The differential impact of deinstitutionalization on white and nonwhite defendants found incompetent to stand trial

Previous studies have reported that state mental hospital deinstitutionalization has resulted in the processing of the mentally ill through the criminal justice system. Using pre- and postdeinstitutionalization samples of defendants found incompetent to stand trial (IST) selected from three states, this study examines changes in the mental health and arrest histories of white and nonwhite ISTs. These data reveal a significant increase in the number of nonwhite ISTs. Also, after deinstitutionalization, nonwhite ISTs had significantly more prior arrests and hospitalizations than white ISTs. There were, however, no differences in the offenses for which whites and nonwhites were arrested.     

When is a capitally charged defendant incompetent to stand trial?

Competence to stand trial is a functional test rather than a bright line test, which therefore requires a case and fact specific assessment of a client's abilities in context. This article discusses competence in the context of capital trial cases. There are serious potential pitfalls for the client when raising incompetence and the decision to do so must be based on the specific ways in which the client's mental illness interferes with specific abilities to communicate with counsel and understand the proceedings. This article addresses counsel's duties in the context of assessing competence, but focuses on the little addressed issue of what abilities a client must have and what tasks a client must participate in so as to be engaged in a competent manner. It also discusses the types of conditions which may interfere with competence to stand trial.     

Evaluation of competency to stand trial in defendants who do not want to be defended against the crimes charged

Implicit but significant assumptions made in the criminal justice system include beliefs that criminals do not commit crimes to be tried and convicted and that, once arrested, defendants' primary motives are to avoid or minimize the legal consequences of the charges they face. When those assumptions are not correct, clinicians and legal decision makers are faced with difficult tasks. The authors present three cases of defendants who were not primarily concerned with defending themselves against the charges they faced, but rather with using the criminal justice procedures to further personal goals, and discuss the problems involved for forensic evaluators and courts.     

A comparison of civil patients and incompetent defendants: pre and post deinstitutionalization

There has been a great deal of speculation that deinstitutionalization has resulted in the criminalization of the mentally ill. Using two samples of defendants found incompetent to stand trial (IST) and two samples of civil patients randomly selected from five states, pre and post deinstitutionalization, this research compares changes in their mental health and arrest histories. After deinstitutionalization, fewer and less dramatic differences in the arrest and mental health histories were evident between ISTs and civil patients. Both patient samples displayed significant increases in prior hospitalization and arrest histories. Among the civil patients there was a significant increase in the frequency and seriousness of criminal activity. There was no evidence that IST commitments are being expanded to hospitalize the nondangerous mentally ill no longer subject to civil commitment.     

Treating incompetence to stand trial

InJackson v. Indiana (1972), the United States Supreme Court held that the primary justification for detaining defendants who are incompetent to stand trial is to provide them with relevant treatment. Unfortunately, the majority of forensic facilities place more emphasis on treating mental disability than on the specific symptoms that legally define incompetence to stand trial. Since this appears to be inconsistent withJackson, a study was conducted to test whether a treatment that deals with the specific symptoms of incompetence to stand trial would be more effective. As predicted, 21 patients who received such treatment showed significantly more improvement on an assessment instrument than 20 patients who received the more common form of treatment. In addition, more patients in the experimental treatment group than in the standard treatment group were able to be recommended to the court as competent. Implications are discussed.     

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.     

A comparison of criminal sexual conduct defendants based on victim age

This study compared defendants charged with Criminal Sexual Conduct whose victims were <6 years of age with defendants whose victims were 12 or more years of age. The study included 163 men referred to the evaluation unit of a state center for forensic psychiatry. Thirty-eight men had younger victims (YVs) and 125 men had older victims (OVs). The variables of comparison were defendant demographic and psychiatric variables frequently identified in the sex offender literature. Controlling for other demographic and psychiatric variables by use of logistic regression modeling, elderly defendants (60 years or greater), and incest offenders were three times more likely to have YVs (Odds Ratio [OR] 3.08 and 3.11, respectively). Unlike previous studies defendants with serious psychiatric pathology (psychosis or mania) were no more likely to have YVs (OR 0.66) than were defendants without psychosis.     

Domains of competency to stand trial

Attempts to improve the clinical rigor of competency to stand trial evaluations have resulted in the development of several psycholegal measures. Among the most widely used of these measures are the Competency Screening Test (CST), the Fitness Interview Test (FIT), and the Georgia Court Competency Test—Mississippi State Hospital Revision (GCCT-MSH). To examine the theoretical domains of the competency construct as assessed by these measures, a series of exploratory factor analyses were performed combining previously reported data on the FIT and GCCT-MSH with a new outpatient sample of 353 court referrals. For the CST, data from a previous sample were compared to the original validation study. Of the three measures, only the GCCT-MSH showed evidence of stable, independent factors. A comparison of the GCCT-MSH to theDusky standard suggested a need to further develop empirical measures to better represent underlying constructs related to the defendant-attorney relationship and defendant's participation in his or her defense.     

受审能力探析

受审能力是被告人接受法庭审判的能力。我国对受审能力的研究还处于起步阶段，立法上还有许多空白之处。本文从评定标准、提起、确认与法律后果等方面对受审能力进行了探讨。     

Use of a television crime-drama series to promote legal understanding in mentally ill, incompetent defendants: a pilot study

Videotaped material is used for educational purposes in many areas of medicine. In forensic facilities, programs designed to restore competency to stand trial (CST) in incompetent, mentally ill defendants have utilized videotaped courtroom proceedings as learning tools. This pilot study reviewed the progress of incompetent defendants (N = 15) who participated in a program that utilized videotaped segments of the television crime-drama "Law & Order", among other techniques, to promote CST in individuals deemed unfit to stand trial. The authors hypothesized that participation in at least one cycle of the Competency Restoration Group (CRG)'s curriculum would be associated with improvement in the areas of understanding, reasoning and appreciation. In order to assess whether the group was beneficial to the patient's treatment goal of competency restoration, patients were screened using the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) prior to starting the group and after completing a cycle of the group's curriculum. The Wilcoxon signed ranks test was employed to analyze the results from the pre- and post-group MacCAT-CA testing. The tests yielded significant (p < 0.005) post-test differences in the hypothesized direction for each of the three subsections: Understanding, Reasoning, and Appreciation as well as a significant post test improvement in the total MacCAT-CA scores. These results suggest that a didactic program, using a popular crime drama series, can be effective in facilitating learning in competency restoration programs. Limitations of this study include its lack of a control group and small population.     

Assessment and conceptualization of competency to stand trial

Based on an examination of current methods used to define and assess a defendant's competency to stand trial, the authors propose an assessment and research instrument, referred to as the Interdisciplinary Fitness Interview (IFI). The IFI is a structured interview and rating scale designed to take into account both legal and mental health issues, and calls for an interdisciplinary approach to the assessment of competency. The purpose of the present study was to provide preliminary reliability and validity data on the use of the IFI in one jurisdiction. The results are discussed in terms of policy implications and the development of methods for evaluating competency with brief screening interviews in less restrictive settings.Support for this project was provided by a grant from the National Institute of Mental Health, Center for Studies in Crime and Delinquency (Grant No. 1 RO 1 MH 33669-01) to the Social Science Research Institute. The data reported here are taken from a larger research project designed to assess the use of a number of methods for assessing competency. Our principal concern in this article is with preliminary analyses of the Interdisciplinary Fitness Interview, a measure developed expressly for this project. The authors thank William Glackman and George Tien for their assistance in data analysis and Amiram Elwork and anonymous reviewers for their helpful comments on earlier drafts.