Chapter 8: The role of Mental illness in Court
Presumptions in Legal system: identifies 2 elements that must be present for criminal guilt
1.A wrongful deed, known as Actus Reus
2.Criminal intent, know as Mens Reus
Fitness to stand trail: if charged with crime, have to be tried fairly, have understanding of the
charges and be able to prepare defense.
•Defendant deficient in these domains, due to mental illness may be unfit to stand trial:
which refers to an inability to conduct a defense at any stage due to mental disorder.
R v. Prichard 1836: considered the key case for the fitness standard. Which delineated these criteria:
•Whether defendant is mute of malice (intentionality)
•Whether defendant can plead to the indictment
•Whether defendant has sufficient cognitive capacity to understand the trial and proceedings.
How many defendants are referred to fitness evaluations?
•Approx 5000 conducted annually in Canada
•Somewhere between 2% and 8% of all felony defendants referred for fitness evaluations.
That’s about 25- 38 000 defendants.
Who can assess fitness?
•Traditionally only medical doctors. Canada still takes this stance, in fact they exclude
psychologists from conducting from conducting court ordered assessments, but prof says this
is not as strict as the book tells us.
•Canadian psychologists, however may be involved in court ordered assessments in a number
oMay be asked to conduct psych assessments
oSubmit assessment to psychiatrist or doctor who incorporate them into report.
•Screening instruments: designed to help evaluations quickly by screening out defendants who
are competent to stand trial. More cost effective system 0-2(severe impairment), decisions
not based on cut off score
•Fitness instrument Test Revised (FIT-R): developed to meet criteria outlined in criminal
code: each item probs defendant to see if they:
oUnderstand nature of object of the proceedings
oUnderstand possible consequences of the proceedings
oCan communicate with counsel
•Competency Screening Test (CST): Has 22 uncompleted sentences respondent must finish.
oEx: when I go to court the lawyer will…
oScored on 3 point scale: 0=low level of understanding, 2=high level of legal
oOverall score of 20 or below= undergo more comprehensive evaluation.
•Competency to Stand Trial Assessment Instrument (CAI): accompanies the CST.
o`semi structured interview assessing 13 functions corresponding to
defendants ability to participate in the criminal process on behalf of their
oOn scale of 1(total lack of capacity for function) to 5(reflecting no
impairment) and 6(if insufficient info for function)
•Interdisciplinary Fitness Interview (IFI): Semi structured interview measuring 3
areas of competency , fuctional memory, appropriateness with lawyer, and
understanding of the justice system