COMPETENCY TO STAND TRIAL: DISCUSSION

Dr. Bahn’s finding that policemen regularly bring assaultive individuals whom they consider to be “mental cases” to hospitals rather than to jails was interesting but not altogether reassuring. Presumably, many such individuals are soon released from the hospitals only to engage again in assaultive behavior. As a citizen, I am not sure that I would not prefer that such individuals be arrested and processed through the criminal justice system, at least initially, even if they were detained-prior to trial, to release on bail, or to some other agreed upon disposition-in a department of corrections hospital rather than jail. At least, then, they would not be released simply to reduce the population of a hospital ward or because they were difficult to manage-as might well be the case now. However, if such individuals are being brought to hospitals, it should not be surprising to discover-as certain studies referred to by Dr. Bahn suggest-that the patient populations of the psychiatric wards of certain municipal hospitals have higher arrest rates, upon release, than that of the general population. Nevertheless, we have to be careful about how we interpret and present such results. For example, one of the studies cited by Dr. Bahn that found such higher arrest rates for released psychiatric patients was titled “Crime and Violence among Mental Patients.”’ But the patient pool involved was entirely that of Bellevue Hospital patients-hardly a representative sample of “mental patients” generally. Undoubtedly, the title “Crime and Violence among Mental Patients” is likely to stir more interest than the more accurate title: Crime and Violence among Psychiatric Patients Released from Bellevue Hospital. The use of the former title, however, does a great and inexcusable disservice to “mental patients” as a group. As for the papers of Drs. Exner and Weinstein, I of course agree with Dr. Exner’s observation that a particular IQ or psychiatric diagnosis does not render a defendant competent or incompetent-especially since a defendant’s competency may depend upon the particular circumstances of the case as well as on his or her state of mind. In one case that I know of, for example, a defendant charged with murder was found competent to stand trial-and properly so-even though he harbored the delusion that his victims had onlyfeigned dying. Since the defendant was willing to allow his attorney to enter a plea of not guilty by reason of insanity, and since the attorney had access to the hospital records necessary to establish that defense, the fact that the defendant was delusional about the events in the indictment would not, and did not, prevent him from receiving a fair trial upon the issue of his insanity.’ Indeed, his