Psychiatric Aspects of Fitness

• Author: Richard D. Schneider; Hy Bloom
• Pages: 67-80

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Psychiatric Aspects of Fitness

It has been common practice for decades for psychiatrists and psychol-

ogists to be appointed by courts (and less frequently, to be retained by

the parties) to assess accused whose tness is suspect. That said, men-

tal health expertise to determine tness is not required by the Criminal

Code, and, in rare instances, judges will determine the issues without a

mental health professional’s involvement.

A. MENTAL DISORDER AND FITNESS

1) The Prevalence of Major Mental Disorder

Clinical practice has made clear that psychosis, which occurs most

commonly in schizophrenia, is the most frequently found condition

leading to a nding of untness to stand trial. There is a strong cor-

relation between psychosis, intellectual impairment, and untness to

stand trial in patients with these conditions.1

The point that there is a considerably higher density and sever-

ity of psychotic symptoms in accused found unt, compared to those

found t, was made in a recent study by Lee et al.2 The authors used the

1 MS Heller et al, “Intelligence, Psychosis and Competency to Stand Trial” (1981)

9Bulletin of the American Academy of Psychiatry and the Law 267.

2 Eugene Lee et al, “Mental Illness and Legal Fitness (Competence) to Stand Trial in

New York State: Expert Opinion and Criminal Defendants’ Psychiatric Symptoms”

(2014) 59:4 Journal of Forensic Sciences 1008.