Making People Competent for Trial by Medication

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 What Is Mental Competency?

In short, competency is a legal term that refers to the mental state required in order for a defendant to stand trial. Generally speaking, a defendant is generally considered competent if they are able to fully understand and participate in their own legal proceedings.

For example, if an individual understands the charges that they are facing, and is actively participating in the process, then they will generally be deemed competent to stand trial.

If an individual is deemed not mentally competent, the Due Process Clause of the 14th Amendment will prohibit their prosecution. As such, if an individual is found to be mentally incompetent through an evaluation made on the scene or at the jail, then they may not be able to stand trial.

In these cases, the jail may refer the individual that is deemed incompetent to a mental health facility or request that the local prosecutions office initiate civil proceedings to have their competency restored through competency restoration treatment and the forced administration of psychoactive medications.

It is important to note that being declared mentally incompetent is different than being declared insane. Insanity is a legal defense that essentially means that at the time the crime was committed, the defendant was not in their right mind and therefore cannot be held liable for criminal actions.

How Is Competency Determined?

It is important to note that a physician is unable to declare someone to be mentally incompetent to stand trial. Instead, the judge for the locality has full discretion when deciding whether or not to declare a defendant to be mentally incompetent.

When making their decision, a judge will typically review any medical notes pertaining to the defendant, any evaluations performed by a physician licensed within the state, as well as any police reports. Further, if a psychiatric evaluation has not been performed, the judge may order that a psychiatric evaluation be performed.

In addition to the above, a judge will typically also analyze a variety of factors when determining competency to stand trial, including but not limited to:

  • Whether or not the defendant can understand and participate in the proceedings;
  • Whether or not the defendant understands the seriousness of their situation and criminal charges (if applicable);
  • Whether or not the defendant can rationally consult with their lawyer;
  • Whether or not the defendant is assisting their attorney in developing a legal defense for their case;
  • Whether or not the defendant can distinguish between irrelevant and relevant factual information; and/or
  • Whether or not the defendant can distinguish between and understand the legal effect of pleading guilty or pleading not guilty.

In addition to all of the above, the judge may also consider the defendant’s demeanor or testimony in court and utilize that to help determine whether or not they are mentally competent to stand trial.

What Happens if a Judge Finds an Individual Incompetent to Stand Trial?

If the judge finds and declares that an individual is mentally incompetent, then the judge will typically enter an order reflecting as much. Typically, the judge’s order will also be accompanied by any medical records to physician’s certificate of medical examinations that may have been generated.

It is important to note that the judge may also initiate civil competency restoration proceedings to have the individual begin treatment to restore competency either in the jail or have them referred to a local mental health facility. Then, if competency restoration is successful and the defendant is later restored to their competency then they may be brought to trial at a later date, if the original charges brought against them are still pending.

What Are Civil Mental Health Commitment Proceedings?

As mentioned above, one of the legal tools that a judge may do is to order a defendant that is mentally incompetent to stand trial to undergo competency restoration. It is important to note that each state will have different laws regarding how competency restoration proceedings are to occur and the criteria for whether or not an individual can be ordered to competency restoration.

For example, in Texas a judge will typically require that the local mental health prosecutor work with the local mental health authority and submit the following:

  1. An application for civil commitment requesting that the defendant either remain in jail or be transferred to a mental health facility for competency restoration;
  2. An information sheet that outlines where the proposed patient is to be transferred to or to remain while receiving competency restoration services;
  3. At least one physician’s certificate of medical examination that was performed within the previous 72 hours;
    • It is important to note that typically the physician will be required to make findings as to whether the individual meets criteria for civil commitment, such as whether or not they are a threat of harm to themselves, a threat of harm to others, or is deteriorating to the point where they cannot function independently; and
  4. Finally, if the defendant or individual requires medications, and refuses to voluntarily take recommended psychoactive medications, then the prosecutor can request that the judge also consider an application for the forced administration of psychoactive medication, along with an additional physician’s written medical examination.

What Happens After Civil Commitment or Competency Restoration Has Been Ordered?

If a Judge or magistrate determines that an individual meets the criteria for civil commitment and mental health competency restoration, then that individual will then begin their treatment. Typically, their treatment will consist of a variety of different methods for mental health restoration, such as group therapy, individual therapy, and other alternative methods of treatment.

However, the main method that physicians use to restore competency is the administration of psychoactive medication. Once again, an individual under an order for mental health competency restoration, also commonly known as an “Order for Protective Custody,” will have the choice of voluntarily participating in the treatment plan outlined by their treating physician, or their treating physician may request that the court force the individual to participate.

For example, a physician may request the local mental health prosecutor to submit an application for forced medication in order to get a court order that the defendant take the psychoactive medication. Typically there will be a separate hearing held to determine whether or not a defendant should be ordered to take psychoactive medication.

During a forced medication hearing, the court will typically consider the following information:

  1. All of the medical records regarding any treatment that the defendant has received;
  2. All of the medical notes and physician’s certificates of medical examination that outline the defendant’s mental health diagnosis, and recommendation for treatment;
  3. Whether or not there are any reasonable alternatives to the forced administration of psychoactive medication, and whether or not those reasonable alternatives would be as effective of a treatment as psychoactive medications;
  4. The court’s file, including the application for forced medication; and
  5. Any witness or expert witness testimony.

Do I Need a Lawyer for Help With Competency Proceedings and Forced Medications?

It is important to note that typically when a prosecutor initiates mental competency restoration proceedings or submits an application for forced medication, an attorney will be provided to the defendant similar to criminal proceedings.

However, a defendant is always entitled to consult or hire a private attorney to represent them in the civil proceedings. It is important to have effective representation when going through competency restoration proceedings and forced medication proceedings to ensure that your legal rights are maintained.

As such, if you or a loved one have had civil competency restoration proceedings initiated, it is important to consult with an experienced criminal defense attorney. An experienced criminal defense attorney can ensure that your legal rights are protected through the civil process, and also assist with any pending criminal charges.

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