Is this patient competent to stand trial?

Based on the beginning of the interview, Mr. P appears to understand the nature and objectives of court proceedings. His delusions about his attorney, however, clearly would impair his ability to assist in his defense.

Reporting to the court. A forensic evaluator’s report to the court might say: “It is my opinion, with reasonable medical certainty, that although Mr. P understands the nature and objectives of the court proceedings against him, he has a significant thought disorder that currently impairs his ability to assist in his own defense. In particular, Mr. P maintains delusions (a fixed, false belief held despite evidence to the contrary) that his attorney is plotting against him.”

Treatment to restore competency. Approximately 30% of evaluated defendants are adjudicated incompetent for a variety of reasons (Table 2).¹¹ They often are committed to a forensic mental hospital for treatment to restore competency, which occurs in up to 90% of cases.¹²

Mr. P will likely be committed to restore competency, which may be achieved by treating his schizophrenia.

Defendants with disorders such as dementia or mental retardation may be considered unable to be restored to competency, and their charges are dismissed or held in abeyance. They may then be involuntarily hospitalized if committed through civil proceedings.

Table 2

7 common reasons defendants are found incompetent to stand trial

• Grisso T. Evaluating competencies: forensic assessments and instruments, 2nd ed. New York: Springer; 2002.
  
• Melton GB, Petrila J, Poythress G, Slobogin C. Psychological evaluations for the courts: a handbook for mental health professionals and lawyers, 2nd ed. New York: Guilford Press; 1997.
  
• American Academy of Psychiatry and the Law. www.aapl.org.