Criminal Topics
Topics of relevance as identified by the
American Board of Psychiatry & Neurology Board Certification Examination Content Outline.
Learn Forensic Psychiatry is not affiliated with nor endorsed by ABPN.
Criminal Competencies
Competency to Stand Trial (CST)
Defendants have a constitutional right to competency to stand trial under Due Process protections
Protects the integrity of the legal process
It would be unjust to try a defendant who doesn’t understand the legal proceedings or is unable to assist counsel in his own defense.
Assessment of Competency to Stand Trial
If a defendant’s competency to stand trial is in question, a competency evaluation may be requested by the defense, the prosecution, or the judge.
A competency evaluation is completed by a trained mental health professional, usually a psychologist or a psychiatrist
The evaluator assesses the defendants’ mental state, as well as their ability to consult with their lawyer, and their understanding of the legal proceedings, in order to form an opinion regarding competency to stand trial. A formal report is prepared.
If the evaluator is of the opinion that the defendant is incompetent to stand trial, the evaluator is also asked to opine on the likelihood of restorability.
Competency to stand trial is a legal determination made by a judge. The evaluator’s report helps to inform the judge’s decision.
If the judge adjudicates the defendant:
Competent: case may proceed to trial.
Incompetent, but restorable: defendant may be committed to a competency restoration program.
Incompetent and unrestorable: charges may be held in abeyance or dismissed.
Relevant Standards
Dusky Standard for Competency to Stand Trial (Dusky v. US, 1960)
Does the defendant have sufficient present ability to rationally consult with his lawyer to assist in his own defense?
Does the defendant have both a rational and factual understanding of the nature and purpose of the legal proceedings?
Standard of proof for competency to stand trial is preponderance of the evidence (Cooper v. Oklahoma, 1996)
Competency Restoration
Involves a combination of psychiatric treatment and education about the legal process aimed at restoring the defendant’s competency to stand trial so that the case may proceed.
Competency restoration programs may take place in a psychiatric hospital, in an outpatient setting, or in a correctional facility.
Defendants receive education about their charges, potential penalties, the roles of courtroom participants, legal procedures, their legal rights, and appropriate courtroom behavior.
The defendant’s competency to stand trial is periodically reevaluated, with reports submitted to the court.
Involuntary Psychiatric Treatment
Defendants who have been found incompetent to stand trial have a right to refuse psychiatric medication.
The defendant’s refusal of involuntary medication may be overridden if certain criteria are met: (Sell v. US, 2003)
A serious overriding government interest is at stake
Treatment is substantially likely to result in competency restoration
Treatment is medically appropriate & unlikely to cause side effects that will interfere with ability to assist counsel
There is no less restrictive alternative available
Confinement for Competency Restoration
Due Process requires that the nature and duration of commitment is reasonably related to the purpose of commitment.
A defendant found incompetent to stand trial cannot be confined for longer than reasonably necessary to determine if there is a substantial probability that capacity will be attained in the foreseeable future. (Jackson v. Indiana, 1972)
If determined to be unrestorable, the defendant may only be further confined via civil commitment proceedings.
CST & Amnesia
Amnesia doesn’t necessarily bar competency to stand trial, however certain factors must be considered: (Wilson v. US, 1968)
The extent to which amnesia impacts the defendant’s ability to consult with counsel and testify on his own behalf
The extent of external information with which to construct and present a defense, and the extent to which the government assisted in the reconstruction of events.
Strength of the government’s case
Competency to Represent Oneself
While the 6th Amendment establishes the right to represent oneself, this right isn’t absolute- a defendant must be competent to do so.
Competency to stand trial does not necessarily equate to competency to proceed pro se. CST standard applies to those represented by counsel. (Indiana v. Edwards, 2008)
States may require defendants who are CST, but incompetent to proceed pro se, to be represented by counsel.
Competency to Testify
Federal Rule of Evidence 601 (FRE 601)
Governs federal criminal cases and most federal proceedings
Establishes that defendants are presumed competent to testify unless specific rules indicate otherwise.
Age and mental status are not automatic disqualifiers.
Competency to Waive Rights
Waiver of constitutional rights requires both that the defendant is competent to do so, and that the decision is knowing, voluntary, and intelligent.
Standard for competency to waive constitutional rights, such as the right to counsel, is not higher than Dusky CST standard. (Godinez v. Moran, 1993)
Confessions
Due Process requires that confessions must be free and voluntary, not the product of coercion
Voluntariness must be demonstrated by a preponderance of the evidence; the state holds the burden of proof.
The standard for voluntariness of a confession is absence of police coercion. Psychosis does not negate voluntariness of a confession. (Colorado v. Connelly, 1986)
Alford Pleas
Pleading guilty while maintaining innocence is permissible as long as the plea is made intelligently, knowingly and voluntarily, with full understanding of the consequences (North Carolina v. Alford, 1970)
“Alford Plea”: pleading guilty while maintaining innocence, often as part of a plea bargain
Criminal Responsibility
Criminal Responsibility
Refers to the legal principle that a person who commits a criminal act should be held accountable unless they lack the physical and mental capacity to understand and control their actions.
Components of Criminal Responsibility: Mens Rea (Guilty Mind) + Actus Reus (Guilty Act)
Diminished Capacity
Argument that while the defendant broke the law, they shouldn’t be held fully liable due to diminished mental capacity.
Serves as a partial defense to charges that require a specific mental state.
Can lead to downward departure, but not acquittal.
Mens Rea
The mental state required to commit a crime.
Helps to differentiate between people who knowingly and intentionally commit crimes vs. those who acted without knowledge or awareness.
Levels of Mens Rea (per MPC)
Negligently
Should’ve been aware of the risk that criminal conduct could result from their actions, but wasn't.
Recklessly
Knew of the risk that criminal conduct could result from their actions, but disregarded the risk and did it anyway.
Knowingly
Knew with practical certainty that their actions would lead to criminal conduct.
Didn’t necessarily intend to commit a crime.
Purposefully
Criminal act was the intended goal.
Defendant knew what they were doing, and intended to do it.
Intoxication Defense
Voluntary intoxication never negates general intent crimes, but may negate specific intent crimes.
Suppression of evidence of voluntary intoxication to demonstrate lack of criminal intent doesn’t violate Due Process (Montana v. Egelhoff, 1996)
Involuntary intoxication may negate general or specific intent crimes.
Insanity Defense
Insanity Defense
A defendant who is determined to meet the legal criteria for insanity at the time of the criminal offense is not held criminally responsible.
Legal Standards
M’Naughten Standard (M’Naughten Case, 1843)
Cognitive Test
A defendant is not criminally responsible if at the time of the offense, due to a mental illness, they:
Didn’t understand the nature and quality of the act (cognitive prong), or
If they did know the nature and quality of their act, they didn’t know that it was wrong (moral prong)
Product Test/ Durham Rule (Durham v. US, 1954)
Volitional Test
“The defendant is not criminally responsible if the unlawful act was the product of a mental disease or defect”
Later overturned and replaced by ALI Model Penal Code (US v. Brawner, 1973)
American Law Institute (ALI) Model Penal Code Standard
Cognitive + Volitional Test
A defendant may not be held criminally responsible if, due to a mental disease or defect, they lack substantial capacity to appreciate the criminality of their actions, or to conform their conduct to the law.
Excludes “mental diseases or defects” that are manifested only by repeated criminal or antisocial conduct.
Federal Insanity Defense Reform Act of 1984
Cognitive Test
At the time of the offense, the defendant, as the result of severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his acts. Mental disease or defect does not otherwise constitute a defense.
Federal standard for insanity
Changed the burden of proof for insanity to clear and convincing evidence (since overruled)
Prohibits expert witnesses from testifying to the ultimate issue (sanity)
Previously established in Washington v. US, 1967
Waiving the Insanity Defense
A defendant may competently refuse to raise an insanity defense if the decision is both “intelligent and voluntary” (Frendak v. US, 1979)
Insanity defense may be raised over an defendant’s objection if they’re unable to make the decision, or their decision to waive the defense is not intelligent and voluntary.
Disposition of Insanity Acquittees
Length of Confinement (Jones v. US, 1983)
There’s no necessary correlation between the duration of commitment of NGRI acquittees and the severity of the offense.
Commitment of insanity acquittees serves a different purpose than incarceration (treatment vs. punishment)
NGRI acquittees may be committed using a lower standard of proof (preponderance of evidence) than ordinary civil commitment (clear and convincing) as the NGRI verdict demonstrates findings of mental illness and dangerousness. NGRI acquittees are considered a special constitutional class, and may thus be treated differently.
Criteria for Confinement (Foucha v Louisiana, 1992)
NGRI acquittees must remain BOTH mentally ill AND dangerous to justify continued commitment.
Once an NGRI acquittee is no longer mentally ill, they are no longer considered a special constitutional class and cannot be treated differently from other criminals (for whom release is expected at the end of sentence)
Constitutionality
There is no constitutional right to a particular legal definition of insanity. Insanity standards vary by state; some have no such defense. (Clark v. Arizona, 2006)
States are not required to implement an insanity standard that considers moral capacity at the time of the offense. (Kahler v. Kansas, 2020)
“Mens rea” approaches focused on mental state at the time of the offense rather than ability to appreciate wrongfulness do not violate Due Process.
Jail Diversion Programs
Mental illness and Substance Use Disorders are very common among individuals involved in the criminal justice system.
The Sequential Intercept Model (SIM) explains how individuals with mental health and substance use disorders enter and move through the criminal justice system
Jail Diversion Programs
Facilitate diversion out of the justice system and into mental health & substance use treatment programs.
Aims
Target criminogenic risk factors
Reduce recidivism
Improve health outcomes
Reduce overcrowding of correctional facilities