Involuntary Competence in United States Criminal Law

This chapter explores all the stages in the United States criminal justice process in which a defendant or prisoner may become incompetent and a potential candidate for involuntary treatment to restore the subject’s competence, including competence to stand trial, competence to plead guilty and to waive trial rights, competence to represent himself, and competence to be sentenced. Other legal systems may treat this as primarily a mental health law question addressed best by mental health laws, but in the United States, it is a criminal law question, although some courts are very deferential to the judgement of mental health professionals. The chapter then surveys the law and offers a normative set of recommendations for when involuntary treatment is justified, as well as recommendations for the disposition of the subject if involuntary treatment is not justified or is unsuccessful.

The Development of Unfitness to Stand Trial in New Zealand

This chapter describes the developments in the doctrine of unfitness to stand trial in New Zealand during the period 1992–2017. The focus is upon the changes to the statutory test for unfitness to stand trial effected by the Criminal Procedure (Mentally Impaired Persons) Act 2003 and how they have been interpreted by courts in New Zealand. The 2003 Act and the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 were instrumental in reinvigorating the notion of trial competence, which for most of the twentieth century was largely an under-utilised doctrine of the substantive criminal law of New Zealand. Case-law developments in the period since 2003 have challenged judicially accepted understandings of where the threshold for determining whether an offender is unfit to stand trial should be set, and recent judgments have embraced the notions of decisional competence and meaningful participation as useful conceptual devices to assist in that determination.

Forensic focused treatment planning: a new standard for forensic mental health systems

Almost no literature addresses treatment planning for the forensic psychiatric patient. In the absence of such guidance, recovery-oriented multifocal treatment planning has been imported into forensic mental health systems from community psychiatric settings, despite the fact that conditions of admission and discharge are vastly different for forensic psychiatry inpatients. We propose that instead of focusing on recovery, forensic treatment planning should prioritize forensic outcomes, such as restoration of trial competence or mitigation of violence risk, as the first steps in a continuum of care that eventually leads to the patient’s ability to resolve forensic issues and return to the community for recovery-oriented care. Here we offer a model for treatment planning in the forensic setting.