The Effect of Time on Competency to Stand Trial Evaluation Outcomes

No empirical studies, or clinical, ethical, or legal guidelines, have examined what effect time may have on the outcomes of competency to stand trial (CST) evaluations, despite rising court orders for these evaluations increasingly straining states to conduct them in a timely manner. Short time frames may be inefficient for CST evaluations and artificially inflate rates of incompetency opinions for several reasons – defendant continued intoxication, acute symptomatic presentation, stress related to recent incarceration, or insufficient time for psychotropic medication to stabilize the defendant. This study examines the relationship between time from court order to CST evaluation on evaluator opinions in CST evaluations. We collected data from CST evaluations at two sites in Texas: a large, urban public defender’s office (Study 1) and a rural community clinic serving several counties (Study 2). Data collected included time of court order and evaluation, evaluator opinion, evaluation characteristics, and defendant characteristics. Study 1 contained only defendants charged with misdemeanors; results indicated the rate of incompetency opinions was high (>60%) and the sample was primarily composed of defendants with SMI. We found that defendants diagnosed with a SMI, particularly if prescribed medication, were more likely be to be opined competent as time to evaluation increased. Study 2 results showed a more normative incompetency rate (approximately 25%). There was an effect for time on evaluation outcomes across the entire sample, with defendants being more likely be to be opined competent as time to evaluation increased. Defendants with bipolar and related disorders, substance-related disorders, and those prescribed medications were more likely to be opined competent as time to evaluation increased. Both studies found several factors, irrespective of time, to be associated with competency opinions, such as schizophrenia spectrum disorder, substance-related disorders, and custody status. Implications for practice, policy, and directions for future research are discussed.