PSYC 2080 Knapp Chapter 5

Changing the name to Adjudicative competence is in response to the theory proposed by Richard Bonnie (1992), who suggested that CST must involve both _____________ and ____________

"competency to proceed" and "decisional competency

The typical cost of a competency evaluation for one defendant is ___________.

$5,000

Gay et al. (2017) found certain psychotic and neuropsychological symptoms predicted nonrestoration. Give two examples

-A diagnosis of intellectual disability -greater number of psychotic and manic symptoms

In some cases, defendants maintain that they can be held only partially responsible diminished capacity because of the following mental disorders:

-PTSD -automatism (sleepwalking) -substance abuse disorders -dissociative disorder -duress -extreme emotional disturbance

When the competency evaluation is court ordered, that means:

-client is the court -can be requested by the defense attorney (client is unable to pay), prosecutor, or judge -Will be shared among all parties

the U.S. Supreme Court has allowed SVP statutes, provided the offender:

-has a history of sexually violent conduct -a current mental disorder or abnormality -a risk assessment saying they could be future sexually violent -a mental disorder or abnormality that is connected to the conduct

Other than past history of mental disorders or presenting signs of mental disorders _____________ might also lead to questions about a defendant's competence.

-intellectual disability -emotional distress -even advancing age

Several reasons account for why a lawyer may not seek a competency eval:

-lawyer's resistance to having client institutionalized -the time and cost involved -belief client is better served if cases dispose of quickly through plea bargain -lawyers may not know that deficits like intellectual disability may render the defendant not competent

When the defense requests and pays for the competency evaluation, that means:

-private evaluation -client is person being examined -Report goes to defense attorney and may or may not be shared with the prosecution

Cases in which defendants actually plead not guilty by reason of insanity (NGRI) are rare, comprising a mere _________% of all felony criminal cases.

1 to 3%

1. In ____________, the Court held that dangerous sexual predators may be civilly committed against their will upon expiration of their prison sentences. In ____________, the Court added that the state also has to prove that the individual has some inability to control his behavior.

1. Kansas v. Hendricks 2. Kansas v. Crane

In high-profile cases, defendants may indicate that they will use the insanity defense but decide not to do it later in the process. Give the two most common reasons.

1. Most defendants who argue that they were not criminally responsible are found guilty 2. defendants who are acquitted on this basis do not go free.

The competency question can be raised by: 1. _____ 2. _____ 3. _____

1. defense attorney 2. prosecution 3. judge. The need for competency is a principle so ingrained in the law that if there is any suspicion that a defendant is not competent, an evaluation should be ordered.

It is recommended that evaluators use multiple sources of data, such as: 1... 2... 3...

1. information from third parties 2. interviews with the defendants 3. more traditional psychological tests.

Restoration to competency typically costs about _________ for three month period __________ annually spent on evaluation/restoration costs in the US

1. roughly $30k 2. $700 million

The law recognizes a number of situations under which an action that would otherwise be criminal is either justified or excused. What are they?

1. self-defense (justified) 2. lacking mens rea (excused but not justified)

The Supreme Court has ruled that the Dusky standards apply to other competencies as well, such as: 1. _____ 2. ______ 3. ______

1. the competency to waive one's Miranda rights 2. plead guilty 3. engage in plea bargaining. some mental health professionals believe that this one-size-fits-all approach leaves much to be desired. The waiver of a number of constitutional rights that a guilty plea entails requires decisional competence that many defendants simply do not have.

The Court also ruled in several cases that a death sentence cannot be imposed upon two groups of convicted offenders:

1. those with severe mental illness 2. those with severe intellectual disability.

using some of the typologies such as "fixated child molester" or "sadistic rapist" to classify sex offenders may screw up the offender's prison career in the following 2 ways:

1. unjustly confine them to a higher level of security 2. prevent them from work programs for early release

Jurisdictional differences in percentages of people found incompetent can be attributed to a number of factors, including: 1... 2... 3... 4...

1. variations in examiner training 2. the extent to which judges scrutinize requests for evaluations 3. the availability of pretrial mental health services. 4. burden of proof

How many states currently accept a volitional prong?

16

Approximately _____ states and the federal government have found a way of controlling some offenders past the time they have served their sentences through sexually violent predator (SVP) statutes.

20

GBMI verdicts are valid in approximately _______ states

20

An estimated _____% of defendants who are found incompetent to stand trial are usually hospitalized for treatment.

20%

When found not competent—roughly ______% of those evaluated—efforts are made to restore defendants to competency, usually in the forensic unit of a psychiatric hospital.

20%

In 2020, ______ states, along with the federal government, authorized the death penalty, though in many states there have been no recent executions.

28

The vast majority of individuals initially found incompetent are restored to competency in a relatively short period, usually within ___________.

3 to 6 months However, defendants may have to wait for treatment for an extended period of time.

Nationwide, about __________ defendants evaluated for CST are found competent.

4 out of 5

Murrie et al. (2020) found that only _____% of 3,644 reports they examined used any psychological testing, and only _____% used forensic assessment instruments.

5.4%; 1.3%

The average sentence for rape, usually considered the most serious such offense, is thought to be about ____ years. What can make it much longer?

7; when children are victims or the defendant has been convicted of it in the past

It should be noted that although courts and statutes continue to use the term competency to stand trial, the psychological research literature is increasingly replacing the term with ____________

Adjudicative competence

When should the following be done during the forensic mental health eval? · explain its purpose to the person being evaluated · stress that this is not a treatment relationship · explain the limits to confidentiality · warn the examinee of the possible uses of the examination · tell the examinee who will be getting copies of the report · obtain the examinee's written consent, if consent is needed.

Before conducting the evaluation

When should the following be done during the forensic mental health eval? · understand the purpose of the referral · decline to conduct the evaluation if there is a conflict of interest or if the examiner has ethical or moral objections to participating · gather background information and records when available · be knowledgeable about the law relative to the assessment · clarify and agree on the method of payment and when it will be made · clarify when a report is needed and to whom it should be submitted.

Before meeting with the person being assessed

_____________ is proof that is just short of absolute certainty. Required in all criminal proceedings and delinquency proceedings. The most stringent standard of proof.

Beyond a Reasonable Doubt

____________ evaluations are among the most detailed and demanding forensic assessments that are performed.

Capital sentencing

____________ evidence is reasonable certainty of the truth, the intermediate standard. Required in some civil proceedings like involuntary commitment

Clear and convincing

The _______________ test is a sentence completion test intended to provide quick assessment of defendants competency.

Competency Screening Test (CST)

What is the difference between competency and sanity?

Competency is one's mental state at time of criminal justice proceedings Sanity (for criminal responsibility) is one's mental state at the time of the crime

____________ is the treatment given to someone found incompetent to stand trial; purpose is to make them competent to stand trial

Competency restoration

_____________ is a legal standard that requires criminal defendants to be able to understand/appreciate charges and help attorneys in preparing a defense

Competency to stand trial (CST), AKA fitness to stand trial or fitness to proceed

___________ is judicial administrative release from institutional setting (jail, prison, psych institution) on condition that one demonstrates good behavior in community or participates in mental health treatment

Conditional release

forensic professionals also may work with the defense team to present arguments for _______________ , which is an attempt by defense team to avoid death sentence based on the factors that lesson offenders culpability. Usually psych or neuro factors.

Death penalty mitigation

clinicians seem to lack consensus is the appropriateness of conducting _____________, which is an assessment of defendants competency and insanity/criminal responsibility at the same time.

Dual-purpose evaluations

The __________ standard is where defendants must be able to understand/appreciate criminal proceedings and be able to assist their attorney in their own defense

Dusky

The standard for competency to stand trial was announced by the Supreme Court in the 1960 case _________________ and has been adopted in most states.

Dusky v. United States

______________ is an interview-based instrument that focuses on the Dusky standard, such as by inquiring into the degree to which defendants understand the role of their lawyers.

Evaluation of Competency to Stand Trial—Revised (ECST-R) The instrument has high interrater reliability

True or False? Questions about a defendant's competence can only arise at the beginning stages of the criminal process

False Questions about a defendant's competence can arise at many different stages of the criminal process, and defendants get evaluated and reevaluated.

True or False? Individuals found NGRI are hospitalized for the same amount of time than the time they would have served had they been convicted.

False They are often hospitalized longer

True or False? Serious mental disorder is the sufficient requirement for most incompetency determinations

False it is not enough

____________ allows defendants to be found guilty while seemingly affording them treatment for mental disorders.

Guilty but mentally ill (GBMI)

Four states do not recognize the insanity defense. They are:

Idaho Montana Utah Kansas although they still allow defendants to demonstrate that a severe mental illness deprived them of the guilty mind

The _______________ was a federal law (1984) that changed the standard for determining insanity in federal courts; made it more difficult for defendants to use this in defense

Insanity Defense Reform Act (IDRA)

In 1972 case, ____________, the U.S. Supreme Court placed a limit on the confinement of defendants found incompetent to stand trial, ruling that they could not be held indefinitely if there was no likelihood that they would be restored.

Jackson v. Indiana However, they can be subjected to civil commitment.

The _____________ is a tool to evaluate ability to benefit from treatment; more widely accepted, better measure. Contains 22 items. Defendants are provided with a vignette describing a situation in which a person is charged with a crime and are asked questions about it. They are also asked questions about their own situation.

MacArthur Competency Assessment Tool—Criminal Adjudication (MacCAT-CA)

__________ means "a guilty mind." It is the intent needed in order to be found guilty of a crime.

Mens rea

The _______________ assesses criminal responsibility, typically to determine if insanity defense could be supported

Mental State at the Time of the Offense Screening Evaluation (MSE) this needs more validation studies

Can a state require a defendant to prove incompetence beyond a reasonable doubt?

No

In some jurisdictions, defendants bear the burden of proving their incompetency, while in others the prosecutor must prove the defendant is competent. Fortunately for these defendants, the Supreme Court has ruled that the burden of proof cannot be greater than a _____________.

Preponderance of the evidence

_____________ is proof that one side has more evidence in its favor than the other

Preponderance of the evidence

By far, the most dominant forensic instruments related to insanity are the _____________ which assess criminal responsibility and detect malingering in cases where defendant is considering raising or has raised insanity defense

Rogers Criminal Responsibility Assessment Scales (R-CRAS) -lots of validity

________ statutes say that sexually violent predators can be civilly committed after completing their sentence

SVP

The ______________ is a well-regarded instrument for detecting the malingering of psychotic symptoms.

Structured Interview of Reported Symptoms (SIRS)

Medication is the primary approach taken to restore incompetent defendants to competency. Why might some individuals found incompetent to stand trial challenge the government's right to give them this medication?

The medications often cause unwanted side effects like nausea, headaches, loss of creativity, inability to express emotions, and lethargy *Note: challenging the medication may also be a defense strategy to buy time to prepare a defense or delay taking the case to trial.

True or False? At sentencing, psychological and psychiatric input is the exception rather than the rule

True

True or False? Outpatient evaluation is far more common than outpatient treatment

True

True or False? Intellectual disability does not guarantee that an individual will not be held responsible for a crime.

True Furthermore, persons with a mild intellectual disability may try to "hide" this disability, even from their lawyers. Thus, the issue is not raised either in pretrial evaluations or in mitigation for the offense, if the individual is convicted.

True or False? Civil commitment of SVPs does not require evidence of a recognized mental disorder.

True mental "abnormality" is sufficient

Why might a jury not believe a NGRI plea?

When the defendant is medicated, they can appear calm and emotionless which is far from the craziness they are claiming caused the crime. Juries are dumb as hell and don't even think about this.

Some clinicians also work with the prosecutor who seeks evidence against death penalty mitigation for evidence of ____________ factors, which are factors of a crime that make it more serious for purposes of sentencing

aggravating -torture murder

Civil commitment of a person found not guilty by reason of insanity cannot be __________ or __________.

automatic or indeterminate

In an evaluation of a defendant's criminal responsibility at the time of the crime, the clinician must determine whether and what sort of disturbances existed at the _________, ________, and _________ levels and clarify how those disturbances relate to the criminal act.

behavioral, volitional, and cognitive

Some research indicates judges are more sympathetic to insanity defense than juries, so a _________ trial is more likely to result in a not guilty verdict in a jury trial

bench

Risk assessment instruments that do not give sufficient attention to the possibility that sex offenders __________ almost guarantee that a sex offender will remain institutionalized.

can change -this needs to be highly validated -courts are highly likely to air on the side of caution and to accept any documentation provided by clinician

How it was made harder in the last 30 yrs to plead insanity: Federal government and most states require defendants to prove insanity either by ____________ or ____________.

clear and convincing evidence or preponderance of evidence

the clinician assessing a defendant's CST must not only consider a person's overall ability to understand charges and help the defense attorney, but must also consider the ______________.

complexity of the specific case

The insanity defense is not ____________.

constitutionally required (for states to have)

How it was made harder in the last 30 yrs to plead insanity: Federal government and most states no longer allow defendants to claim they could not _____________; if they knew right from wrong, can still be held responsible

control their behavior so no volitional prong in 34 states or at the federal level

Research indicates that most competency evaluations are _________ ordered and that no more than one evaluation is performed.

court;

Sanity evaluations are also called ____________ evaluations.

criminal responsibility (CR) or mental state at the time of the offense (MSO)

Judges will frequently order both a competency evaluation and a ___________ evaluation, which determines whether in defense of insanity can be supported.

criminal responsibility AKA "mental state at time of offense" evaluation or "insanity" evaluation

The American Psychiatric Association has publicly ___________ the practice of civil commitment for sex offenders The American Psychological Association has ____________ the practice.

denounced; neither denounced nor strongly advocated psychologists still do the evals

Because persons so identified in a screening test are likely to be hospitalized for further evaluation, this presents a significant _____________ for the defendant who would otherwise be free while awaiting trial.

deprivation of liberty

federal government and approximately 15 states today have adopted _______________, attempts to make punishment fit the crime and have an offender serve sentence they supposedly deserve, regardless of individual characteristics and rehabilitation

determinate sentencing

in contrast to competency to stand trial, where the Dusky standard is universal, there is no uniform standard for ____________.

determining insanity

Forensic psychologists are often advised not to include diagnoses in their reports, why?

diagnoses are often subjective, and they are labels that can carry undue weight with judges, lawyers, and juries who are not mental health professionals.

In states with determinate sentencing, courts may still consider evidence of __________ or ___________ and may reduce the sentence that would otherwise be imposed.

diminished mental capacity or extreme emotional distress Psychologists may be called on to assess risk or to testify as to whether the individual might benefit from specific types of treatment, such as substance abuse, anger management, or sex offender treatment.

Sexual psychopath laws did what?

diverted minor sex offenders and homosexuals to psychiatric institutions under the guise that they were "sick" nowadays, minor sex offenders are sent to outpatient treatment

Clinicians typically are asked to make some assessment of the likelihood that an individual will be restored to competency or even estimate how long this will take. If restoration is highly unlikely, the state must decide whether to:

drop criminal charges and if necessary, initiate involuntary civil commitment proceedings person might be sent to a psychiatric hospital or mandated to receive treatment on an outpatient basis

A major criticism of determinate sentencing focused on harsh penalties doled out to _________ offenders

drug

The R-CRAS has been validated through a series of _________ studies.

empirical

competency evaluations, assessments of mental state at time of offense (criminal responsibility or sanity evaluation), and presentencing evaluations are all examples of _______________.

forensic mental health assessments (FMHAs)

Developments in ____________ may explain the frequency of competency evaluations.

forensic psychology itself The evaluation process has been made considerably simpler with the development of competency assessment instruments and the training of graduate and postgraduate students in making these assessments.

Clinical input also may be sought in death penalty cases, particularly when statutes require that the jury take into account the _____________ of the person being sentenced

future dangerousness

people are referred for competency evaluations if they:

have a past history of mental health disorders or presenting signs of current mental disorders

If there is more than one evaluator and they disagree as to whether the defendant is CST, the judge is more likely to find the defendant _____________.

incompetent This is likely because, when there is doubt, the judge prefers to err on the side of caution.

Criminal sentencing in the United States went through a period of reform during the last quarter of the 20th century. Until that time, sentencing was primarily _______________, when offenders are sent to prison for a range of years

indeterminate sentencing

When it is a mental disorder that robs the individual of a guilty mind, the law refers to this as ___________, the judicial determination that an individual's mental disorders relieves him or her of criminal responsibility for illegal actions.

insanity insanity excuses criminal conduct but does not justify it

When psychological testing was used, it was most likely to be __________ testing, testing for ___________, or ____________ measures.

intelligence; feigned symptoms; personality

Many defendants are still evaluated while in __________ or _________.

jail or while hospitalized in a forensic unit of a psychiatric facility

The rates of acquittal due to insanity vary widely by ____________. Some multistate surveys have found acquittal rates of __________% while others are __________%.

jurisdiction; 20% to 25% while others are 8%-10%

Approximately 20% of defendants referred for competency evaluations nationwide are initially found incompetent, but these percentages vary widely across _________ and _________. 1. Another reason for the jurisdictional differences may be the burden of proof. a. I It is the standard required in most civil suits and may be relevant to criminal proceedings as well. For example, when states require criminal defendants to prove they are incompetent to stand trial, they cannot require this by a standard more demanding than a preponderance of the evidence.

jurisdictions and evaluation settings

Appellate courts have consistently reiterated that a waiver of constitutional rights must be ___________, ____________, and ___________.

knowing, intelligent, and valid

if a person is forced to rob a convenience store while a loved one is being held hostage, the person is robbing under duress. This is an example of _________.

lacking mens rea (without insanity)

Dual-purpose evaluations are highly discouraged in ________ and ________ literature but still occur with some frequency in many jurisdictions.

legal and psychological

lawyers do not always seek competency evaluations for their clients, even when they suspect, a decision that seems to be in conflict with the spirit of the law. This is particularly likely to occur in ________ cases

less serious

A confession, which is a waiver of one's right to remain silent, is not valid if it is not ____________.

made voluntarily

The ECST-R is the first competency assessment measure that specifically screens for _____________.

malingering

People cannot be held responsible for crimes of they did not possess ____________ at the time the criminal acts were committed.

mens rea

All insanity tests require that a documented ___________ first be shown.

mental disorder

The ___________ courts are intended to prevent the perpetuation of a revolving-door process by diverting primarily nonviolent individuals with mental disorders from the criminal process and providing community supervision and meaningful treatment.

mental health courts

In its most recent ruling on the civil commitment of sex offenders (United States v. Comstock), the Court allowed the federal government also to hold violent sexual offenders beyond their prison sentence if they were ___________.

mentally ill

It is important to stress that competency evaluations routinely involve defendants charged with relatively _________ crimes.

minor

Insanity cases appear to be decided more on __________ or ____________ rather than on correct legal grounds.

moral grounds or on what jurors believe is the "right" decision jurors are finger sniffing morons

As in all forensic mental health evaluations, the assessment of adjudicative competence should begin with a ____________ and ___________.

notice to the person being evaluated of the limits of confidentiality and the purpose of the evaluation.

Using the (ECST-R), Vitacco, Rogers, Gabel, and Munizza (2007) found suspected malingering in about __________ of a sample of persons evaluated for competency to stand trial.

one fifth

Determinate sentencing contributes to _____________.

overcrowding in prison

Typically, prosecutors agree to accept the evaluator's findings and accept the NGRI plea. In ___________ or __________ cases, the prosecutor may request a separate evaluation.

particularly very serious or high-profile

The competency screening test (CST) has a high false-___________ rate (53.3%)

positive identifying many competent defendants as incompetent.

Because the competency report is often shared among the attorneys and the presiding judge, examiners are often reminded to carefully limit the report to the defendant's _____________ and not to include ____________.

present status; information that might provide details about the crime itself

psychologists are often asked to provide assessments of convicted sex offenders to help courts decide on a just punishment. These evaluations are known as ________________ - background info, test results, observations, and maybe risk assessment (probably)

psychosexual assessments also typically include recommendations for treatment, managing any risk believed to be posed by offender

The __________ has little sympathy for insanity defense

public

The CST's main advantage is the ability to ____________.

quickly screen out the obviously competent defendants.

Two recent longitudinal studies of large numbers of insanity acquittees in Connecticut and Oregon, have found that conditional release was an effective approach, and __________ was low.

recidivism providing adequate community supervision occurred.

Indeterminate sentencing was based on a ________________.

rehabilitative model of corrections it was assumed that prisoners would be provided with rehabilitative services while in prison and that they would be released when they had made sufficient progress.

As with risk assessment instruments, practitioners should be aware of the ____________ pertaining to any competency assessment instrument they use.

research evidence

Once an individual has been found incompetent to stand trial, efforts are made to ______________ so as to proceed with the trial. This is usually achieved through ____________.

restore the person to competence; the administration of psychotropic medication

This trend of not seeking competency evals seems to have __________ in recent years.

reversed leading to an increasing demand for competency related services.

According to Heilbrun et al. (2002), more promising than typologies are the _____________ that have been developed specifically for sex offenders, though these also have been strongly criticized.

risk assessment scales

The Competency Screening Test (CST) taps defendant's knowledge about ___________ and ____________.

role of their lawyer and rudiments of court process. If defendants score below a certain level, they are evaluated more completely.

The majority of persons found incompetent to stand trial are those suffering from ____________ and __________.

schizophrenia and psychotic symptoms

Despite the continuing development of forensic assessment instruments, they do not appear to be widely used in forensic practice, partly because there is not sufficient ___________ or ___________ for many of these instruments.

scientific reliability or validity

Among the most problematic/difficult/controversial assessments for forensic psychologists involve the sentencing of _____________.

sex offenders

In the 20th century, some states began to find a different way of controlling sex offenders other than imprisonment. At first, a variety of "___________" laws were passed

sexual psychopath

Defendants found guilty but mentally ill are no more likely to receive _____________ than other imprisoned offenders.

specialized treatment for their disorder so they'll receive treatment, but not anything that goes above and beyond or different from any other inmate receiving mental health treatment in prison

Even though psych input isn't common at sentencing, it is becoming more common if the sentencing judge is interested in knowing an offender's amenability to ____________ treatment or ____________ treatment.

substance abuse; sex offender bruh why tf they always trying to set sex offenders loose

Researchers have found that many sex offenders do not ____________, despite the fact that many if not most mental health practitioners believe all sex offenders need treatment.

suffer from mental disorder or mental illness

Research indicates that juries on insanity cases rarely apply the ______ for insanity, so changes in standards may not be that significant.

tests

"Competing" evaluations are not the norm. When there are no opposing experts, though, judges almost always accept the recommendation of ____________.

the clinician conducting the evaluation

If an NGRI defense is planned, then the court-appointed evaluator's report is shared with __________ and __________.

the court and the prosecution

Medication used for restoration to competency can also cause problems by affecting ______________.

the defendant's ability to participate in the proceedings some antispsychotics and old school antidepressants cause intense drowsiness

Some states do not allow incompetent defendants to be held for longer than _____________.

the maximum sentence they would have served had they been convicted

According to Roesch et al. (1999), it is "cognitively almost impossible" for a judge to keep competency and sanity distinct when ___________.

the reports are combined an evaluation of criminal responsibility is likely to include a good amount of background information that should be irrelevant to the limited question of whether the defendant is competent to stand trial.

when individuals with intellectual disabilities are found IST (incompetent to stand trial), restoration is unlikely to occur because ____________.

their condition is chronic Intellectual disability means that some defendants will simply lack the ability to actively participate in their trials. And this is fine, how?

An unknown number of criminal defendants are reevaluated over a period of years after their first cases have been resolved because ___________.

they are charged with additional crimes

The examination process itself (of the forensic mental health eval) varies widely according to the examiner's __________ and __________. Some conduct only a clinical interview, others conduct an interview and ___________.

training and theoretical orientation; administer measures

There is a notable lack of ____________ with SVP commitments.

treatment

Sex offenders are not very successful with ____________ and have a high rate of ____________.

treatment; recidivism

How it was made harder in the last 30 yrs to plead insanity: Federal courts and some states say forensic examiners are not allowed to express ___________ on whether a defendant was insane.

ultimate opinion this is obscene because who the hell else is qualified?

In some states, even if a person knew the difference between right and wrong and was aware that what they were doing was wrong, evidence of an inability to control behavior satisfies the standard. This is sometimes referred to as the ______________. It acknowledges that, because of serious disorder, individual was unable to conform their behavior to the requirements of law

volitional prong For example, in these states a person who—as the result of a mental disorder—is compelled by "voices" to kill the victim could be excused.