In Dusky v. United States, the United States Supreme Court set forth a definition of competency to stand trial (CST) that has been the gold standard in federal court and most state jurisdictions. As outlined by the courts, the defendant must have sufficient present ability to consult with his attorney with a reasonable degree of rational understanding and a rational as well as factual understanding of proceedings against him or her. The two prongs of the Dusky standard are as follows: the defendant's capacity to understand the criminal process as it applies to him or her, which includes the role of the participants in that process; the defendant's ability to function within the legal process, most notably in regard to his or her ability to consult with counsel in the preparation of a defense.
When a defendant's competency to stand trial is in question, an evaluation can be requested by the courts, prosecution or defense. The complexity of CST evaluations varies from one individual to another; however, my standard CST evaluation includes the following:
Review of records regarding the specific offense (e.g., police records, witness statements)
Review of background records and history (e.g., academic, hospital/psychiatric and substance abuse)
Clinical interview(s) with defendant
Mental status examination
Psychological testing
Assessment of Malingering
Assessment of the defendants ability to understand the legal, criminal, process; ability to assist in their own defense
Conclusions/opinions regarding competency to stand trial