The role of competency to stand trial in mental health courts

Concerns have been raised in the literature about the competency to stand trial and competency to make treatment decisions of defendants referred to mental health courts. However, there is little information reported about the evaluation and prevalence of incompetence, characteristics of incompetent mental health court defendants, and disposition of mentally ill defendants too disturbed to be diverted from the criminal justice system through mental health courts. This study reports on the 85 potential mental health court defendants referred for trial competency evaluations during the first three years of operation of the Akron Ohio Mental Health Court. Of the 80 defendants who could be located for evaluation, 77.5% were found incompetent, and 53% of the incompetent defendants were not restored to competence even after an average of 49 days of treatment in a state psychiatric hospital. The implications of these findings in terms of the diversion potential of mental health courts for the severely mentally ill are discussed.     

The question of sanity restoration in jail

Severe mental illness, especially psychotic disorders that are worsening, acute or complicated, normally require intensive psychiatric care and treatment that is most appropriately provided in a mental hospital. For criminal defendants, transfer to a forensic security hospital has traditionally been the means of achieving hospital care for mentally disordered defendants who have been found incompetent to stand trial or not guilty by reason of insanity. In recent years, with the shortage of intermediate and long-term hospital beds in the United States, including forensic security hospital beds, jail-based competency restoration programs are being established, seemingly obviating hospital transfer. Potential advantages of and concerns about jail-based, as opposed to hospital-based, competency restoration programs are discussed in the literature. If defendants with severe mental illness traditionally treated in a forensic security hospital for competency restoration are now treated for competency restoration in jail, it is not inconceivable that insanity acquittees could one day be treated in jail for sanity restoration. With the premise that it is better to consider the potential consequences before this becomes a serious proposal and is implemented, this analysis examine the advantages and concerns that have been put forth for jail-based competence restoration programs as they may or may not apply to jail-based sanity restoration programs. Substantial commonality is recognized, but also some differences, as well as reason for skepticism of the purported virtues of either alternative to care and treatment in forensic security hospitals.     

Competent and incompetent criminal defendants: a quantitative review of comparative research

Thirty studies comparing competent and incompetent criminal defendants (N = 8,170) were quantitatively reviewed to identify variables associated with judgments about defendants' competency to stand trial. Effect sizes reflecting the magnitude of the relationship between competency status and defendant characteristics were derived and averaged across studies. The characteristics most strongly related to incompetency were (a) poor performance on psychological tests or interviews specifically designed to assess defendants' legally relevant functional abilities, (b) a psychotic diagnosis, and (c) psychiatric symptoms reflective of severe psychopathology. To a lesser degree, traditional psychological tests, previous psychiatric hospitalization, previous legal involvement, marital resources, and demographic characteristics were also related to competency status. Although these results are generally consistent with the legal standard for competency to stand trial, some of the correlates of competency may reflect potential biases in the decision-making process. Limitations of existing research and directions for future inquiry are discussed.     

Can defendants with mental retardation successfully fake their performance on a test of competence to stand trial?

The purpose of this study was to determine whether criminal defendants with mental retardation can feign poor performance on a test of competence to stand trial. Four groups of adjudicated criminal defendants were given a test of competence to stand trial. In the experimental condition, defendants with mental retardation (MR) and mentally typical defendants (non-MR) were given instructions to fake their performance on the test. In the control, MR defendants and non-MR defendants took the test under standard conditions. The results indicated that both the MR and non-MR fakers scored significantly lower than the MR and non-MR controls. There was no significant difference in the scores of the MR and non-MR fakers. The results suggest that defendants with mental retardation may be able to successfully fake their performance in certain circumstances. Implications of these findings are discussed.     

Communication and language in severely deaf adolescents

One of the most important psychological effects of early severe or profound deafness is an impairment in natural language-processing ability, with a consequent reduction in communicative skill secondary to the sensory deficit. Prelingual damage blocks the development of certain sequential/syntactical skills necessary for the acquisition of normal linguistic competence. Educators of the deaf in the UK have typically attempted to improve linguistic ability using amplification and intensive training in lip-reading, but evidence from several psychological studies suggests that communication systems based upon manual signing are more productive of both linguistic and basic cognitive skills. This paper reports an experimental study of the communicative characteristics of both oral and total communication systems as a function of language structure. For almost all types of structure investigated, the total system was found to be the more effective method of communication.     

Effects of Defendant Ethnicity on Juries' Dispositions of Felony Cases1

This research examined jury decisions in 317 noncapital felony cases in El Paso, Texas, and assessed the impact of juror ethnicity on jury trial outcomes. Results revealed that there was no relation between defendant ethnicity and the probability of conviction. Anglo American defendants, however, received sentences that were approximately twice as severe as Hispanic defendants. Sentences imposed by juries were significantly related to defendant ethnicity and type of crime for which they were tried. Sentences were also influenced by defendant ethnicity in interaction with jury ethnic composition. Important differences appeared when there was a critical mass of 6 or more Hispanics on juries. This study, using criminal court data, provides a unique opportunity to examine the utility of social psychological theories for understanding actual trial outcomes.     

Defense attorneys' concerns about the competence of adolescent defendants

Research indicates that a sizable proportion of adolescent defendants have difficulty understanding and participating in legal proceedings against them, and may be incompetent to stand trial. To examine attorneys' experience in defending adolescents with competence‐related difficulties, 214 juvenile attorneys were surveyed. Findings indicated that attorneys have doubts about the competence of approximately 10% of adolescent defendants, and that they find these cases particularly challenging to defend. Most attorneys appear to recognize that developmental factors may contribute to adolescents' competence‐related difficulties, and believe that the law should accept developmental immaturity as a basis for incompetence findings. In approximately half of the cases in which attorneys had doubts about competence, attorneys did not request a competence evaluation but instead made other efforts to address competence issues, such as by teaching adolescents about legal proceedings and further involving their parents. The implications of these findings are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Crowd psychology in South African murder trials.

South African courts have recently accepted social psychological phenomena as extenuating factors in murder trials. In one important case, eight railway workers were convicted of murdering four strike breakers during an industrial dispute. The court accepted conformity, obedience, group polarization, deindividuation, bystander apathy, and other well-established psychological phenomena as extenuating factors for four of the eight defendants, but sentenced the others to death. In a second trial, death sentences of five defendants for the "necklace" killing of a young woman were reduced to 20 months imprisonment in the light of similar social psychological evidence. Practical and ethical issues arising from expert psychological testimony are discussed.     

Linguistic flexibility in signed and written language productions of deaf children

Linguistic flexibility of deaf and hearing children was compared by examining the relative frequencies of their nonliteral constructions in stories written and signed (by the deaf) or written and spoken (by the hearing). Seven types of nonliteral constructions were considered: novel figurative language, frozen figurative language, gestures, pantomime, linguistic modifications, linguistic inventions, and lexical substitutions. Among the hearing 8- to 15-year-olds, oral and written stories contained comparable numbers of nonliteral constructions. Among their age-matched deaf peers, however, nonliteral constructions were significantly stories contained comparable numbers of nonliteral constructions. Among their age-matched deaf peers, however, nonliteral constructions were significantly more common in signed than written stories. Overall, hearing students used more nonliteral constructions in their written stories than did their deaf peers (who used very few), whereas deaf students used more nonliteral constructions in their signed stories than their hearing peers did in their spoken stories. The results suggest that deaf children are linguistically and cognitively more competent than is generally assumed on the basis of evaluations in English. Although inferior to hearing age-mates in written expression, they are comparable to, and in some ways better than those peers when evaluated using their primary mode of communication.     

Second-Guessing the Jury: Stereotypic and Hindsight Biases in Perceptions of Court Cases1

This research examined the effects of stereotypic beliefs and hindsight biases on perceptions of court cases. Subjects read evidentiary material pertaining to a criminal trial in which the defendant either was a stereotyped offender or was not. Additionally, some subjects were given outcome information about the verdict attained in the trial; half of these subjects were told that the defendant had been found guilty, and the other half were told that he had been found not guilty. The remainder were not given any outcome information. Subjects were than asked to predict the likely outcome of a trial based on the presented evidence. Typical hindsight bias effects were expected and obtained for nonstereotyped offenders; subjects considering these cases viewed the evidence as less incriminating when they were told the defendant had been found not guilty, and they found it to be more incriminating when they were told the defendant had been found guilty, when compared to the no-outcome-information group. However, no hindsight biases were evident in judgments of cases involving stereotyped defendants, who were seen as relatively more likely to be guilty regardless of the nature of outcome information presented. Particularly striking was the lack of impact of the “not guilty” outcome information on perceptions of the guilt of stereotyped defendants. These findings suggest that strong expectations held in foresight may not be amenable to modification in hindsight.     

Fixing forensic patients: Psychiatric recommendations for treatment in pretrial settings

This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of treatment as a central forensic issue at METFORS. Among a sample of 592 defendants, 134 were considered in need of outpatient care. Persons recommended for hospitalization were most likely to exhibit histories of mental health rather than criminal justice contacts; to be arrested for nonviolent offenses; to manifest psychotic behavior while at METFORS; to be found unfit for bail, incompetent to stand trial, in need of further assessment and dangerous to self; and to experience higher rates of hospitalization, but lower levels of criminalization during the two years following their initial forensic assessment. Psychiatric reports at METFORS tended to merge recommendations for treatment and assessment; to suggest prison or probation as means for securing clinical treatment; and to provide little written support for judgments about the need for intervention. Along with competency and dangerousness, treatment is a key issue in forensic practice, and warrants further attention in the psycholegal literature.     

Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: clinical and legal issues

The clinical and legal literature abounds with articles dealing with competence to stand trial; while most agree that criminal defendants must be capable of defending themselves before the state can bring them to trial, a number of articles are quite critical of the procedures by which these concepts are operationalized, some even going so far as to suggest abolishing the requirement for competence altogether. One of the major problems leading to the criticisms is the unnecessary loss of liberty involved. Although the length of incarceration has decreased significantly since the 1970s, the majority of states still permit, or require, hospitalization for evaluation of competence, and even more so for treatment to restore competence.The author reviews case law and presents data from his survey of current state statutes and responses from state forensic mental health program directors, to demonstrate the rarity of outpatient treatment to restore competence. He argues that outpatient treatment for defendants who do not require hospitalization on clinical or public safety grounds should be available, on both clinical and legal grounds, and provides recommendations for establishing such programs in the community.     

Language First: Deaf Children from Deaf Families Spontaneously Anticipate False Beliefs

ABSTRACT

Being connected to other people at the level of inner and unobservable mental states is one of the most essential aspects of a meaningful life, including psychological well-being and successful cooperation. The foundation for this kind of connectedness is our theory of mind (ToM), that is the ability to understand our own and others’ inner experiences in terms of mental states such as beliefs and desires. But how do we develop this ability? Forty-six 17- to 107-months-old children completed a non-verbal eye-tracker false-belief task. There were 9 signing deaf children from deaf families and two comparison groups, that is 13 deaf children with cochlear implants and 24 typically developing hearing children. We show that typically developing hearing children and deaf children from deaf families, but not deaf children with cochlear implants, succeeded on a non-verbal eye-tracking ToM task. The findings suggest that the ability to recognize others’ mental states is supported by very early, continuous and fluent language-based communication with caregivers.     

Recognition of affective and noncanonical linguistic facial expressions in hearing and deaf subjects

This study explores the use of two types of facial expressions, linguistic and affective, in a lateralized recognition accuracy test with hearing and deaf subjects. The linguistic expressions represent unfamiliar facial expression for the hearing subjects whereas they serve as meaningful linguistic emblems for deaf signers. Hearing subjects showed left visual field advantages for both types of signals while deaf subjects' visual field asymmetries were greatly influenced by the order of presentation. The results suggest that for hearing persons, the right hemisphere may predominate in the recognition of all forms of facial expression. For deaf signers, hemispheric specialization for the processing of facial signals may be influenced by the differences these signals serve in this population. The use of noncanonical facial signals in laterality paradigms is encouraged as it provides an additional avenue of exploration into the underlying determinants of hemispheric specialization for recognition of facial expression.     

Expressing generic concepts with and without a language model

Utterances expressing generic kinds ("birds fly") highlight qualities of a category that are stable and enduring, and thus provide insight into conceptual organization. To explore the role that linguistic input plays in children's production of generic nouns, we observed American and Chinese deaf children whose hearing losses prevented them from learning speech and whose hearing parents had not exposed them to sign. These children develop gesture systems that have language-like structure at many different levels. The specific question we addressed in this study was whether the gesture systems, developed without input from a conventional language model, would contain generics. We found that the deaf children used generics in the gestures they invented, and did so at about the same rate as hearing children growing up in the same cultures and learning English or Mandarin. Moreover, the deaf children produced more generics for animals than for artifacts, a bias found previously in adult English- and Mandarin-speakers and also found in both groups of hearing children in our current study. This bias has been hypothesized to reflect the different conceptual organizations underlying animal and artifact categories. Our results suggest that not only is a language model not necessary for young children to produce generic utterances, but the bias to produce more generics for animals than artifacts also does not require linguistic input to develop.     

The competency of criminal defendants to refuse,for delusional reasons,a viable insanity defense recommended by counsel

This article addresses the issues of whether mentally ill defendants charged with serious crimes who refuse to plead a viable and counsel-recommended insanity defense for delusional reasons (but who are otherwise competent to stand trial) should be considered to be competent, or incompetent, to stand trial; whether such defendants should be allowed to represent themselves with a delusional defense; and whether an insanity defense may properly be imposed upon such defendants. Based on an analysis of relevant Supreme Court decisions and other relevant cases, it is concluded that such defendants should not be allowed to go forward with a delusional defense (at least until reasonable efforts to treat the defendants' delusions are made). It is also argued, however, that unless an insanity defense would be viable (as well as recommended by counsel) delusional defendants who are otherwise competent to stand trial should be permitted to go forward, and represent themselves, with the defense of their choosing.     

Does language about similarity play a role in fostering similarity comparison in children?

Commenting on perceptual similarities between objects stands out as an important linguistic achievement, one that may pave the way towards noticing and commenting on more abstract relational commonalities between objects. To explore whether having a conventional linguistic system is necessary for children to comment on different types of similarity comparisons, we observed four children who had not been exposed to usable linguistic input - deaf children whose hearing losses prevented them from learning spoken language and whose hearing parents had not exposed them to sign language. These children developed gesture systems that have language-like structure at many different levels. Here we ask whether the deaf children used their gestures to comment on similarity relations and, if so, which types of relations they expressed. We found that all four deaf children were able to use their gestures to express similarity comparisons (point to cat + point to tiger) resembling those conveyed by 40 hearing children in early gesture + speech combinations (cat + point to tiger). However, the two groups diverged at later ages. Hearing children, after acquiring the word like, shifted from primarily expressing global similarity (as in cat/tiger) to primarily expressing single-property similarity (as in crayon is brown like my hair). In contrast, the deaf children, lacking an explicit term for similarity, continued to primarily express global similarity. The findings underscore the robustness of similarity comparisons in human communication, but also highlight the importance of conventional terms for comparison as likely contributors to routinely expressing more focused similarity relations.     

A chronometric study of sentence processing in deaf children

It has been consistently reported the deaf children have tremendous problems in reading English sentences. Three experiments were conducted in the present study to investigate the nature of deaf children's reading inability. The first experiment looked into the letter-decoding process. It was found that deaf subjects took longer than normal-hearing subjects in encoding and decoding alphabetic letters. The second experiment employed a sentence-picture verification paradigm. The results showed that deaf subjects adopted a visual-imagery coding strategy rather than a general linguistic coding strategy as described by H. H. Clark and W. Chase (Cognitive Psychology, 1972, 3, 472–517) and by P. A. Carpenter and M. A. Just (Memory and Cognition, 1975, 3, 465–473). However, when the sentence was presented in manual signs (Experiment 3), deaf subjects' verification time showed that they adopted a general linguistic coding strategy. Thus, deaf subjects are capable of linguistic coding strategy, but they do not apply it to process printed English sentences. A second-language hypothesis was advanced to account for the obtained data. Deaf children's reading inability was also discussed from this perspective.     

Craziness and criminal responsibility.

This article addresses why mental disorder is relevant to criminal responsibility. It begins by considering the meaning of criminal responsibility because it is impossible to understand the relevance of mental disorder unless one understands responsibility clearly. The next section provides a theoretical account of responsibility and excuse in general and addresses common misconceptions about these topics. The third section examines in detail why mental disorder can sometimes produce either a complete or partial excusing condition, such as legal insanity or "partial responsibility," and whether the U.S. Constitution requires the provision of an excuse based on mental disorder. The section proposes that mental disorder should produce an excusing condition in appropriate cases. The next section considers the relation of mental disorder to mens rea, the mental state "element" that is a definitional criterion of most crimes, and whether the U.S. Constitution requires that defendants be permitted to use evidence of mental disorder to negate mental state elements of the crime charged. This section argues that mental disorder rarely negates mens rea, but in those cases in which a plausible claim for negation could be made, defendants should be allowed to make this claim.     

Competency to stand trial: Legal and clinical issues

A fundamental principle of criminal law is the right of defendants to a fair trial. Courts have long recognized that an essential component of this fairness doctrine is the ability, or competency, of defendants to participate in their defense. Mental health professionals have been extensively involved in assisting the courts in the evaluation of competency to stand trial. Three aspects of competency to stand trial in criminal cases are reviewed: the legal criteria defining competency to stand trial, the clinical assessment of competency, and the treatment of defendants found incompetent to stand trial.