Tuesday, August 16, 2016

Forensic Mental Health - Part 1: It's Not What You Think

I want to use this entry to clear up a couple things about forensic mental health.  I believe there is a lot of misinformation and misunderstanding about a couple of concepts: being found Incompetent to Stand Trial (IST), and being found Not Guilty by reason of Insanity (NGI).  I became well acquainted with, and well versed in, both topics during my time working at a state hospital.  I will speak to the application of these laws in my state.  
I like to read the comment sections of news articles.  Maybe I’m a masochist, but that’s a topic for another entry…not to mention my therapist!  At any rate, I find the lack of knowledge on this topic alarming.  As a member of a society, I want to know what a law means and how it is applied.  Remember our stages of moral development?  We can’t live by rules and laws we don’t understand.  So for these two topics in particular, here goes…

Incompetence to Stand Trial:  A person is arrested and accused of a crime.  They are, according to the 6th amendment of the US Constitution, afforded the right to a fair trial.  This means two things under IST law: If the person is 1) unable to understand the nature of the criminal proceedings, or 2) unable to assist his or her attorney in a rational manner, they can be found incompetent to stand trial.  Either or both of these conditions MUST be due to mental illness.  In either case, the person’s symptoms prevent them for understanding what is going on in court.  They have to be able to work with their attorney.  The 6th Amendment of the US constitution affords the right of the accused to know the nature of the charges, and the evidence against the defendant.  A person can’t do this if their mental illness is keeping them from understanding this information.   It is usually the judge or the public defender who will raise the issue of the defendant’s trial competence.  At that point, the defendant is transferred to the State Hospital.  By law, they have 3 years in which to become competent to stand trial.  Should they become competent, they will be transferred back to county jail to await trial.  During the time they are hospitalized, they will receive treatment for the mental illness, and education about their diagnosis, treatment, and the court process.  If the 3 years go by and the person has not regained competency, usually one of two things will happen: If the crime is not serious and the time they would have been incarcerated had they been found guilty is less than the time they have spent in the State Hospital, the prosecuting attorney may decide to drop the charges.  If this is not the case and the charges are for a violent crime, the patient will often be put on a conservatorship.  This means they will be assigned to a county mental health worker.  Often, especially if the charges are for a violent offense, the person will be confined to the State Hospital indefinitely, until such a time they regain competency to stand trial.  Read that again: They will be confined to the State Hospital indefinitely.  Being found IST is NOT a Get Out Of Jail Free card. 
Tomorrow's post will be about what happens when a person is found Not Guilty by reason of Insanity.  Stay tuned to find out just how hard it is to be released from a State Hospital!

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