Competency to stand trial is one of the most important mental health inquiries to arise within the criminal legal system; estimated to be a relevant issue within approximately 5% of all criminal cases. Dusky v. United States (1960) is the landmark case from which the standard for competency to stand trial stems; all states utilize some variation of this measure. The “Dusky Standard” indicates competency hinges on a defendant possessing, “Sufficient present ability to consult with his attorney with a reasonable degree of rational understanding and a rational as well as factual understanding of the proceedings against him.” Essentially the defendant must understand the charges against him and possess the ability to assist his attorney in his own defense. The interpretation of this standard continues to evolve through arduous debate and case law. What does “Sufficient present ability” mean? It transcends orientation to time, place, and some recollection of events, more accurately it is an indication of a defendant’s ability to consult their lawyer with a reasonable degree of rational/factual understanding. Early competency evaluators equated psychosis with incompetence; however, psychosis does not provide ample justification alone for incompetency to stand trial.
Delaying trial due to incompetence has its roots in English common law, an alleged offender could have trial stayed if they were “Absolutely mad”. Early 17th century English courts determined whether defendants who did not enter a plea were “Mute of malice” or “Mute by visitation of God” (Those who were “Mute of malice” were forced to enter a plea with the placement of increasingly heavy weights upon their chest (a procedure known as peine forte et dure); those who were “Mute by visitation of God” (ex visitation Dei) i.e. the deaf, mute, and later “lunatics” were not expected to enter a plea) . One of the earliest and most cited English formulations for judging adjudicative competence appears in King v. Pritchard, 173 Eng. Rep. 135 (1836), in which the Court instructed a jury first to consider whether a defendant was “mute of malice or not; secondly, whether he can plead to the Indictment or not; thirdly, whether he is of sufficient intellect to comprehend the course of proceedings on the trial.” English common law identified several reasons for only prosecuting competent defendants. First, the defendant must assist in acquiring all of the facts of the case to ensure accuracy during proceedings. Second, due process is dependent upon the accused maintaining their ability to exercise the right to choose and assist legal counsel, confront their accusers, and testify. Third, an incompetent defendant undermines the integrity and dignity of the process regarding inherent morality and outward representation. Finally, punitive restoration is subverted when a defendant is sentenced but fails to comprehend the sanction and reasons for imposing it.
One of the first Federal cases linking competency with the U.S. Constitution was Youtsey v. United States (1899). Youtsey suffered from a seizure disorder and had been tried in absentia (Not being present at the trial) for embezzlement. The case was eventually overturned by the Sixth Circuit Court of Appeals as Youtsey’s memory and mind were impaired and he was incapable of appreciating his situation and intelligently advising his counsel in his own defense. The Court noted, “Does the mental impairment of the prisoner’s mind, if such there be, whatever it is, disable him . . . from fairly presenting his defense, whatever it may be, and make it unjust to go on with his trial at this time, or is he feigning to be in that condition”. Competency to stand trial includes complex requisites surrounding a defendant’s awareness of the court and its processes as well as the ability to have meaningful participation in his defense.