Criminal Court’s Disability

“Do criminal courts meaningfully accommodate psychiatric disability? A review of competency proceedings across the United States suggests not. In competency to stand trial (CST) proceedings, criminal courts offer a narrow vision of psychiatric disability that excludes many defendants. Ultimately, the institutional context of criminal court under-mines even the meager accommodations that the competency framework provides.

CST proceedings are the constitutional accommodations available to disabled defendants if they can establish that they are unable to consult with their lawyers or if they do not have a rational or factual understanding of the proceedings against them.

Criminal court judges and examiners systematically deny recognition to one group of diagnoses: personality disorders (PDs). Even when defense attorneys argue that defendants’ PD symptoms impede their ability to collaborate, courts and some forensic experts insist that the defendants are competent. Examiners and courts reframe these difficulties as deliberate acts of subversion and conclude that defendants with PDs choose to be uncooperative. In doing so, they give PDs an exceptional and paradoxical status: They are considered psychiatric conditions, yet their expressions are deemed volitional. This Essay argues that the outcomes of CST proceedings reveal court actors’ preoccupation with determining responsibility rather than advancing defendants’ trial rights. In the process, courts selectively apply the competency standard, discounting its interpersonal dimensions and prioritizing the accused person’s cognitive capacities.

CST proceedings illustrate that it may not be possible for criminal courts to embrace and adapt to the reality of neurodivergence while also pursuing criminalization.”