This provides an assessment of a defendants capacity to understand and acquire and process new information. 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.
This is not the case for most defendants who are actually incompetent and hospitalized (see Ref 40, Tables 46): the understanding scale: 33.2 percent clinically significant impairment, 15.9 percent mild impairment, and 50.9 percent minimal or no impairment; the reasoning scale: 41.3 percent clinically significant impairment, 13.8 percent mild impairment, and 44.9 percent minimal or no impairment; and the appreciation scale: 44.5 percent clinically significant impairment, 9.2 percent mild impairment, and 39.2 percent minimal or no impairment. 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. Zapf and Roesch (2011), in their review of competency restoration programs, identified the pressing need for research Focusing on specific cognitive deficits and symptoms of mental disorder and the interplay between these and various competency-related abilities and deficits (p. 46). Court outcome is an imperfect criterion as studies show that judges routinely accept the recommendations or opinions of evaluators, with agreement rates of over 90% (Cox & Zapf, 2004; Zapf, Hubbard, Cooper, Wheeles, & Ronan, 2004).
The standard for competency to stand trial was established by the Supreme Court's decision in Dusky v. United States31 with a one-sentence formulation requiring that the defendant has sufficient present ability to consult with his lawyer with a reasonable degree of rational understandingand whether he has a rational as well as factual understanding of the proceedings against him. Rogers and Shuman14 provide a legal summary of Dusky's three prongs: a rational ability to consult one's own attorney, a factual understanding of the proceedings, and a rational understanding of the proceedings. The Evaluation of Competency to Stand Trial-Revised (ECST-R; Rogers, Tillbrook, & Sewell, 2004) presents a clinical interview with both semi-structured and structured components.
WebThe purpose of this study was to develop and validate an instrument for the assessment of competence to stand trial in criminal defendants with mental retardation.
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.
Many legal scholars and researchers criticized the Godinez decision, arguing, particularly with respect to competency to represent oneself, that this requires a higher level of competency (Melton, Petrila, Poythress, & Slobogin, 2007; Perlin, 1996). 
It assesses response style to provide an indication of malingering or feigning incompetency, as well as scale scores on four aspects of competency: factual understanding of the courtroom proceedings, rational understanding of the courtroom proceedings, consult with counsel, and overall rational ability. They differ in that the ECST-R examines how severe psychopathology may affect the defendant's rational abilities. With reference to forensic concerns, can the concept be empirically tested and does the research have the potential to disprove the conclusion? Additionally, in the case of a particular scientific technique, the court ordinarily should consider the known or potential rate of error. The complexity of the material provides a useful yardstick for evaluating the defendant's capacity to absorb and address complex legal material. 
The MacCAT-CA also assesses courtroom personnel and then uses a hypothetical case to evaluate criminal charges related to assault and matters such as plea bargaining. Others have estimated that 28% of all felony defendants are referred each year for an evaluation of competency (Hoge, Bonnie, Poythress, & Monahan, 1992; LaFortune & Nicholson, 1995).
The ECST-R focuses on both courtroom proceedings and defendants' understanding of their own criminal charges. Could each forensic psychiatrist or psychologist develop his or her own specific questions and systematic examination of competency? 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. This observation is a likely explanation for the differences in cut scores between the two measures. Unlike the MacCAT-CA, which restricts its normative data to presumably competent participants, the ECST-R includes both competent and incompetent defendants in its normative group, thereby mirroring the entire population that it is intended to evaluate. Therefore, it assesses rational abilities but does not consider the actual defendant-attorney relationship or the ability to communicate rationally.
While competency to stand trial is the most commonly used term, competency in the criminal trial process encompasses all stages of participation in the legal process, including pretrial, trial, sentencing, and appeals. There are 280 inmates at the Bexar County Jail that have been designated incompetent to stand trial because of mental health issues, intellectual disabilities, or
In one attempt to identify a criterion, Golding, Roesch, and Schreiber (1984) used a panel of experts, referred to as a blue ribbon panel, to serve as an independent criterion.
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.
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. State laws typically do not specify what should be contained in a report, although the Utah statute is a clear exception. Most competency evaluations are typically done by psychologists or psychiatrists, but social workers are also qualified in some states to conduct these evaluations (Jenkins v. United States, 1962; Roesch, 2015). Lessons from Slade et al. The following subsections provide a brief description of the measures and their development. As an outgrowth of the previous section, practitioners must not only consider the relevance of the psycholegal constructs but also the meaning of its classifications. In this regard, the ECST-R is distinguished from the other two competency measures by its highly reliable scales that screen for feigned incompetency. For the rational-understanding prong, both the MacCAT-CA and the ECST-R elicit information about the likely outcome of the case.
8The McGarry criteria (or questions) are known as the Competency to Stand Trial Instrument and are a widely used assessment procedure in the area Been an inpatient for 60 consecutive days in preceding 12 months. Research on the GCCT-MSH indicates high levels of reliability and validity (Nicholson, Robertson, Johnson, & Jensen, 1988).
Competency for trial: A screening instrument. Competence for execution is an infrequently raised competence issue, and the reader is referred to Zapf (2016) for a review and discussion. In fact, this approach is embraced by the AAPL Task Force in its summary statement about competency measures: Instead, psychiatrists should interpret results of testing in light of all other data obtained from clinical interviews and collateral sources (Ref. Table 1provides a summary of the specific scales on competency measures with descriptive data regarding their type of inquiry and the complexity of their questions.
The lower limit for unimpaired persons is 22.38 words. Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree?
A total of 128 criminal defendants compose the following groups: no mental retardation or mental disorder (n = 46), mental retardation but no competency evaluation, (n = 24), mental retardation and competent (n = 27), and mental retardation and incompetent (n = 31). Each of these three sections provides clinicians with specific questions that tap into different areas involved in competency.
WebState 1960 The criteria for determining competency to stand trial in Georgia was handed down by the Georgia Supreme Court in Brown v. State (1960) two months before Dusky For the most part, evaluators will need to determine that the level of mental disorder is severe enough to affect a defendants ability to proceed with trial. One strength of the ECST-R is that it both prompts and educates defendants with insufficient responses on factual understanding. 
Competence has come to refer to all aspects of participation in the legal process, from pretrial through sentencing and later in the appeal process. The CAST-MR is composed of three competency scales: Basic Legal Concepts (25 multiple-choice questions), Skills to Assist Defense (15 multiple-choice questions), and Understanding Case Events (10 open-ended questions).
Grisso emphasizes the contextual nature of a competency determination and the importance of understanding the demands of the defendants case, noting that an interaction between individual ability and situational demand, not an absolute level of ability, is of special significance for competence decisions (pp.
CST was developed by Lipsitt, Lelos, and McGarry in 1971 and is usually administered before Your current browser may not support copying via this button.
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Mental Illness. To be sure, the presence of a severe mental disorder such as a psychosis is an important first step in the evaluation of competence (Rosenfeld & Wall, 1998).
The Jackson decision led to revisions in state statutes that provided alternatives to commitment and limited the length of commitment (Roesch & Golding, 1980).
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. 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. The specific issue there was whether the standard for competency to stand trial and competency to represent oneself should be the same. Finally, general acceptance can yet have a bearing on the inquiry. On a five-point scale, the ratings were somewhat variable, with Skills to Assist in Defense reaching an average score of only 3.03 regarding the appropriateness of its content (Ref. (1978) as a screening device to screen out those defendants who were clearly competent. The practice has evolved to assess first if a defendant has a psycholegal ability incapacity and if so, whether the defendants mental status (mental illness or intellectual deficit) is causally connected to that incapacity. A small group of 10 professionals (lawyers, administrators, and forensic psychologists) rated the appropriateness of the CAST-MR content. The MacCAT-CA has excellent normative data for 446 jail detainees, 249 of whom were receiving mental health services. State v. Dean Garfoot Both criteria measure certain areas of knowledge and mental ability that are useful in a court setting. Utah Code Annotated 77-15-1 et seq. Hardcover in English. WebThe Competence to Stand Trial Assessment Instrument, often called the Competency Assessment Instrument (CAI), was developed in 1973 as a companion instrument to the For some, this resulted in confinement that lasted years and, for a few, a decade or more (Roesch & Golding, 1980), often spending more time in confinement than they would have been if convicted and sentenced on their original charges. 9, p 592).
Stated in Daubert terms, the error rate is five percent or smaller. The ECST-R demonstrates high internal consistency, with alpha coefficients for the competency scales ranging from .83.89 and alpha coefficients for the feigning scales ranging from .63.87. He refused to consent to treatment, and the treatment facility attempted to force medication involuntarily.
The IFI was revised (Golding, 1993) and in its current form, the Interdisciplinary Fitness Interview-Revised taps 31 relatively specific psycholegal abilities organized into 11 global domains, addressing issues such as the iatrogenic effects of psychotropic medications (Riggins v. Nevada, 1992), a defendants decisional competency to engage in rational choice about trial strategies, decisions to represent oneself, and decisions about whether to plead or go to trial.
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Specific issue there was whether the standard for competency to stand trial competency! Jail detainees, 249 of whom were receiving mental Health services these sections... Additionally, in the case of a particular scientific technique, the error rate is five percent or.! Treatment facility attempted to force medication involuntarily defendants who were clearly competent rational-understanding prong, both MacCAT-CA... The conclusion: how often do evaluators agree, and what do judges decide evaluators!
37, p S43). Fundamental justice requires that criminal defendants should be able to understand the charges against them, appreciate the nature and range of penalties, and communicate with their attorney. 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.
Competency to stand trial is an extremely complex issue, and practice has required that the psychiatrist play a major role in its determination.
8, issues 24) and the American Journal of Public Health (vol. The Interdisciplinary Fitness Interview (IFI) was designed to assess both the legal and psychopathological aspects of competency (Golding et al., 1984), ideally involving interviews conducted by a psychologist and a lawyer team. 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. Daubert reviews have also considered several forensic measures for which the adequacy of their psychometric properties has been debated: competency to confess measures23,24 and the Mental State at the Time of the Offense scale.25,26.
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