Competency to stand trial is one of the most frequently misunderstood areas of forensic mental health. Misconceptions can lead attorneys to delay evaluations, misinterpret behavior, or underestimate the value of expert input. Let’s examine some common myths that routinely ruin cases.
Myth #1: No History of Mental Illness = No Mental Illness
Mental illness alone does not render a defendant incompetent. However, mental illness can undermine communication, understanding, and/or the ability to assist counsel. Because mental illness can come with poor insight, or a lack of understanding that something is wrong, people may not report mental health problems or may not have a history of seeking out care/receiving a diagnosis. Populations over-represented in the criminal justice system face heightened stigma and myriad barriers to care. Just because someone has no prior diagnosis or history of mental health treatment, does not mean they have no problem. In fact, the population’s social determinants of health greatly increase their risk of mental illness.
Myth #2: Odd or Disruptive Courtroom Behavior Equals Incompetence
There is a difference between someone being unwilling to participate in their defense and being unable to do so. Defiant or disruptive behavior may reflect personality traits, the transient effects of substance use, malingering, or situational stress. Courts and evaluators must distinguish between uncooperative behavior and true functional impairment rooted in mental illness or cognitive limitations relevant to competency.
Myth #3: No History of Intellectual Disability or Learning Disorders = No Problem
The population over-represented in the criminal justice system often attended underfunded schools, has limited formal education – or both. Additionally, people with Intellectual Disabilities and Learning Disorders are over-represented in the criminal justice system, making these issues highly relevant in the criminal court context. While a prior diagnosis of Intellectual Disability or Learning Disorder is clear evidence that these conditions are present, the lack of prior diagnosis is not clear evidence that they are not.
Myth #4: Competency Evaluations are Straightforward
While the legal standard may appear straightforward, competency evaluations can be very complex. Clients may present with limitations from cognitive issues, manifestations of trauma, impacts from neurodevelopmental disorders or symptoms of untreated/under-treated symptoms of mental illness. Symptoms overlap, interact and fluctuate. And the degree of impairment is not able to be determined based on diagnosis alone. Further, malingering must also be considered. Oversimplifying competency can lead to flawed conclusions that result in violations of a defendant’s right to effectively participate in their defense.
Myth #5: Competence Restoration = Treatment and Rehabilitation
Competency restoration is short-term, focused, and, especially when hospitalization is involved, very expensive. Defendants may regain competency through treatment, education, or stabilization, but the process does not allocate resources or develop plans for the individual’s ongoing care. This can contribute to a cycle of short term restoration, deterioration in the correctional facility or community, then re-evaluations of competence. If the goal is to facilitate successful societal re-entry or decrease recidivism, competency restoration alone is not the path.
Myth #6: Competency Evaluations Are All the Same
Not all evaluations are equal. In some cases, evaluators are paid by evaluation, potentially incentivizing quantity over quality. Further, when evaluations are not trauma-informed or lack structural or cultural competence, key considerations may be overlooked. Further, inadequate use of collateral data and/or testing in relevant cases may result in insufficient information for a strong expert opinion. Relying on assumptions or incomplete evaluations can expose the integrity of the court process to avoidable risk.
