The forensic psychiatric contribution on “competence to stand trial”: evaluation standards in the U.S.A. and Italian perspectives

Abstract

The Competence to Stand Trial (CST) evaluation is one of the most important issues in forensic psychiatry. In the U.S.A., the basic standards of competence to stand trial were specified by the U.S. Supreme Court in the Dusky decision. In that decision, the court determined that the key test of competency to stand trial is “whether he has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding - and whether he has a rational as well as factual understanding of the proceedings against him”. Over the years, Courts have amplified the Dusky criteria: a criminal defendant is incompetent to stand trial if a preponderance of the evidence shows that he is presently sufferingfrom a mental disease or defect rendering him mentally incompetent to the extent that he is unable to understand the nature and consequences of the proceedings against him or to assist properly in his defense. In the light of the Duskystandard, we provide a brief overview regarding the concept of competence to stand trial in the U.S. legal system, its assessment in the American courtrooms and we highlight recent empirical studies on CST. In conclusion, we discuss whether some of these findings could be applicable to the Italian legal system.