Going Beyond Competency To Stand Trial TU Professor Tests a New Mental Health EvaluationTool

Tuesday, November 23, 1999

Thousands of criminal defendants are evaluated every year in the United States for their “competency to stand trial.” Now a University of Tulsa psychology professor has successfully tested a new mental health assessment tool that evaluates a person’s reasoning and appreciation as well as the old benchmark of competency -- understanding.

“This is the best tool now available to help a judge or a jury decide if a defendant is mentally capable of participating in the proceedings against him or her,” says TU psychology professor Robert Nicholson.

“This assessment tool is the first to combine standardized administration, objective scoring, and coverage of competence-related abilities beyond simple understanding of legal proceedings,” says Nicholson. Most other assessment tools focus only on a defendant’s understanding of the judicial process, such as the roles of the judge and the prosecuting and defense attorneys. The new instrument also evaluates an individual’s ability to exercise reason in assisting their defense attorney and a person’s appreciation of his or her legal situation.

“Our findings also provide the first normative data to help interpret the results of an evaluation,” Nicholson notes. “An individual’s performance can be compared to the scores of the 729 subjects in our study.” Such norms are not available for any other competency assessment instrument.

Nicholson and several colleagues at the University of South Florida recently completed a two-year investigation, funded by the National Institute of Mental Health, to evaluate the reliability and validity of the instrument, known as the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA). Results were presented Aug. 21 in Boston at the annual convention of the American Psychological Association,

The MacCAT-CA was administered to pretrial felony defendants in South Carolina, Alabama, Louisiana, Michigan, Wisconsin, Oklahoma, Utah and Washington. Of the total, 283 were recruited from state forensic units after being adjudicated incompetent to proceed. The other 446 defendants were in jail and presumed competent because none had been referred for competence assessment. More than half of the latter group were receiving treatment for mental health problems in the jail.

Subjects were presented with a hypothetical crime -- a fight between two men in a bar -- and then asked questions to probe key areas defined by the U.S. Supreme Court. Eight questions measure understanding (a person’s capacity for factual understanding of the legal system and the adjudication process) and eight questions assess reasoning (the ability to distinguish more relevant from less relevant factual information and to make important decisions about the case in a rational manner). Six final questions probe a person’s appreciation of his or her own particular legal circumstances.

The 1960 case of Dusky vs. U.S. states that the test for competence to stand trial must be whether a defendant “has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding, and whether he has a rational as well as a factual understanding of the proceedings against him.” Nicholson notes that the term “adjudicative competence” is considered a more appropriate term than “competence to stand trial” because about 90 percent of criminal cases end in guilty pleas, rather than in a trial.

“Our system of law requires that a person accused of a crime be able to assist in his or her own defense,” says Nicholson. “Meaningful participation by the defendant is necessary in order to preserve the moral dignity of the legal process, prevent unfairness to the defendant, and promote reliability of judicial outcomes. A defendant must also be able to make the important decisions about the case that are reserved to the defendant by law, such as the decision to enter a plea of guilty. Because determination of a defendant’s competence involves consideration of such issues as justice, fairness and the moral dignity of the proceedings, the ultimate determination regarding a defendant’s competence is a social, political and moral decision that goes beyond the expertise of a psychologist or a psychiatrist.”

The MacCAT-CA, created by the MacArthur Foundation Research Network on Mental Health and Law, and an accompanying professional manual based on the study, were recently published by Psychological Assessment Resources of Tampa, Fla.

“Our results show that the MacCAT-CA is sufficiently reliable and valid to merit clinical use in the conduct of competency evaluations nationwide,” said Nicholson. He added that use of the instrument and the manual should help shift the goal from assessing a person’s overall competence to that of providing the courts with a careful, systematic description of the defendant’s legally-relevant abilities, “properly leaving the ultimate decision about competence or incompetence in the hands of the trier of fact.”

Nicholson has conducted research on competence to stand trial for 10 years. His publications include the chapter “Forensic Assessment” in a book published this year, “Psychology and Law: The State of the Discipline.”