Competency to Stand Trial. For this question,
the issue is the defendant’s state of mind at the time
of the trial, not when the offense was allegedly
committed. A defendant may have been insane
when the crime was committed but later be com-
petent to stand trial. The reverse is also possible. In
fact, issues ofcompetency to stand trialare raised much
more often than the insanity defense. Competency
to stand trial was defined by the U.S. Supreme
Court in the caseDusky v. United States(1960) as
“...sufficient present ability to consult with his
attorney with a reasonable degree of rational under-
standing and whether he has a rational as well as
factual understanding of the proceedings against
him.”Thus, in contrast to the assessment of insan-
ity, the assessment of competency to stand trial
focuses on present mental state.
In answering questions of competency, several
basic issues commonly come to the fore (Greene &
Heilbrun, 2011): (a) Can the person appreciate the
nature of the charges? (b) Can the person cooperate
in a reasonable way with counsel? (c) Can the per-
son appreciate the proceedings of the court? In
most instances, the evaluation factors noted in the
previous paragraph will apply here as well.
Civil CasesA very large number of civil issues engage the atten-
tion of forensic psychologists, running the gamut
from trademark litigation to class action suits. Two
areas that are especially important for clinical psy-
chologists are (a) commitment to and release from
mental institutions and (b) domestic issues such as
child custody disputes. Let us focus on these areas
as examples of activity in the civil arena.
Commitment to Mental Institutions. Picture
this scenario. Not too long ago, a disheveled man
in his late 30s entered a restaurant and began
haranguing customers as they approached the cashier
to pay their checks. He was incoherent, but it was
possible to pick out the obscenities and references to
God that peppered his remarks. He did this for about
5 minutes, whereupon the manager appeared and
unceremoniously escorted him to the door. Outside,
he continued his tirade while pacing back and forth
before the door. He repeatedly accosted customers
and tried to make them listen to him. The manager
finally called the police. After a brief interrogation,
they“helped”him into the patrol car and subse-
quently deposited him in the emergency ward of
the local psychiatric hospital.
This and related scenarios are repeated thou-
sands of times, day after day, across the nation.
After an examination (sometimes a rather cursory
one), the individual may be involuntarily detained
for hours or days depending on particular state laws.
But in a few states, even emergency detentions
require judicial consent.
Hospitalization that occurs against the will of the
individual is referred to as aninvoluntary commitment.
Some, such as Szasz (1970), have argued strenuously
that involuntary hospitalization is a dangerous and
often misused power that hasbeen repeatedly exercised
by psychiatrists and others to maintain control over
those who will not conform to certain social dictates.
The permissible length ofinvoluntary commitment
typically varies from 1 day to 3 weeks or so depending
on the jurisdiction. After that, a hearing must be held
to decide whether detention should continue.
In avoluntary commitment, the individual agrees
to admission and may leave at any time. Some hos-
pitals require patients to sign a form stating that their
leaving is“against medical advice.”Others demand
that such patients indicate their intention to leave
several days in advance. This enables the hospital to
initiate commitment proceedings if the patient is
believed to be dangerous to self or others or so dis-
turbed as not to be responsible. It should be noted
that“voluntary”admission is often not as voluntary
as it might appear at first glance. Most often, there is
strong pressure from relatives, friends, police, court
authorities, or mental health personnel.
For the court to commit someone, a hearing
must be held to determine whether the person
involved meets the criteria laid out by law and
whether treatment will be helpful. Most often,
these criteria refer to a person who (a) is dangerous
to self or others, (b) is so disturbed or disabled as to
be incapable of making responsible decisions about
self-care and hospitalization, or (c) requires treatment548 CHAPTER 19