MENTAL ILLNESS DEFENSE: CRIMINAL CASES INVOLVING INSANITY DEFENSE VS. COMPETENCE TO STAND TRIAL
In Massachusetts a person cannot be held responsible for a crime if he has a “mental disease or defect,” and as a result of that condition he is substantially unable to appreciate the wrongfulness of his conduct or he is substantially unable to conform his conduct to the requirements of the law. Put otherwise, the defendant’s mental condition must have rendered him unable to realize that his behavior was wrong or unable to make himself behave lawfully. While lawyers and judges in the Commonwealth refer to this as “criminal responsibility,” it is more commonly known as an “insanity defense.” If the defense is successful, the accused will be found “not guilty by reason of insanity.”
I have represented multiple clients accused of serious violent crimes who have been found not criminally responsible for their crimes. It is important to have an attorney who has experience working with individuals who suffer from mental illness who can immediately identify a potential criminal responsibility defense and line up a forensic psychologist to evaluate the client quickly. A client behaving bizarrely at his initial court appearance will likely be sent for an evaluation at Bridgewater State Hospital (which is a prison with enhanced mental health treatment) or a locked Department of Mental Health hospital where he will be medicated upon arrival. It is essential that the psychologist hired by the defense team evaluate the client within days of his court appearance so that there has not been enough time for the medication to take effect and improve his functioning. It is essential that the psychologist sees the individual at a similar level of mental functioning as when the crime occurred.
Criminal responsibility is separate and apart from the issue of competence to stand trial and the two legal issues are often confused.
Whether an individual is competent to face his charges rests on whether he presently is able to consult with his lawyer with reasonable understanding of the proceedings against him. When evaluating a question of criminal responsibility, one looks at the accused individual’s mental state at the time that he committed the offense. The question of competency focuses on the individual’s present state and whether he can understand the legal proceedings regardless of his condition at the time of the offense. A person can start a case lacking competence, have competence restored with treatment and then may once again not be competent at a later time during the proceeding. Some individuals are charged with crimes and can never be found competent to face criminal charges. In those cases, where there is medical evidence that my client will never be restored to competency, I petition the court to dismiss the charges prior to the statutory expiration date.