mental retardation (MR) who were originally found incompetent and who were referred for treatment. The effect of competency restoration training was examined. Site of training was also investigated. Because habilitation facilities are specially designed to help individuals with MR, it was suspected that training at habilitation centers would have a greater effect on restoration of defendants with MR than the training at state hospitals. Results showed that significantly more defendants did not gain competency following training than those who did. Analysis revealed that (a) higher IQ and (b) being African American rather than Caucasian American were predictive of restoration. When discriminating factors were held constant, site of training did not significantly affect competency restoration. Possible explanations for this finding were discussed.     

Restoration of competency to stand trial: Assessment with the Georgia Court Competency Test and the Competency Screening Test

Evaluations of the Georgia Court Competency Test—Mississippi Version Revised (GCCT-MSH) and the Competency Screening Test (CST) have supported their use with pretrial defendants in initial assessment of competency to stand trial. The present study evaluated the efficacy of these measures, as well as the Texas Competency Instrument, with an inpatient sample of defendants involved in a competency restoration program. Both measures were factor analyzed in an attempt to replicate previously identified factor structures. Neither factor structure was replicated; however, a distinct factor structure was identified for the GCCT-MSH. The relationships among sociodemographic variables, clinical variables, current symptomatology, and competency status (as measured by the GCCT-MSH) were evaluated using discriminant function analyses. The best predictors of GCCT-incompetency in this sample are a diagnosis of either a psychotic disorder or a nonpsychotic affective disorder as well as a low measured IQ. Current symptomatology, as measured by the SCL-90-R, was not an effective predictor of competency status.     

Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree?

Despite many studies that examine the reliability of competence to stand trial (CST) evaluations, few shed light on "field reliability," or agreement among forensic evaluators in routine practice. We reviewed 216 cases from Hawaii, which requires three separate evaluations from independent clinicians for each felony defendant referred for CST evaluation. Results revealed moderate agreement. In 71% of initial CST evaluations, all evaluators agreed about a defendant's competence or incompetence (kappa = .65). Agreement was somewhat lower (61%, kappa = .57) in re-evaluations of defendants who were originally found incompetent and sent for restoration services. We also examined the decisions judges made about a defendant's CST. When evaluators disagreed, judges tended to make decisions consistent with the majority opinion. But when judges disagreed with the majority opinion, they more often did so to find a defendant incompetent than competent, suggesting a generally conservative approach. Overall, results reveal moderate agreement among independent evaluators in routine practice. But we discuss the potential for standardized training and methodology to further improve the field reliability of CST evaluations.     

A Community‐Based Model for Remediating Juveniles Adjudicated Incompetent to Stand Trial: Feedback from Youth,Attorneys, and Judges

This study examined client satisfaction with a community‐based restoration services program for youth adjudicated incompetent to stand trial in Virginia. The sample consisted of 130 youth (ages 8‐21 years), 80 attorneys, and 43 juvenile court judges. Youth overwhelming found restoration services helpful to them, although some concepts were harder to learn than others. Both judges and attorneys were generally knowledgeable about juvenile competency law, although both were less knowledgeable about competency evaluators and the services provided to youth. Results will be used to improve teaching tools, training of Restoration Counselors, and communication between program providers and the legal community.     

A validation study of the Competency Screening Test

This study was designed to assess the utility of the Competency Screening Test (CST) as a method of determining competency to stand trial. Fifty male residents of a state forensic unit were administered the CST. These residents were later interviewed by the Forensic Team who determined whether they were competent to stand trial. The CST correctly predicted the competency recommendations of the Forensic Team in 82 percent of the 50 cases. These data are consistent with previous research, and suggest that the CST should be further investigated as a preliminary screening instrument in the determination of competency to stand trial.     

Feigning incompetency to stand trial

The vulnerability of competency to stand trial instruments to malingering was previously unexamined. In this study, the Georgia Court Competency Test (GCCT) was administered to offenders asked to feign incompetency; their results were compared to controls and pretrial defendants (both competent and incompetent). Offenders appeared to be able to simulate incompetency and tended to score lower on the GCCT than their truly incompetent counterparts. For the detection of simulators, a newly developed Atypical Presentation scale for the GCCT showed promise. In addition, several strategies were explored that included simulators' failure of very simple items (i.e., floor effect) and variable success on items of increasing difficulty (i.e., performance curve). Optimal cutting scores are presented for forensic clinicians to screen defendants for feigned incompetency.     

Competency Restoration: An Examination of the Differences Between Defendants Predicted Restorable and Not Restorable to Competency

According to the U.S. Supreme Court's decision in Jackson v. Indiana (1972), examiners must determine if a defendant has substantial probability of regaining competency through treatment in the foreseeable future. Previous research has indicated that, given the low base rate of defendants unable to be restored to competency, examiners are relatively poor at predicting which defendants will regain competency. Determining the characteristics of not restorable incompetent defendants and restorable incompetent defendants is a necessary first step toward improving examiners' ability to predict a defendant's likelihood of regaining competency. This study examined the competency evaluation reports of 468 defendants evaluated for competency to stand trial. Incompetent defendants significantly differed from competent defendants with regard to age, employment status, ethnicity, criminal charges, and psychiatric diagnosis. Few significant differences existed between defendants predicted restorable and those predicted not restorable by mental health examiners—the differences that did exist were related mainly to nonpsychiatric variables.     

An evaluation of procedures for assessing competency to stand trial

In a field experiment involving 120 defendants at Bridgewater State Hospital in Massachusetts, the authors evaluated three instruments for assessing competency to stand trial: the Competency Screening Test (CST), Competency Assessment Instrument (CAI), and Interdisciplinary Fitness Interview (IFI). The CST (a paper-and-pencil test) was administered by a research assistant and scored by trained graduate students. Lawyers, psychologists, and social workers were recruited and trained in the use of the other instruments, then assigned as individuals (CAI) or teams (IFI) to conduct interviews and assess subjects. The performance of the project interviewers was compared against two yardsticks: (1) actual decisions reached by the regular Bridgewater staff, and (2) a consensus of two nationally respected experts who reviewed the cases and formed independent competency judgments. Both the CAI and IFI performed well under these conditions, indicating that one-time interviews by well-trained persons can lead to accurate competency decisions in the majority of cases. The authors conclude that hospitalization for competency assessment is rarely necessary.     

A Comparison of Defendants with Mental Illness Represented by Public Defenders and Private Attorneys: an Analysis of Court-Ordered Pretrial Psychiatric Evaluations

This study compared the characteristics and court-ordered evaluation questions and responses among 4,430 defendants to determine if differences existed between those represented by public defenders and private attorneys when receiving trial competency or responsibility psychiatric evaluations from a state department of mental health. Defendants represented by public defenders were more likely to be younger, to have less education, to have psychotic disorders, to have a history of inpatient psychiatric treatment, to live in urban or rural counties, and to be jailed at the time of the evaluation. In addition, defendants represented by public defenders were less likely to have a request for a criminal responsibility evaluation and more likely to be evaluated as having a mental illness, to be incompetent to stand trial, and to need hospitalization pending trial. Consideration of whether defendants with public defenders receiving less requests for responsibility evaluations was indicative of a therapeutic jurisprudence approach is discussed. Implications for research on types of legal representation of defendants with mental illness are discussed.     

A new pretrial screening program

Pretrial screening of defendants for competency to stand trial and responsibility at the time of the crime reduces unnecessary hospitalization. It can be developed on a statewide basis at little cost, resulting in great savings. Such programs should be established in every state.     

Detection of malingering in competency to stand trial evaluations

A simulation design with multiple contrast groups was used to test the effectiveness of two instruments, the Structured Interview of Reported Symptoms (SIRS) and the Georgia Court Competency Test—Mississippi State Hospital (GCCT-MSH) in detecting malingering of competency to stand trial. Thirty simulators were compared with 23 incompetent defendants, 25 competent defendants, 30 offender controls, and 7 suspected malingerers on both instruments. Results revealed that the simulators and suspected malingerers scored significantly higher on all of the SIRS primary scales and significantly lower on the GCCT-MSH than the three comparison groups. The SIRS had an overall hit rate of 97.8% using three or more primary scales as the criterion for malingering. Information concerning the simulator's strategies of deception is presented.     

LEGAL AND JUDICIAL INTERPRETATION OF COMPETENCY TO STAND TRIAL STATUTES AND PROCEDURES

This study provides an analysis of the views of the legal community with respect to competency to stand trial statutes and procedures. Responses from North Carolina judges and defense attorneys reveal significant areas of disagreement or misunderstanding. While many judges believed that defense attorneys misunderstood or misused the competency procedures, the judges uniformly granted the motions. Defense attorneys indicated reasons for requesting competency evaluations that were frequently unrelated to concerns about competency. Hearings to determine competency were often not even held, and if a defendant was found to be incompetent. most judges believed that involuntary commitment to a mental institution should be automatic regardless of perceived dangerousness. The authors argue that these issues demand further attention and resolution to allow the competency laws to accomplish their intended goal without jeopardizing defendants’ rights.     

THE IMPACT OF STATE MENTAL HOSPITAL DEINSTITUTIONALIZATION ON COMMITMENTS FOR INCOMPETENCY TO STAND TRIAL*

Previous studies have reported that state mental hospital deinstitutional-ization has resulted in the criminalization of the mentally ill. Utilizing two samples of defendants found incompetent to stand trial (IST) pre- and post-deinstitutionalization, selected from three states, this study examines the correlation between the rate of deinstitutionalization and increases in the frequency of incompetency commitments, as well as changes in the characteristics of incompetent defendants. These data suggest that increases in IST commitments and the mental health histories of the post-deinstitutional cohort are positively related to deinstitutionalization. Contrary to the criminalization hypothesis, there is no evidence that incompetent defendants are now being arrested for less serious offenses.     

Effects of advanced age and dementia on restoration of competence to stand trial

Elderly defendants (age 65+) and defendants with dementia adjudicated incompetent to stand trial and hospitalized for restoration to competence (RTC) often present unique challenges to clinicians charged with their restoration. In this study, we attempted to better identify predictors of successful RTC by building upon previous research correlating increased age with decreased likelihood of RTC. We identified elderly non-demented defendants (n = 31) and defendants diagnosed with dementia (n = 47) from a state database of 1380 individuals hospitalized for competence restoration from 1988–2004. Using regression analysis and correcting for demographic variables and common admission psychiatric diagnoses, we studied the relationship of age at hospital admission and dementia diagnosis on the likelihood of successful RTC. Both advanced age and dementia diagnosis were associated with decreased RTC. After correcting for dementia diagnosis, increased age retained its negative correlation with restoration success. Both elderly non-demented defendants and defendants diagnosed with dementia were significantly less likely to be restored to competence than all other RTC admissions (n = 1302). However, a substantial percentage of both demented and elderly non-demented defendants were successfully restored to competence, potentially justifying restoration attempts for both of these groups of defendants.     

Examining the use of the M-FAST with criminal defendants incompetent to stand trial

The Miller Forensic Assessment of Symptoms Test (M-FAST) was developed to provide evaluators with a brief, reliable, and valid screen for malingered mental illness. This study examined the initial validity of the M-FAST in a sample of 50 criminal defendants found incompetent to stand trial because of a mental illness. The M-FAST total score and items were compared with the Structured Interview of Reported Symptoms (SIRS) and the fake-bad indicators of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Results indicated good evidence of construct and criterion validity, demonstrated by t tests, receiver operating characteristics analysis, and high correlations between the M-FAST, SIRS, and the fake-bad indices on the MMPI-2. Tentative cut scores for the M-FAST total score and scales were examined and demonstrated high utility with the sample of criminal defendants incompetent to stand trial.     

The processing and disposition of incompetent mentally ill offenders

Pretrial hospitalization of mentally ill offenders has been increasing in recent years and a number of abuses have been noted with respect to competency to stand trial. This is a report on 431 male felony defendants who were found incompetent to stand trial, hospitalized, and returned to court for a final disposition. Approximately one-half of those brought back to the court gained release to the community, with one-half continuing to be held in a hospital or a prison, and with 70% continuing in treatment in one setting or another. Disposition was significantly related to race, criminal history, severity of charges, and the recommendations of mental health professionals. Offenders were found to have spent unnecessarily long periods of time in jail and in the hospital awaiting court processing, raising questions about the fairness and efficiency of current procedures.     

受审能力的法律辨析

目前司法领域对受审能力缺乏明确的立法规定，实践中也没有统一标准。本文就受审能力的适用于诉讼的范围、受审能力的二分法、评定程序等问题，从法律而非医学的角度来进行分析。以纠正目前对受审能力的部分错误认识。     

When courts and experts disagree: Discordance between insanity recommendations and adjudications

Discordance between state examiner recommendations of culpability and subsequent insanity adjudications was investigated. The discordant group was compared with groups of defendants where concordance occurred between recommendation and adjudication. Data were collected from casefile materials (totalN=80) and comparisons were made on defendant's background, the offense, and the forensic evaluation. To determine how purposeful and goal directed the offense was, offenses were rated on a rationality scale. Results indicated that defendants in the discordance group committed emotionally charged or unusual offenses, were likely to have a psychiatric history (65%) and were more likely to have been found incompetent to stand trial than defendants recommended and adjudicated culpable. The discordant group was dissimilar to defendants recommended and adjudicated insane in frequency of prior felony arrest (65%), alcohol/drug use at time of offense (55%), paucity of psychosis (20%) and higher frequency of claimed amnesia (35%). On the rationality scale, discordant defendants were intermediate between those defendants recommended and adjudicated insane, who typically committed irrational offenses, and those defendants recommended and adjudicated culpable, who typically committed purposeful and goal directed offenses.     

Incompetency to stand trial: As status,as label,and as potential source of sentencing disparity

Criminal defendants are considered to be incompetent to stand trial if they are unable to understand the proceedings against them and unable to cooperate adequately with their attorneys. The purpose of this study was to compare the sentencing patterns of a group of defendants who had raised this issue and been returned to court as competent, with those of a group of defendants who had not raised the issue. Results showed that raising the issue of incompetency seemed to be a significant factor in the consumption of court resources, and lessened a defendant's likelihood of having his or her case dismissed. It did not make a significant contribution to the explanation of the variance associated with sentence length or with the granting of probation.