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Article CommentaryAnalysis and Commentary

Competency to Stand Trial and Defendants Who Lack Insight Into Their Mental Illness

Andrew D. Reisner, Jennifer Piel and Miller Makey
Journal of the American Academy of Psychiatry and the Law Online March 2013, 41 (1) 85-91;
Andrew D. Reisner
Dr. Reisner is Executive Director, Forensic Diagnostic Center of District Nine, Byesville, OH. At the time this article was written, Dr. Piel was a Fellow in Forensic Psychiatry, University Hospital, Case Medical Center, Cleveland, OH. She is currently Staff Psychiatrist, VA Puget Sound Healthcare System, Seattle, WA. Mr. Makey is recently retired, former Director of the Forensic Psychiatry Center for Western Ohio, Dayton, OH.
PsyD
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Jennifer Piel
Dr. Reisner is Executive Director, Forensic Diagnostic Center of District Nine, Byesville, OH. At the time this article was written, Dr. Piel was a Fellow in Forensic Psychiatry, University Hospital, Case Medical Center, Cleveland, OH. She is currently Staff Psychiatrist, VA Puget Sound Healthcare System, Seattle, WA. Mr. Makey is recently retired, former Director of the Forensic Psychiatry Center for Western Ohio, Dayton, OH.
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Miller Makey Jr
Dr. Reisner is Executive Director, Forensic Diagnostic Center of District Nine, Byesville, OH. At the time this article was written, Dr. Piel was a Fellow in Forensic Psychiatry, University Hospital, Case Medical Center, Cleveland, OH. She is currently Staff Psychiatrist, VA Puget Sound Healthcare System, Seattle, WA. Mr. Makey is recently retired, former Director of the Forensic Psychiatry Center for Western Ohio, Dayton, OH.
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Abstract

Forensic evaluators often assess patients who lack insight into their mental illnesses. This lack of insight can have a significant impact on the defendant's ability to make legal strategy decisions that rely on their acceptance of their mental illness. In this article, the relationship between refusing an insanity plea and competency to stand trial will be explored in the context of defendants who lack insight into their mental illness. The authors argue that an adequate competency assessment should take into account the defendant's ability to consider his available pleas rationally. Such evaluations may have the effect of negating the necessity of a Frendak inquiry in those jurisdictions that can impose the insanity defense on defendants.

Footnotes

  • Disclosures of financial or other potential conflicts of interest: None.

  • © 2013 American Academy of Psychiatry and the Law
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Journal of the American Academy of Psychiatry and the Law Online: 41 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 41, Issue 1
1 Mar 2013
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Competency to Stand Trial and Defendants Who Lack Insight Into Their Mental Illness
Andrew D. Reisner, Jennifer Piel, Miller Makey
Journal of the American Academy of Psychiatry and the Law Online Mar 2013, 41 (1) 85-91;

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Competency to Stand Trial and Defendants Who Lack Insight Into Their Mental Illness
Andrew D. Reisner, Jennifer Piel, Miller Makey
Journal of the American Academy of Psychiatry and the Law Online Mar 2013, 41 (1) 85-91;
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