02/21/2020
I saw this news article/post going around a lot of the mental health blogs this week (I have no involvement or specific knowledge of this case in Maryland - but speak broadly here) and saw a lot of comments wondering why defendants are not restored.
Why are some persons with mental illness/defendants not able to be restored to competency to stand trial? Being competent to stand trial in Virginia is based on the Dusky v U.S. (1960) standards, so defendants need a factual and rational understanding of their legal situation, ability to assist counsel in their defense, and comport in court.
Many defendants with mental illness and active symptoms can learn factual legal issues information. Rational abilities are a common domain that is typically associated with unrestorable opinions. Rational abilities have to do with an individual's deeper understanding of their case, understanding of evidence, ability to weigh evidence, ability to talk about the events leading up to their arrest free from delusional beliefs (noted above), ability to discuss and appreciate legal strategy and advice from their defense counsel, ability to appreciate, fully, potential outcomes from court like prosecution, potential incarceration, and how that will affect their life.
Serious mental illness tends to hurt rational domains related to competency. For example, residual symptoms like auditory hallucinations affect attention, concentration, and ultimately comprehension so it's hard for individuals to meet with their attorney, or track the demands of the courtroom and trial process. Underlying disorganized thought processes again make it hard to engage in executive functioning abilities required for more complex court cases which require multiple hearings, recalling information from previous hearings, ability to track witnesses testifying, or ability to testify. Disorganized thought processes and delusional beliefs also distort an individual's narrative of the events leading up to his or her arrest which means they cannot provide accurate information to their defense attorney. The very setting of a courtroom can be so anxiety provoking that it becomes hard for an individual to comport and maintain control of his or her behavior. If individuals with mania or psychosis become too anxious/distress it tends to exacerbate other symptoms of mental illness, such as triggering hallucinations.
Next time, I'll comment on what it takes to support an unrestorable opinion and what happens next to the patient/defendant. Stay tuned!
The Maryland mother cannot be held indefinitely on homicide charges while she remains mentally unfit to be tried, her defense attorney argues.