Competency to Stand Trial

Competency-to-stand-trial (CST) cases predominate forensic referrals in the criminal domain. Annually, estimates of competency referrals range from 50,000 (Skeem, Golding, Cohn, & Berge, 1998) to 60,000 (Bonnie & Grisso, 2000) with mental health issues arising in as many as 10–15% of criminal cases (Melton, Petrila, Poythress,&Slobogin, 1997). CST consultations enjoy two benefits often not present in other criminal consultations— the clarity of the legal standard and the existence of standardized assessment methods. The legal standard for competency to stand trial was articulated in the Supreme Court's decision in Dusky v. United States (1960; hereinafter Dusky) and the Court has not vacillated in its approach to CST since that time. In addition, the assessment methods for CST evaluations have been standardized and refined for more than four decades. Accordingly, CST consultations have benefited greatly from the consistency and uniformity of the relevant legal standard and the empirical research on its standardized assessment.