PT  - JOURNAL ARTICLE
AU  - Douglas Mossman
AU  - Rebecca M. Brown
AU  - Bridget A. Casey-Leavell
AU  - Christopher P. Marett
AU  - Elliot R. Lee
TI  - Response to Disclosure as an Indicator of Competence to Stand Trial
AID  - 10.29158/JAAPL.003747-18
DP  - 2018 Jun 01
TA  - Journal of the American Academy of Psychiatry and the Law Online
PG  - 195--203
VI  - 46
IP  - 2
4099  - http://jaapl.org/content/46/2/195.short
4100  - http://jaapl.org/content/46/2/195.full
SO  - J Am Acad Psychiatry Law2018 Jun 01; 46
AB  - 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.