The article acknowledges the past polarization of forensic practitioners on acceptance versus rejection of competency measures. Treatment is usually relatively brief, as approximately 75% are restored to competency within six months and are returned at that point to court for the resumption of their criminal cases (Morris & Parker, 2008; Nicholson & McNulty, 1992). 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. In their studies of reports of competency evaluators in Utah, Skeem et al.

For the third scale (CWC), it is theoretically possible to score in the severe range based only on ratings of 2. Consistent with the American Academy of Psychiatry and the Law Practice Guideline, it recommends the integration of competency interview findings with other sources of data in rendering evidence-based competency determinations. Overall agreement (unanimous agreement among three evaluators) of initial evaluations of competency was lower than other studies (71%), which might be expected when more than two evaluators are studied.

Minimal or no impairment had assessed deficits that fell within 1 standard deviation (SD) of the presumably competent detainees. Competence can even arise in death penalty cases in which the competence to proceed with appeals or to be executed is questioned (Cunningham, 2013). 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.

The competency issue is raised when an officer of the court (defense, prosecution, or judge) has reason to believe there is a bona fide doubt as to a defendants competence. The defendant Ahmad Edwards attempted to steal a pair of shoes from a department store in Indiana, and when security officers tried to apprehend him, he fired shots at them. 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. 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 There is no standard report format, but a number of sources provide guidelines that forensic evaluators can reference (Otto, DeMier, & Boccaccini, 2014; Zapf & Roesch, 2009). 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. 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. It is likely that the number is higher today given the increase in mentally ill individuals in jail (Steadman, Osher, Robbins, Case, & Samuels, 2009). The court later adopted this report. Readers may wish to refer to the Federal Judicial Center16 and special issues of Psychology, Public Policy, and Law (vol.

Rogers Criminal Responsibility Assessment Scales (R-CRAS) and Test Manual. WebThe Competence to Stand Trial Assessment Instrument, often called the Competency Assessment Instrument (CAI), was developed in 1973 as a companion instrument to the Competency Screening Test (CST) and sought to standardize as well as quantify the criteria for competence to stand trial. We have found the MacCAT-CA especially useful in competency cases in which the defendant has expressed an interest in serving as his or her own attorney. A small group of 10 professionals (lawyers, administrators, and forensic psychologists) rated the appropriateness of the CAST-MR content. One sound approach to ascertaining error rates is to estimate the accuracy of individual scores on competency measures.

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. The next section addresses the admissibility of expert evidence in light of the Daubert9 standard. Specific factual aspects of cases must also be considered. He had a history of mental illness and although initially found competent, he later deteriorated and was found to be incompetent.

Research generally reports high agreement in studies of the reliability of CST evaluations, with agreement about the ultimate opinion regarding competency in the 90% range (Cox & Zapf, 2004; Poythress & Stock, 1980; Rosenfeld & Ritchie, 1998). Another pertinent consideration is whether the theory or technique has been subjected to peer review and publication.

The items are scored on a 3-point scale with a score of 2 indicating full understanding of the item. The modern standard for defining competence to stand trial was established in Dusky v. United States (1960), in which the U.S. Supreme Court held: It is not enough for the district judge to find that the defendant is oriented to time and place and has some recollection of events, but that the test must be whether he 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. Of mostly historical interest, first-generation measures have limited data on their psychometric properties, a lack of normative data, and poor correspondence to the relevant legal standard.38 Although reviews of these measures are readily available,39 this article focuses more selectively on three published competency measures. The ECST-R uses the following classification: 60 to 69 T, moderate impairment, usually associated with competent defendants; 70 to 79 T, severe impairment, which can reflect competent or incompetent defendants; 80 to 89 T, extreme impairment, usually associated with incompetent defendants; and 90 to 110 T, very extreme impairment, almost always associated with incompetent defendants.

Mossman (2007) gives an example of a line of research that addresses this issue.

As well, following the Edwards decision, a defendant could be found competent to stand trial but still denied the right to defend him or herself.

For assessments, the use of reliable and valid measures is the most direct and empirically defensible method of achieving this standardization. study was their follow-up of the court decisions. WebThe issue of a defendants competency to stand trial is usually raised by a written motion suggesting that the defendant is incompetent to stand trial. Bonnie and Grisso (2000) estimated some 60,000 annual evaluations, a figure that was a substantial increase over prior estimates (Hoge et al., 1997). You could not be signed in, please check and try again. The contextual nature of competence means that the necessary level of psycholegal abilities may vary depending on the nature of the legal proceedings expected of a defendant.

Could each forensic psychiatrist or psychologist develop his or her own specific questions and systematic examination of competency? In his seminal work, Robey34 proposed in 1965 a standardized checklist for operationalizing competency to stand trial. In their study, they asked two experts to make judgments about competency based on a review of records, reports from hospital evaluators, and evaluations using the Interdisciplinary Fitness Interview (IFI). Researchers and practitioners are likely to find this a valuable resource in evaluating forensic measures. Because the law has provided only vague criteria, incompetency to stand trial has tended to be equated with mental illness by both psychiatrists and members of Overall, these two studies suggest that while agreement between evaluators is generally high, there are a substantial number of cases in which evaluators disagree (18% in Utah and 29% in Hawaii). They found that for the 17 cases seen by the blue-ribbon panelists, they agreed with the IFI panelists 88% of the time, with the hospital staff 82% of the time, and with the courts 88% of the time, and they concluded that on the basis of these data it would be hard to argue for one criterion definition over another (p. 331).

Charles Sell was a dentist who was charged with fraud and attempted murder. The original IFI collected data from defendants interviewed by a two-person team, composed of a lawyer and either a psychologist or a social worker, and found high agreement about their final opinions of competency (Golding et al., 1984).

As part of a special issue of the Journal on evidence-based forensic practice, this article examines three published competency measures: the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), the Evaluation of Competency to Stand Trial-Revised (ECST-R), and the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST-MR). if there is reasonable cause to believe that the defendant may Because of small sample sizes and large variability, they provide the following caution: only a gross estimate can be made of the degree to which CAST-MR total scores discriminate between groups found to be competent versus those found to be incompetent (Ref. Neither the CAST-MR nor MacCAT-CA assesses defendants' knowledge of their own criminal charges and the severity of these charges.

With Daubert used as the conceptual framework, this section examines competency measures as evidence-based practice. 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. The Georgia Court Competency Test (GCCT) was developed by Wildman et al. 41, p 31). Nonetheless, the AAPL Task Force recommends the use of specific questions and a systematic examination covering 15 areas of inquiry. Although classifications based on the ECST-R evidence a high concordance with legal outcome (88.9%), classifications by ECST-R scales are based on construct validity and the use of normative data. Subsequently, Edwards asked to proceed pro se, but this was denied by the trial judge. Once the issue is raised, the trial court will typically request an evaluation. Thus, once it is established that a person does have a mental disorder or cognitive deficits, the next step is to demonstrate how that mental disorder impairs a defendants legal abilities. 2324). Forensic practitioners should decide which is most relevant to a particular competency evaluation. 1. (a) Examination by Experts.

As previously noted, a rating of 4 shows substantially impaired competency by itself, whereas a rating of 3 shows deficient competency but does not, by itself, show substantially impaired competency.

As evidence of their growing importance, an American Psychiatric Association Task Force undertook a multiyear analysis of psychiatric measures resulting in a comprehensive textbook.47 Beyond these general trends, specific contributions to competency measures have been multidisciplinary from the early efforts in the 1970s. Melton and his colleagues were the first to raise the concern of whether competency measures appear to permit gross incongruencies between item ratings and scale interpretations (Ref.

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An interesting feature of the MacCAT-CA is that that an education component is built into the measure. 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). Simply put, how are these classifications established and what is their relevance to the Dusky standard? The case carried through the appeals process and was eventually heard by the U.S. Supreme Court, which held that a trial judge can deny a defendant the right to proceed pro se even if he or she had previously been found competent. speculated may have been due to differences in training and also how they viewed the relationship between psychosis and competence.

Indeed, the term itself is misleading because few defendants actually go to trial, as the vast majority of cases are resolved through plea bargaining. For two scales (FAC and RAC), such ratings would show only moderate impairment, which is typically associated with competent defendants. 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. Readers can independently evaluate the following analyses of competency measures in light of this disclosure.

The focus of the ECST-R inquiries is not on the decision itself but rather on the reasoning underlying the decision. Lipsitt, P. D. , Lelos, D., & McGarry, A. L. (1971). He was allowed to represent himself, and his behavior during the trial led Perlin to comment that the Godinez decision resulted in a trial in which dignity, a prerequisite for a fair trial, was not preserved. Without providing standardized questions, it provides a nuanced statement that Assessing and documenting a defendant's functioning usually requires asking specific questions that systematically explore competency-related abilities (Ref. Defendant entered notice of appeal in open court.

The foregoing discussion focused on the congruence between competency measures and the Dusky standard. Expected 90 day duration of illness. If a defendant received a rating of less than a 2, the examiner provides the answer and then asks the defendant to repeat the provided answer in his or her own words. For example, the three competency measures differ in the extent to which they have been evaluated for pretrial defendants with mental retardation.

Evaluations conducted in the legal context should always consider the possibility of malingering since there may be motivation to feign or exaggerate symptoms with the intention of being found incompetent or for establishing an insanity defense later (Vitacco, Rogers, Gable, & Munizza, 2007). Psychological Evaluations for the Courts (ed 3).

The opening paragraph of this article noted the professional schisms between traditional practice and the growing movement toward evidence-based practice. Reference Manual on Scientific Evidence (ed 2). Competency restoration practices are reviewed later. Professional Manual for the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA). WebCompetence to stand trial: the legally determined capacity of a criminal defendant to proceed with criminaladjudication.Jurisdictionalstatutesand case law set out the Perlin cited the case of Colin Ferguson, who was accused of murdering six people and injuring 19 others on the Long Island Rail Road. 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).

(2002). A reliability assessment does not require, although it does permit, explicit identification of a relevant scientific community and an express determination of a particular degree of acceptance within that community [Ref. Validity of evaluators conclusions about competence is more difficult to assess, as there is no gold standard against which to compare evaluator opinions (Zapf & Roesch, 2009). The issue reached the U.S. Supreme Court in the case of Sell v. United States (2003). WebThe Competence to Stand Trial Assessment Instrument, often called the Competency Assessment Instrument (CAI), was developed in 1973 as a companion instrument to the

He refused to consent to treatment, and the treatment facility attempted to force medication involuntarily.

For competency determinations, the Supreme Court in Dusky established the three prongs for which the fit or congruence of scientific evidence must be considered. Its competency scales parallel the Dusky prongs: Consult With Counsel (CWC; six items), Factual Understanding of the Courtroom Proceedings (FAC; six items), and Rational Understanding of the Courtroom Proceedings (RAC; seven items). The use of psychotropic medication has been shown to be effective in restoring competence, as evidenced by the high rate of restoration noted. 9, pp 5934]. We revisit these objections later in the context of evidence-based competency measures. Enter multiple addresses on separate lines or separate them with commas. 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). WebTHE CST WAS CONSTRUCTED BY MCGARRY AND OTHERS AS AN OBJECTIVE, PRELIMINARY SCREENING INSTRUMENT. However, most of the reliability studies examine agreement between two examiners using the same competency measure making dichotomous decisions about competence. A number of instruments have been developed that may assist the examiner in evaluating the possibility of malingering (see Miller, 1995; Rogers, Bagby, & Dickens, 1992), including one designed specifically for feigning competence-related abilities (Guenther & Otto, 2010). The shift to other settings has been driven in part by research showing that opinions about a defendants competence can be made after a relatively brief assessment (see Zapf & Roesch, 2009).

A question has been raised about whether reports should offer an opinion about whether the defendant is competent or not (Slobogin, 1989).

Preliminary Steps The assessment template includes a list of documents that the evaluator should obtain or consider Rule 3.211 - COMPETENCE TO PROCEED: SCOPE OF EXAMINATION AND REPORT. In addition, the lack of information about specific prongs is a limiting factor about the CAST-MR classifications.

A major strength of the three competency measures is the excellent data on their reliability and errors in measurement. As noted by one reviewer, it would be utterly nave to attempt to equate any test or laboratory findings with an ultimate or penultimate legal opinion. We do not capture any email address. PDF. WebCompetency to Stand Trial Assessment Instructions I. Defendants with serious mental disorders or mental retardation are likely to have substantial deficits in capacity to process information. 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. For defendants found incompetent, treatment is usually successful in restoring competence and allowing them to return to court and proceed with the resolution of their cases. Field reliability of competence to stand trial opinions: How often do evaluators agree, and what do judges decide when evaluators disagree? The ECST-R manual provides extensive data on the accuracy of its measurements. 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. In the absence of specific data, one option would be to use the lower limit for normal persons (i.e., 22 words) as the upper limit for competency measures used with potentially impaired defendants. Get info about his position, age, height, weight, draft status, shoots, school and more on Basketball-Reference.com However, consistent with the functional approach to competency assessments, the scale scores are not summed to total one final score for the ECST-R, and no cut-offs are used to determine whether a defendant is competent or incompetent.

Evaluation of Competency to Stand Trial-Revised (ECST-R) and Professional Manual. Obviously, the group of hospitalized legally incompetent defendants should theoretically evidence clinically significant impairment, given their combined psychiatric and legal status. A more sound approach would be the integration of clinical interviews with standardized measures. Several points should be emphasized: 1.

of Docs., U.S. Govt. Utah courts can expect details about specific abilities, such as how to behave appropriately in court, testify relevantly if applicable, and whether medication is necessary and the impact it might have on the defendants demeanor, affect, and ability to participate in the proceedings (Utah Code Annotated, 2002). The Competency Screening Test (CST) is a screening measure for identifying clearly competent defendants and thus avoiding inpatient evaluations (Lipsitt, Lelos, & McGarry, 1971). In this regard, the ECST-R is distinguished from the other two competency measures by its highly reliable scales that screen for feigned incompetency. Once a competency evaluation is ordered, the evaluation itself can take place in a range of settings, including jails, forensic facilities, or if a defendant is released on bail, in an outpatient setting. 3233). This provides an assessment of a defendants capacity to understand and acquire and process new information. The feigning scales were developed by using two primary detection strategies: rare symptoms and symptom severity. Gutheil and Bursztajn48 wisely counsel that forensic practitioners avoid even the appearance of ipse dixitism with respect to unsubstantiated opinions.

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