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J Am Acad Psychiatry Law. 2018 Jun;46(2):195-203. doi: 10.29158/JAAPL.003747-18.

Response to Disclosure as an Indicator of Competence to Stand Trial.

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1
The coauthors are eternally grateful for their mentor and friend, Douglas Mossman, M.D., who passed away on January 4, 2018. Dr. Mossman was Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH. Drs. Brown, Casey-Leavell, and Marett are psychiatrists at Summit Behavioral Healthcare, Cincinnati, OH. Dr. Marett is also Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH. Dr. Lee is a Clinical Adjunct Assistant Professor, Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI.
2
The coauthors are eternally grateful for their mentor and friend, Douglas Mossman, M.D., who passed away on January 4, 2018. Dr. Mossman was Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH. Drs. Brown, Casey-Leavell, and Marett are psychiatrists at Summit Behavioral Healthcare, Cincinnati, OH. Dr. Marett is also Assistant Professor of Psychiatry, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH. Dr. Lee is a Clinical Adjunct Assistant Professor, Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI. marettcr@ucmail.uc.edu.

Abstract

Ethics guidelines recommend that forensic mental health professionals begin in-person assessments by explaining the nature and purpose of the examination. To learn whether evaluees have understood and can give consent, forensic practitioners may ask evaluees to paraphrase the explanation. This article explores how a forensic evaluee's disclosure response (DR) reveals substantive information relevant to the purposes of a forensic examination. We examined archival data from 255 reports on competence to stand trial (CST) that a Midwest public sector hospital had previously submitted to courts. We classified each evaluee's DR at one of three levels: DR = yes (accurate paraphrasing), DR = no (inability to paraphrase or provide a relevant response), or DR = other (an intermediate level implying a less-than-accurate response). None of the 28 DR = no evaluees was CST, and only 7 (17%) of the 48 DR = other evaluees were CST. Thus, a CST evaluee who cannot paraphrase an examiner's explanation is likely to be incompetent to stand trial, and an examiner would need to adduce a strong argument to support any opinion to the contrary.

PMID:
30026398
DOI:
10.29158/JAAPL.003747-18

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