Psychiatric Treatment and Competence to Stand Trial Evaluations

Facts of the Case

This case involves the shooting death of 17-year-old Kiaria Williams. She was struck by a bullet sent through her home, and she died one month later from her injuries. After the shooting, Theodore Bell told witnesses that he shot at a house after someone shot at his car. In a voluntary interview, Mr. Bell told police that he and an acquaintance were looking for someone else when someone shot at them, and they later returned to “shoot up the house,” that he was the driver, and that his acquaintance discharged the gun that struck Ms. Williams.

Mr. Bell was charged with first-degree murder, assault with intent to murder, possession of a firearm by a felon, and commission of a felony with a firearm. Several weeks after his arrest, he developed symptoms of delirium and displayed bizarre behavior while in jail and was moved to the mental health ward for observation. Records note that doctors related his delirium to withdrawal from his use of nonprescribed alprazolam, a medication Mr. Bell had been taking prior to his arrest. Records from October 2009 indicated Mr. Bell was given a diagnosis and treated for substance abuse, mental health problems, and high blood pressure. A report from February 2010 indicated that Mr. Bell was irritable and experiencing sleep difficulties, though he denied psychotic symptoms.

In March 2010, Mr. Bell pleaded guilty to several charges. The trial court accepted his plea and sentenced him to 23 to 40 years. Later, Mr. Bell submitted a motion to withdraw his guilty plea, claiming his counsel had been ineffective by failing to initiate an evaluation of his competence to stand trial before his plea. Mr. Bell further claimed that he had been taking medication that affected his ability to understand the proceedings. The trial court denied the motion as there was no indication Mr. Bell was incompetent at the time of his plea. Both the Michigan Court of Appeals and the Michigan Supreme Court denied Mr. Bell’s request for appeal.

Mr. Bell filed a habeas corpus petition in October 2011, which was dismissed. Both the Michigan Court of Appeals and the Michigan Supreme Court again denied Mr. Bell’s request for leave to appeal this denial. Mr. Bell then filed an amended petition for writ of habeas corpus, claiming ineffective assistance of counsel for failure to have his competency evaluated, among other claims. The district court denied Mr. Bell’s amended petition, which he then appealed to the U.S. Court of Appeals for the Sixth Circuit.

Ruling and Reasoning

Mr. Bell had petitioned for a certificate of appealability (COA), which required him to make a substantial showing that his constitutional right was denied and demonstrate that reasonable jurists could debate the district court’s assessment or find it was in error. In support of this, Mr. Bell argued that his attorney failed to request an evaluation of his competence after he experienced delirium, confusion, bizarre behavior, irritability, and difficulty sleeping, which rendered his plea involuntary. To prove his counsel was ineffective, Mr. Bell had to show “his attorney’s performance was objectively unreasonable and that he was prejudiced as a result” (Bell, p 6; citing Strickland v. Washington, 466 U.S. 668 (1984), p 687).

The court stated that a counsel’s failure to request an evaluation of an individual’s competence to stand trial (CST) might render a counsel’s performance objectively unreasonable if there “are sufficient indicia of incompetence to give objectively reasonable counsel reason to doubt the defendant’s competency” (Bell, p 7, citing United States v. Dubrule, 822 F.3d 866 (6th Cir. 2016), p 881). The court, however, did not find that such indicia were present in Mr. Bell’s case.

The court reviewed the records Mr. Bell had submitted in support of his petition and did not find that the evidence called into question his CST at the time of the plea hearing. The report from February 2010 indicated he had denied having any psychotic symptoms. The transcript also suggested that he was competent at the time of the hearing and was “perfectly capable of looking after his own interests” (Bell, p 8). Although Mr. Bell had submitted a report that suggested the medications he was taking could have had an impact on his cognition, he offered no opinion about his mental condition at the time of the hearing. Finally, the court disagreed with Mr. Bell’s assertion that his counsel should have had him evaluated after visiting Mr. Bell in a psychiatric facility where he was taking medications.

Citing precedent in United States v. Miller, 531 F.3d 340 (6th Cir. 2008), the court stated that, although mental illness is certainly relevant to the matter of CST, it is not dispositive. The court reasoned that an attorney failing to request an evaluation solely because of the existence of a mental health diagnosis and a history of treatment was not enough to demonstrate a substantial showing of ineffectiveness. Mr. Bell had not been able to demonstrate how his symptoms or his use of psychiatric medication affected his CST at the time of the hearing. His assertion that his attorney should have known to request an evaluation after visiting him in the psychiatric ward was insufficient to draw a nexus between this event and his mental condition at the time of the trial.

The court, therefore, ruled that Mr. Bell’s counsel was not ineffective for failing to request an evaluation of his CST prior to the plea hearing nor was there any evidence that his plea had been involuntary due to his mental health. After considering Mr. Bell’s other claims, the court denied his application for a COA.

Discussion

The matter presented in Bell is whether counsel is ineffective for failing to request an evaluation of a defendant’s competence to stand trial (CST) on the basis that the defendant has a history of mental health treatment and use of psychiatric medication. Although the court in Bell ultimately held that counsel had not been ineffective for not requesting a CST evaluation, the question remains as to what factors would necessitate such an evaluation.

While the Bell decision is not binding law outside of the federal courts within the Sixth Circuit, Bell offers guidance on circumstances which may trigger counsel’s requirement to request an evaluation of a defendant’s CST. Bell makes it clear that a CST evaluation is not warranted in every case in which a defendant has been given the diagnosis of a mental illness or has received treatment with psychiatric medication. The court provides useful instruction that there needs to be a nexus between the defendant’s mental condition and trial abilities affected by the condition. In other words, the defendant’s CST must be affected by the mental health condition or treatment in order for an evaluation to be required or rise to the level of ineffective legal assistance when counsel fails to seek an evaluation. Bell also suggests that the parties should take into consideration the fluctuating nature of a defendant’s mental health and ensure that a defendant’s state of mind is assessed throughout the court proceeding.