Currently working in an Arizona State Mental Health Facility as a Forensic Psychologist, I have been recently given the task, court ordered by the judge to evaluate a patient’s competency to stand trial. His name is Edward Wilson. He is a 25 year old male with a history of mental illness, stemming from the age of seventeen. According to the police report found in Edwards file, on Feb 4, 2012 Edward was arrested and charged with killing both his parents. Edward has been at the facility for three months now and his previous records indicate that he possesses a low IQ as well as being mildly mentally challenged. Records state Edward has been hospitalized before due to a self inflicted gunshot to his mouth. He was diagnosed at the age of 19 with paranoid schizophrenia and placed on psychotropic medications after he had an unexpected outburst and physically as well as verbally attacked his younger sister without provocation.
The medication seemed to stabilize his condition and mental status at the time. Since Edward has been at the facility he has stated that he believed several conspiracy theories in reference to his parents as well as the Mayor. He also states that as a teen he came across “the rock of creation” as he referred it, which possessed five different animal faces upon it, and thusly sent it to the Mayor. He also stated that he was not taking any of his psychotropic medications at the time of his parents’ murder. Edward does have a public defender who counseled with his for ten minutes at which time the public defender asked the judge to request a competency evaluation. Thusly, bringing Edward to this facility for competency restoration, evaluation, and into my care. I will evaluate this individual, assess his mental stability and inform the judge of my findings.
Competency to Stand Trial requires that a defendant comprehends the nature and reason of the legal proceedings against him and be able to effectively and appropriately cooperate with the counsel in his defense. He must be able to comprehend the proceedings, as well as understand the charges against him and the penalties if found guilty. He must also have some level of comprehension of courtroom procedure and the functions of those who participate in it. Also, he must be able to cooperate with counsel, he must be able to competently discus a legal strategy with his counsel, be able to recall and relate pertinent facts and events, that actually occurred, including his motives and actions at the time of the offense, and be able to testify in his behalf and to challenge prosecution witnesses.
The case of Dusky v. United States (1960) developed the foundation of, that in order to be able to be competent to stand trial a defendant has to possess adequate coherent ability to consult with his attorney within an acceptable degree of rational comprehension as well as a rational factual understanding of the proceedings before him and charges against him. This case set the current groundwork for adjudicative competence in the United States and now is the standard used in Federal Court. The statutes addressing competency vary from state to state; however, the aspects defined in the Dusky v. United States decision are contained the infallible fact that the defendant must truly comprehend the charges against him and must have the mental capacity to assist his attorney in defending himself.
Given the amount of information in pertaining to Edward I would need to delve deeper into Edwards past, his up bringing and childhood as well as early teen life to gain a better perspective upon his background and if his mental issues began at an earlier age. I would need his past medical records, all medication records as well as mental records, including his stints at all mental and other hospital facilities. I would also need to check all his lab work, blood tests, x-rays, CT’s or MRI’s he had done for any abnormalities. I would need to know if there is a history of mental illness within the family as well. Also, I would need to know how his social life was as a child and early teen. Did he possess the normal social skills and characteristics to develop adequate childhood relationships or was he socially inept, kept to himself and wouldn’t involve himself in normal childhood activities? Did he possess violent tendencies as a child and or teen? Does Edwards have a criminal background? How was his relationship with his parents and with his sister? Was the relationship with his mother abnormal? Was he abused or shunned by his parents? How, was his relationship with his sister before he violently attacked her?
Was he homeschooled, or did he attend a public or private school? Since his records state he has a low IQ and possess a mild form of retardation, at what age was this diagnosed and did he receive proper treatments as well as the education for this issue? At what age did he truly begin to show signs of mental retardation as well as mental instabilities? Did he, as a child and or early teen, repeatedly draw any graphic, horrific, disturbing drawings? Did Edward have any friends, did he engage in sports or after school extracurricular activities? Did he have any pets? If so did he care for them properly or harm them? Was his self inflicted gunshot wound intentional, was he attempting to commit suicide? There are a plethora of people I would need to interview to discus Edwards upbringing and background. First off, I would truly need to speak with his sister. Ask her to recall what she can about his childhood, his personality as a child and a young teen. How was her relationship with him then? Also as her to recall and state in great detail the events that lead up to him verbally and physically attacking her, and recall if he has done this before.
I would also need to interview other family members if there are any, close family friends, neighbors as well as Edwards teachers and all his doctors and or caregivers. I would talk to the people who found Mr. and Mrs. Wilson, talked to Edward and eventually called the police. I would need to gather pertinent pieces of information from each to begin to ascertain and build my evaluation study upon Edward. This information could develop to show an ongoing history of mental illness thus uncovering a possible undiagnosed mental illness at an earlier age. Evaluating Edward and asking him the proper question at to ascertain the validity of his mental status could prove difficult. Especially if he is mentally incapable of comprehending the questions rendered and directed towards him. But I believe the questions I would ask would be, first off the basic sentient set of questions as in, “Do you know the date, do you know what time of year it is, do you know what year it is, who the president is, what own his name and date of birth is, where he is and does he understand why he is there?” Depending upon Edward’s answers the groundwork for the next questions would be set.
I would have to then ask him does he know what happened to his parents and where are they? The questions asked would all depend on Edwards mental capabilities. His records indicated that he has a diminished mental faculty, a mild retardation. Edward is going to feel comfortable answering questions he is able to understand, to be sure. I would have to ascertain if Edward completely understood what has happened, why he is there in the mental facility and explain the court proceedings to him and ask if he understands them. I would have to assess whether Edward comprehended the entire conception pertaining to “being able to be mentally sound to stand trial” and ask him the specifics of the aforementioned definition thereof. I may also ask Edward about his past, if he remembers his childhood and how it was. Also about his relationship with his parents and sister, as well as possible friends he had, pets he was responsible for and how he felt about them all.
I would have to gain a background upon Edward, but through his eyes, perceive the world as he does per se. Besides determining his mental status through the interview process, another way to assess Edward’s competence would be to observe his verbalizations, responses to questions and or others actions. Watch his body language, facial expressions and impulsive behaviors. Observe how he interacts with others, or if he does at all. Maybe observe him in a group therapy session to see if he cooperates, involves himself and understands the structures of the group therapy. Read through all his charts from past to present and as I aforementioned inquire with other medical professionals and staff members about Edward. I would want to gather every piece of collective information about Edward as possible before I made my clinical decision about his mental competency to stand trial. There are also, just to mention a few, The Competency to Stand Trial Screening Test (CST) and The Competency to Stand Trial Assessment Instrument (CAI).
These instruments specifically designed for assessing adjudicative competence was developed in 1965 and was thusly called The Robey’s Checklist for Psychiatrists after noted psychiatrist Ames Robey. According to the previous statements pertaining to Edwards’s behaviors at the time of the crime as well as his mental state, there is a vast difference between being “fit to stand trial” and being criminally responsible. Edward was not taking his prescribed psychotropic medications at the time of the murders, hence was he mentally stable then? He may comprehend the court proceedings now that he has been back on his medications within the mental facility, but not pertaining to when the incident occurred. The judge may request or inquire if Edward’s actions can be distinguished between the aspects regarding fitness for trial, thusly referring to Edward’s present mental capabilities and status during adjudication and criminal responsibility, which of course refers to an Edward’s mental state when the murders occurred. I do not think by the conclusions of the aforementioned information gathered and Edward’s previous actions as well as statements he is mentally fit to stand trial.
But if the judge does indeed deem him fit to stand trial, the ruling that he is competent to stand trial cannot not prevent him and or his attorney from trying to establish an insanity defense and such a finding is not admissible at trial. He would definitely have to proceed as any other person charged with a double homicide. He would have to go through each and every step as a normal person would as well as all the court proceedings. Then the jury will have to decide if indeed Edward was sane and or mentally stable at the time of the murders and either charge him thusly or not. I am not sure a jury would find in Edward’s favor, even though he possess a diminished mental faculty doesn’t mean he didn’t purposely stop taking his prescribed medication, which, as stated, stabilized his paranoid schizophrenic symptoms, and that he didn’t know between right from wrong.
I think all in all, Edward could be found guilty, but placed within a prison mental facility to serve his sentence. The theory that can best describe Edward’s behaviors, I believe is The Psychological Theories. I view Edward as very socially inept, thus he didn’t interact very much with others than his own family. Did Edward possess an abnormal relationship with his mother, within his own perceptions? Psychological Theories can pinpoint and make reference to most of Edward’s anti-social behaviors as well as his diagnosed paranoid schizophrenia. All Edward’s symptoms, diagnosis, behaviors and criminal causations all have reference to psychological theories. Psychological based criminal theories explain criminal behavior as the consequence of individual factors, such as negative early childhood experiences, and inadequate socialization, which results in criminal thinking patterns and or incomplete cognitive development. This clearly describes Edward’s behaviors and mental instabilities.
If I was inquired by the determining judge to stand and give my professional assessment of Edward Wilson’s future emotional and mental stability and if he is a threat to himself and or society, I would have in state, “yes”. I believe Edward could very easily pose as a threat, especially if he is not under the constant supervision of a doctor to make sure he is taking his proper prescribed medications. Another episode of someone losing their lives, let alone Edward possibly committing suicide, just isn’t worth the risk of a “we’ll see” type of situation with Edward. His hallucinations and grandiose ideals of conspiracy pose as a threat to himself as well as society. Edward clearly has a chemical imbalance and requires psychotropic medications to possibly curb those paranoid schizophrenic symptoms and behaviors as well as be under the constant care of several doctors.
Greene, E., Heilbrun, (2010). Psychology and the legal system (7th ed.). Florence, KY: Cengage Learning.
COMPETENCE AND INSANITY
Competent to Stand Trial
Mental Competency – United States Supreme Court Cases
Evaluating Competency to Stand Trial with Evidence-Based Practice
AAPL Practice Guideline for the Forensic Psychiatric Evaluation of Competence to Stand Trial
Psychological Explanations Of Deviant Behavior