Mental Health Law Primer

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With this page, I mean to provide a basic understanding of the law with respect to mental illness, and mental health in general, as it is applied to criminal cases and cases of involuntary civil commitment in Georgia. It is not meant as legal advice and is no substitute for competent legal counsel.

Competency to Stand Trial


Often, one of our first tasks as defense attorneys in the field of mental health is trying to determine whether or not our clients are speaking on the same level with us. When a person's symptoms of mental health challenges are such that their mind is operating at hyper-speed, we as attorneys often can't have a meaningful conversation with them as far as their case is concerned. These concerns give rise to questions as to whether a particular client is Competent to Stand Trial in a criminal case.


Different states view issues of competency in slightly different ways, but they are all required to take it into account when pursuing criminal charges. Why? Because the Supreme Court has determined that our federal Constitution requires, essentially, that a defendant have the capacity to understand his or her rights under that pact, and if it is found that she cannot, then it would violate that same Constitution to hold criminal proceedings because it would almost be as though the proceedings were going forward without the Defendant present. Can you imagine being charged with a crime and being told you cannot confront your accusers? Or that your ability to develop a defense was being withheld from you? Or that you couldn't have an attorney with you in the courtroom to help you with complicated legal concepts? That you, very simply, were to be convicted before the verdict ever came down?


This is precisely what would happen to an individual with acute symptoms of mental health challenges--mind-numbing voices in one's head; uncontrollably racing thoughts; a tidal wave of beliefs not rooted in reality--were we to force them to go to trial in spite of them. It would be as though they weren't even there. So, we protect those rights by ensuring that an accused is of the right state of mind to move forward with those proceedings. Furthermore, these concepts apply just as much to other major components of a criminal case and to potential resolutions to them, as well. If a client can't understand the rights he gives up by foregoing trial and entering a guilty plea instead, then a Court shouldn't accept such a plea. In fact, since having your charges read aloud in Court is a guaranteed right under the 6th Amendment, a Court should accept no plea of any kind, including those of Not Guilty, until the Defendant is properly restored to competency.


So, when we talk about competency, we're talking about the here and now, not whether a person was in a compromised state of mind at the time the offense is alleged to have occurred. Can we move forward with criminal proceedings in light of the accused's mental complications? This question is, by and large, answered by the opinion of a forensic professional in the field of psychiatry or psychology, and if the answer is no, then the proceedings MUST come to a halt until the issue is resolved.

Criminal Responsibility (The Insanity Defense)


Where Competency looks at the present, the Insanity Defense requires us as attorneys, jurors, and forensic evaluators to look back in time to the moment of the alleged offense. Except for Kansas, Idaho, and Utah, every state in the country allows for some form of an Insanity Defense, and even those three states allow for mental illness to be brought to issue, in some form, when required in a criminal case. For the remaining 47 states, the criteria for an Insanity Defense are essentially derived from one of four places (or a combination thereof): English Common Law (the M'Naughten Rule), U.S. Supreme Court precedent (the 1954 Durham Rule--now only utilized in New Hampshire), State Supreme Court precedent (the 1887 Alabama-born "Irresistible Impulse" Rule), or the Model Penal Code, developed in the 1970s to address gaps in the three former concepts).


Regardless of where it is derived, the Insanity Defense takes into account our values as Americans: that we don't hold someone criminally accountable for doing something bad when they are unable either to recognize the "evil" in their acts and/or are quite literally unable to resist committing that bad act because of active symptoms of mental illness. It does not mean there aren't any consequences for such a defendant to committing those bad acts, but it does mean that we aren't going to hold that person Criminally Responsible for a crime in the same way we would a person who, say, was capable of knowing what they were doing violated the law and our collective sense of morality.


While ultimately decided by a finder of fact (jury or judge), Criminal Responsibility is, like Competency to Stand Trial, generally determined by the opinion of a forensic professional in the field of psychiatry or psychology who is an expert with respect to the symptoms of mental illness and how they are to be applied to the law in whatever jurisdiction a case is presented. In every case involving the Insanity Defense, a criminal defendant must admitting to committing the bad act, but they are simultaneously arguing that they were not capable of forming that guilty mind because of their symptoms at the time and, thus, should not be found guilty of the charges. The expert or experts will look back to the moment of that stipulated offense, apply the concepts of medical and psychiatric science to the law and evidence as presented to them, and form an opinion as to whether the individual was "responsible" for committing the crime.


The Insanity Defense is always a tough hurdle to get past (and has a number of important exceptions), and even a successful defense in that regard may result in consequences not desirable to a client given alternatives. But, it is a useful and, in some cases, critical tool for us as defense attorneys to have at our disposal when necessary.