Criminal Matters

00:00 Now, let’s talk about Criminal Matters in Forensic Psychiatry. For the purpose of your exam, there are really only 2 concepts here you need to know about. One is competence to stand trial and the second is the insanity defense. Let’s have a quick look. Using the case of Bob. So “Bob is arrested for assault. He’s accused of slapping a man across the face in broad daylight at a food restaurant. Bystanders said that they noticed Bob standing in line and thought he looked kind of strange because his clothes were tattered, he was talking to himself and he seemed pretty agitated. They said that he slapped the bystander without provocation and then asked the man “Would you like fries with that?” He then began laughing hysterically and said “They told me to get you first.” Bob then began slapping himself in the face and when police officers arrived on the scene, he offered them his Coke and then asked for a ride home before he burst into tears. When he met with his attorney because Bob was charged with a crime for his actions, well, Bob rambled on incoherently to his attorney. He accused counsel of being in on it and said that he would not go to court because he’s sick of being part of a reality TV show. When his attorney explained the seriousness of the charges against Bob, he exclaimed “I won!” Well, how would you determine if Bob is competent to stay on trial? Well this is something where forensic psychiatrist usually intervenes and competency really requires for criminal charges that an individual understand the nature of the charges against them and also have the present ability to assist counsel and their defense. Bob is found to be incompetent to stay on trial. He undergoes a psychiatric hospital admission and has started in treatment with an antipsychotic medication to help reduce his command auditory hallucinations, paranoid thinking and also impulsive behaviors.

02:13 He’s doing a lot better and is later found to have been restored to competency and he is able to work with his attorney now on formulating a good defense strategy. He chooses to enter an insanity plea for the charges against him. So, let’s move on now to talk a little bit about insanity and what’s the legal definition of insanity. Well, one must have a mental illness, not understand right from wrong and not understand the consequences of actions at the time the act was committed. This is the general definition of insanity. It tends to vary a little bit based off of jurisdiction but this is the main point. One of the more common statutory criteria for insanity is known as the M'Naghten rule. This is the most stringent test and is standard in most US jurisdictions. It assesses whether an individual understands the nature, consequences and wrongfulness of his or her actions. Because it’s so interesting, we take a moment to share with you the evolution of the insanity defense. So back in the 18th century, it started with a standard called the wild beast which was a total deprivation of memory and understanding. That’s what was required to be found insane. Then things evolved into the irresistible impulse test where it was needed to be shown that some controlling disease was the acting power within the individual which he could not resist. Then the M'Naghten rule came about in 1843, again where the defendant did not know the nature and quality or wrongfulness of the offense. In the mid 1950s, the American Law Institute’s Model Penal Code combined M'Naghten with the irresistible impulse standard and then in 1984 there is a Federal Insanity Defense Act Reform. So that’s a little bit about the 2 things you need to know about for your exam in terms of Criminal Matters in Forensic Psychiatry, competence to stand trial and a little bit about the insanity defense.