We consider interviews, relevant records, and testing when appropriate. Together, these sources help clarify current functioning and abilities related to understanding proceedings and assisting counsel.
Competency evaluations assess an individual’s ability to understand criminal proceedings and meaningfully assist their attorney. At Utah Center for Psychological Services, we evaluate current psychological functioning and provide objective, clearly reasoned opinions to support the court’s competency determination.
Competency evaluations examine whether a person currently has the abilities needed to understand criminal proceedings and participate in their defense.
The focus is on present functioning. It does not assess the person’s mental state at the time of the alleged offense. The evaluator provides a clinical opinion, while the court makes the legal determination of competency.
UCPS provides competency evaluations in Utah for individuals involved in criminal proceedings. These evaluations address concerns about a person’s current ability to understand the legal process and assist their attorney in their defense.
To clarify these questions, we use a structured, objective assessment of present functioning. We then explain the findings and their relevance to the referral. Our role is to provide clear, evidence-based opinions that support informed legal decisions.
Competency evaluations are typically requested when there are concerns about an individual’s ability to participate meaningfully in legal proceedings.
These evaluations may be ordered in situations such as:
A competency evaluation may be requested by the court, defense, or prosecution at any point when concerns arise.
A competency evaluation focuses on an individual’s current ability to function within the legal process.
This typically includes:
Competency is based on whether an individual can understand the proceedings and assist in their defense, not simply whether a mental health condition is present.
We discuss the referral concerns, relevant history, and current symptoms. This helps clarify the questions the competency evaluation needs to address.
We assess psychological and cognitive functioning through interviews and testing as appropriate. This helps identify factors that may affect participation in legal proceedings.
We review relevant records and speak with others when appropriate. Together, these sources provide context about the individual’s history and current functioning.
We examine the individual’s understanding of the proceedings and ability to assist their attorney. This includes applying legal information to their own situation.
We prepare a report explaining the findings, clinical opinion, and relevant limitations. The report addresses the referral questions to support the court’s competency determination.
Competency evaluations address questions about an individual’s present ability to participate in criminal proceedings. For this reason, we assess relevant abilities carefully and explain how the evidence supports our clinical opinions.
We consider interviews, relevant records, and testing when appropriate. Together, these sources help clarify current functioning and abilities related to understanding proceedings and assisting counsel.
We examine demonstrated abilities and difficulties rather than relying on a diagnosis alone. When information is incomplete or conflicting, we explain how it limits our conclusions.
We explain the connection between assessment findings and our competency opinion. As a result, the court can follow our reasoning when making the legal determination.
Professional resource: Specialty Guidelines for Forensic Psychology from the American Psychological Association.
Competency to stand trial evaluations require the integration of clinical assessment, forensic methodology, and legal standards governing a defendant’s ability to participate in criminal proceedings. Determining competency involves more than identifying mental illness or cognitive impairment; it requires examining how those conditions affect an individual’s factual and rational understanding of the proceedings and ability to assist legal counsel. At Utah Center for Psychological Services, our forensic psychologists apply evidence-based assessment methods within the framework of applicable Utah statutes and constitutional principles. The following sections explore the legal and clinical complexities of competency evaluations, including adjudicative abilities, functional impairment, response validity, competency restoration, and the limits of forensic expert opinions.
Competency to stand trial is a fundamental constitutional protection intended to ensure that criminal defendants possess the mental capacities necessary to understand the proceedings against them and meaningfully participate in their defense. Unlike evaluations of criminal responsibility, which examine an individual’s mental state at the time of an alleged offense, competency evaluations focus on the defendant’s present ability to participate in criminal proceedings.
The foundational legal standard was established by the United States Supreme Court in Dusky v. United States, 362 U.S. 402 (1960). In Dusky, the Court held that competency requires more than basic orientation or factual knowledge of the legal proceedings. Rather, the defendant must possess a sufficient present ability to consult with legal counsel with a reasonable degree of rational understanding and must have both a rational and factual understanding of the proceedings.
The Supreme Court further clarified the procedural protections surrounding competency in Drope v. Missouri, 420 U.S. 162 (1975). The Court emphasized that competency is not necessarily a static condition and that trial courts have a continuing obligation to consider evidence suggesting a defendant may be unable to proceed. Relevant indicators may include irrational behavior, courtroom demeanor, and prior medical opinions. Importantly, a defendant who was previously found competent may require reevaluation if subsequent circumstances raise substantial concerns about their ability to participate meaningfully in the proceedings.
Utah statute incorporates the constitutional principles outlined in Dusky into its statutory definition of competency. Under Utah Code § 77-15-2, a defendant is competent to stand trial when the individual possesses:
Factual understanding: Knowledge of the criminal proceedings, including the charges, potential punishment, and roles of relevant courtroom participants.
Rational understanding: The ability to appreciate the nature and significance of the proceedings and apply that understanding to one’s own legal circumstances.
Ability to assist counsel: The capacity to communicate and consult with an attorney with a reasonable degree of rational understanding to assist in preparing a defense.
These abilities are related but distinct. A defendant may correctly identify the roles of a judge, prosecutor, and defense attorney while holding delusional beliefs that substantially interfere with the ability to rationally understand the proceedings. Similarly, an individual may demonstrate adequate factual knowledge of the legal system but experience cognitive or psychiatric difficulties that compromise the ability to communicate relevant information, consider legal advice, or participate meaningfully in defense preparation.
Importantly, competency is a functional legal determination rather than a psychiatric diagnosis. The presence of schizophrenia, bipolar disorder, intellectual disability, or another mental health condition does not automatically establish incompetence. Instead, the evaluation must examine whether qualifying impairments interfere with the specific abilities required under the applicable legal standard.
Utah law further defines incompetent to proceed in § 77-15-2 as a defendant who is not competent to stand trial as a result of mental illness or intellectual disability. This distinction requires forensic evaluators to consider both the nature of an individual’s impairment and its functional relationship to the defendant’s adjudicative abilities.
The procedures governing court-ordered competency evaluations are addressed in Utah Code § 77-15-5. Under this statute, a court must identify a bona fide doubt regarding competency before ordering an examination. When the statutory requirements are satisfied, the court orders the Department of Health and Human Services to arrange competency evaluations by qualified forensic evaluators. The statute also permits a party to obtain an additional competency evaluation by selecting and paying for an additional forensic evaluator.
These provisions are particularly relevant when defense counsel or prosecutors seek an independent assessment of a defendant’s competency, including circumstances involving disputed findings or concerns about the adequacy of an existing evaluation.
A comprehensive competency to stand trial evaluation therefore requires more than determining whether a defendant can answer basic questions about the legal system. It involves examining the interaction between psychological or cognitive impairments and the defendant’s ability to understand, reason about, and participate in the actual proceedings.
At Utah Center for Psychological Services, our forensic psychologists approach competency evaluations by integrating clinical assessment findings with the functional requirements established by Dusky and Utah law. Our objective is to provide independent, scientifically grounded opinions that assist the court in determining whether a defendant possesses the capacities necessary to proceed through the criminal justice system.
One of the most important distinctions in competency to stand trial evaluations is the difference between the presence of a mental disorder and the functional impairment necessary to establish incompetence. Although psychiatric symptoms, intellectual disability, and cognitive impairments may affect a defendant’s ability to participate in criminal proceedings, the presence of a diagnosis alone does not establish that an individual is incompetent to stand trial.
Under Utah Code § 77-15-2, incompetence to proceed requires that a defendant lack the abilities necessary for competency as a result of mental illness or intellectual disability. Consequently, forensic evaluators must consider not only whether a qualifying condition is present, but also whether and how that condition interferes with the defendant’s rational and factual understanding of the proceedings or ability to consult with counsel.
This distinction is particularly important because individuals with the same diagnosis may demonstrate substantially different levels of adjudicative competence. For example, a defendant experiencing schizophrenia may retain an adequate understanding of the legal proceedings and the ability to work rationally with an attorney, while another individual with the same diagnosis may experience delusional beliefs that substantially interfere with these abilities.
Similarly, intellectual disability does not automatically establish incompetence. An individual may demonstrate limitations in intellectual or adaptive functioning while retaining sufficient understanding of the charges, courtroom procedures, and ability to assist counsel. Conversely, cognitive limitations may interfere with the ability to comprehend legal information, appreciate the consequences of legal decisions, or communicate meaningfully with an attorney.
The United States Supreme Court addressed the relationship between mental illness and functional legal abilities in Indiana v. Edwards, 554 U.S. 164 (2008). The Court recognized that mental illness varies in severity and may affect different capacities in different ways. Importantly, the Court distinguished competency to stand trial with the assistance of counsel from the potentially greater abilities required to conduct one’s own defense. This decision illustrates why competency cannot be reduced to a single diagnostic label or generalized assessment of mental functioning.
A comprehensive evaluation of the relationship between mental illness, intellectual disability, and competency may consider:
Psychiatric symptoms: Whether hallucinations, delusions, disorganized thinking, mood disturbances, or other symptoms interfere with understanding or participation in legal proceedings.
Intellectual functioning: Whether limitations in reasoning, comprehension, or learning affect the defendant’s ability to understand legal information and assist counsel.
Cognitive functioning: The potential effects of memory impairment, executive dysfunction, attention difficulties, or other cognitive limitations on adjudicative abilities.
Rational appreciation: Whether the defendant can apply factual knowledge of the legal system to their own circumstances without substantial distortion from psychiatric symptoms or cognitive impairment.
Communication with counsel: Whether the defendant can provide relevant information, understand legal advice, and participate in discussions concerning defense preparation.
Functional variability: Whether the defendant’s abilities fluctuate with symptom severity, treatment response, environmental conditions, or other factors.
Alternative explanations: Whether apparent deficits reflect a qualifying mental condition, limited education, language barriers, unfamiliarity with the legal system, unwillingness to cooperate, or other influences.
The American Psychological Association’s Specialty Guidelines for Forensic Psychology emphasize the importance of examining competing hypotheses, integrating multiple sources of information, and using assessment methods appropriate to the legal questions presented. These principles are especially important in competency evaluations, where observed difficulties may arise from multiple sources and must be interpreted within the applicable statutory framework.
A defendant’s ability to participate in legal proceedings may also change over time. Psychiatric stabilization, medication, competency education, or other interventions may improve certain functional abilities, while worsening symptoms or cognitive deterioration may compromise previously adequate functioning. Accordingly, competency evaluations focus on the defendant’s present capacities rather than relying exclusively on historical diagnoses or prior evaluations.
Ultimately, the central question is not simply whether a defendant has a mental illness, intellectual disability, or cognitive impairment, but whether a qualifying condition interferes with the specific functional abilities required to proceed through the criminal justice system.
At Utah Center for Psychological Services, our forensic psychologists emphasize the relationship between clinical findings and legally relevant functional capacities. Our evaluations seek to distinguish diagnostic symptoms from actual impairments in adjudicative competence, providing courts and attorneys with objective, scientifically grounded opinions that address the applicable legal standard.
One of the most complex aspects of competency to stand trial evaluations is determining whether a defendant possesses the rational understanding and functional abilities necessary to meaningfully participate in criminal proceedings. Although factual knowledge of the legal system is an important component of competency, the ability to identify courtroom participants or describe basic legal procedures does not necessarily establish that a defendant can rationally appreciate their own legal circumstances or effectively assist counsel.
In Dusky v. United States, 362 U.S. 402 (1960), the United States Supreme Court established that competency requires both a rational and factual understanding of the proceedings, as well as the present ability to consult with counsel with a reasonable degree of rational understanding. This distinction is fundamental to forensic competency assessment because defendants may demonstrate adequate factual knowledge while experiencing psychiatric or cognitive impairments that substantially interfere with their ability to apply that knowledge to their own circumstances.
For example, a defendant experiencing persecutory delusions may correctly identify the roles of the judge, prosecutor, and defense attorney while believing that the defense attorney is secretly conspiring with the prosecution. Although the defendant may possess factual knowledge of the legal process, these beliefs could interfere with the ability to communicate openly with counsel, evaluate legal advice, or participate rationally in defense preparation.
Similarly, a defendant with significant cognitive limitations may understand the charges in general terms but struggle to appreciate the consequences of available legal options or meaningfully communicate information relevant to the defense.
Under Utah Code § 77-15-2, competency requires sufficient present ability to consult with counsel with a reasonable degree of rational understanding and a rational and factual understanding of the proceedings. Accordingly, forensic competency evaluations must assess not only what a defendant knows, but also how effectively the defendant can use that knowledge in the context of their own legal situation.
A comprehensive assessment of rational understanding and ability to assist counsel may consider:
Rational appreciation of legal circumstances: Whether the defendant understands the nature of the charges, potential consequences, and significance of the proceedings as they apply to their own case.
Understanding of legal options: Whether the defendant can meaningfully consider plea agreements, trial proceedings, and other relevant legal decisions.
Communication with counsel: Whether the defendant can provide relevant information, understand legal advice, and engage in productive discussions concerning defense preparation.
Reasoning and decision-making: Whether the defendant can weigh information, consider potential consequences, and make decisions based on a rational understanding of the available options.
Influence of psychiatric symptoms: Whether delusions, hallucinations, disorganized thinking, or severe mood symptoms interfere with the defendant’s ability to participate meaningfully.
Cognitive and intellectual limitations: Whether difficulties with comprehension, memory, reasoning, or executive functioning compromise adjudicative abilities.
Consistency of functional abilities: Whether the defendant demonstrates these capacities consistently or whether functioning fluctuates due to psychiatric symptoms, treatment effects, or other factors.
The distinction between factual knowledge and functional competence is also reflected in Indiana v. Edwards, 554 U.S. 164 (2008). Although the decision specifically addressed competency to represent oneself at trial, the Supreme Court recognized that mental illness may affect different legal capacities in different ways. The Court held that states may require representation by counsel for defendants who are competent to stand trial with an attorney’s assistance but lack the mental capacity necessary to conduct trial proceedings independently.
This distinction illustrates why competency assessments must be closely tied to the particular functional abilities required by the legal standard rather than relying solely on psychiatric diagnoses or generalized impressions of cognitive functioning.
Importantly, a defendant’s disagreement with counsel, refusal to accept a plea agreement, or decision to pursue an unconventional legal strategy does not, by itself, establish incompetence. Forensic evaluators must distinguish decisions that may appear unwise or contrary to legal advice from impairments that genuinely compromise rational understanding or the ability to assist in defense preparation.
At Utah Center for Psychological Services, our forensic psychologists emphasize the assessment of functional adjudicative abilities within the context of each defendant’s specific legal circumstances. By examining the relationship between psychiatric or cognitive impairments and the defendant’s ability to understand, reason about, and participate in the proceedings, we provide courts and attorneys with objective opinions that address the substantive requirements of competency to stand trial.
Competency to stand trial evaluations require more than a clinical interview or a determination of whether a defendant meets criteria for a psychiatric diagnosis. A comprehensive forensic evaluation examines the defendant’s present adjudicative abilities using methods appropriate to the referral questions, while considering the reliability of the information obtained and the potential influence of psychiatric symptoms, cognitive limitations, and response style.
Unlike many traditional clinical evaluations, competency assessments focus on specific functional abilities relevant to criminal proceedings. Evaluators must determine whether identified psychological or cognitive impairments interfere with the defendant’s factual and rational understanding of the proceedings or ability to assist counsel. This requires integrating clinical findings with information about the defendant’s legal circumstances and observed functioning.
Structured competency assessment instruments can support this process by providing systematic methods for evaluating legally relevant abilities. Commonly used instruments include the Evaluation of Competency to Stand Trial–Revised (ECST-R) and the MacArthur Competence Assessment Tool–Criminal Adjudication (MacCAT-CA). These instruments can help organize the assessment of adjudicative abilities, although their findings must be interpreted alongside clinical interviews, records, and other relevant information. No single test score independently establishes whether a defendant is legally competent.
A comprehensive competency evaluation may incorporate:
Clinical and forensic interviews: Assessment of psychiatric symptoms, cognitive functioning, mental status, and the defendant’s understanding of the legal proceedings.
Structured competency assessment: Use of standardized or structured instruments to examine factual understanding, rational appreciation, and abilities relevant to assisting counsel.
Psychological and cognitive testing: Assessment of intellectual functioning, memory, attention, executive functioning, or other abilities when clinically indicated.
Records review: Examination of relevant medical and psychiatric records, correctional observations, prior competency evaluations, and other available documentation.
Collateral information: Information from treatment providers, correctional personnel, attorneys, or other sources when appropriate and authorized.
Behavioral observations: Consideration of the defendant’s communication, reasoning, behavior, and consistency of functioning across assessment settings.
Response validity assessment: Evaluation of whether reported symptoms, demonstrated deficits, and test responses provide a reliable basis for interpretation.
Response validity is particularly important in forensic competency evaluations because defendants may have various motivations that influence how they present their symptoms or abilities. Some individuals may exaggerate psychiatric symptoms or cognitive difficulties, while others may minimize genuine impairments. Apparent inconsistencies may also reflect severe mental illness, intellectual disability, language differences, limited education, misunderstanding, or other factors unrelated to intentional deception.
The assessment of feigned incompetence therefore requires more than identifying unusual responses or poor performance on competency-related questions. Evaluators must consider whether the observed presentation is consistent with known psychiatric or cognitive conditions, whether reported deficits are supported by collateral evidence, and whether alternative explanations adequately account for the findings.
The Evaluation of Competency to Stand Trial–Revised (ECST-R) includes scales designed to assess competency-related abilities and atypical presentations potentially associated with feigned incompetence. However, findings from these scales should not be interpreted in isolation or treated as definitive evidence of malingering.
Importantly, poor performance on a competency assessment does not necessarily establish incompetence, just as unusual symptom presentation does not automatically establish intentional feigning. The evaluator must determine whether the findings reflect genuine functional impairment attributable to a qualifying condition and whether those impairments affect the abilities required under the applicable legal standard.
The scientific foundation of competency assessment methods is particularly important when findings are presented as expert evidence. Under Utah Rule of Evidence 702, expert testimony must satisfy requirements concerning the expert’s qualifications, the reliability of the underlying principles and methods, and their application to the facts of the case.
These considerations are relevant when selecting competency assessment instruments, interpreting response validity findings, and determining whether conclusions are adequately supported by the available evidence.
Forensic psychologists must also recognize that competency is ultimately a legal determination. Structured assessment findings, psychiatric diagnoses, and cognitive test results provide information relevant to competency, but they do not replace the evaluator’s analysis of functional adjudicative abilities or the court’s responsibility to determine whether the defendant is competent to proceed.
At Utah Center for Psychological Services, our forensic psychologists emphasize the integration of structured assessment methods, clinical findings, collateral information, and careful evaluation of response validity. Our objective is to provide courts and attorneys with scientifically grounded opinions that distinguish genuine adjudicative impairment from other factors that may influence assessment performance.
Competency to stand trial proceedings involve specific procedural safeguards intended to protect a defendant’s constitutional right not to be tried while incompetent. In Utah, these procedures are governed primarily by Utah Code Title 77, Chapter 15, which establishes the process for raising competency concerns, ordering forensic evaluations, conducting competency hearings, and determining whether a defendant may proceed through the criminal justice system.
Under Utah Code § 77-15-3, a competency petition may be filed by the defendant, someone acting on the defendant’s behalf, the prosecuting attorney, or an individual responsible for the defendant’s custody or supervision. The petition must identify reasonable grounds for questioning competency and describe the observations or circumstances supporting those concerns. Additionally, Utah Code § 77-15-4 permits the court to raise competency concerns at any time during the proceedings.
Once competency is questioned, Utah Code § 77-15-5 governs the procedures for determining whether an evaluation is warranted. The court must identify a bona fide doubt regarding the defendant’s competency before ordering an examination. When this threshold is satisfied, the court directs the Utah Department of Health and Human Services to arrange an evaluation by qualified forensic evaluators.
Under the statutory framework effective May 6, 2026, Utah generally requires one court-ordered competency evaluation, with two evaluations required for capital felony cases or when the court finds good cause in other felony cases.
Importantly, Utah law expressly permits parties to obtain an additional competency evaluation at their own expense. Under § 77-15-5(3)(c), either party may select and retain an additional forensic evaluator. This provision allows defense counsel or prosecutors to seek an independent opinion when additional assessment is warranted, including circumstances involving disputed findings, concerns about an existing evaluation, or questions requiring further forensic examination.
The constitutional principles governing competency proceedings have been addressed in several United States Supreme Court decisions.
In Medina v. California, 505 U.S. 437 (1992), the Supreme Court considered whether placing the burden of proving incompetence on a criminal defendant violates procedural due process. The Court held that the federal Constitution permits states to require defendants to establish incompetence by a preponderance of the evidence. The decision distinguishes the constitutional prohibition against trying an incompetent defendant from the procedural mechanisms states may adopt to determine competency.
Although Medina establishes an important constitutional principle, the procedures and applicable burdens in Utah competency proceedings are governed by Utah law.
Similarly, in Drope v. Missouri, 420 U.S. 162 (1975), the Supreme Court emphasized that courts must remain attentive to evidence raising concerns about a defendant’s competency throughout criminal proceedings. A prior finding of competency does not necessarily eliminate the need for further evaluation when new information or changes in the defendant’s functioning raise substantial concerns.
Independent competency evaluations can be particularly valuable when existing forensic opinions are disputed or when additional clinical information may materially affect the court’s determination.
Under Utah Code § 77-15-5, competency evaluations must address the defendant’s present ability to rationally and factually understand the proceedings and consult with counsel. The statute identifies specific functional considerations, including the defendant’s ability to understand the charges and potential penalties, communicate relevant information, engage in reasoned consideration of legal options, and demonstrate behavior sufficient to permit the proceedings to continue.
An independent evaluation may be appropriate when:
Existing evaluations reach conflicting conclusions: Different evaluators offer substantially different opinions regarding the defendant’s adjudicative abilities.
New clinical information becomes available: Psychiatric records, treatment developments, or other evidence may affect the interpretation of the defendant’s functioning.
Competency appears to have changed: Improvement or deterioration in psychiatric or cognitive functioning raises questions about the defendant’s current abilities.
Assessment methodology is disputed: Concerns exist regarding the adequacy of the evaluation, interpretation of findings, or consideration of relevant evidence.
Specialized assessment is warranted: Complex psychiatric presentations, intellectual disability, or cognitive impairment may require additional expertise.
An independent opinion is requested: Counsel seeks an additional forensic evaluation to assist in addressing competency-related questions before the court.
Utah Code § 77-15-5 also permits additional or updated department evaluations under specified circumstances, including changes in the defendant’s condition or newly available information that could materially affect the competency determination.
When forensic evaluators disagree, the court must consider the competing evidence and determine whether additional testimony or evaluation is necessary. Importantly, a disagreement between experts does not automatically establish that either evaluation is scientifically inadequate.
Although forensic psychologists provide opinions regarding a defendant’s adjudicative abilities, the ultimate determination of competency rests with the court. The evaluator’s responsibility is to apply appropriate clinical and forensic methods, explain the relationship between identified impairments and legally relevant functional abilities, and clearly communicate the evidentiary basis and limitations of the conclusions offered.
At Utah Center for Psychological Services, our forensic psychologists conduct competency evaluations with an emphasis on independent clinical judgment, careful assessment of adjudicative functioning, and familiarity with Utah’s statutory requirements. Whether conducting an initial evaluation or providing an additional opinion at the request of counsel, our objective is to offer scientifically grounded findings that assist courts in making informed competency determinations.
When a defendant is found incompetent to stand trial, an important question is whether the individual can attain the functional abilities necessary to proceed through the criminal justice system. Competency restoration involves interventions intended to address the psychiatric, cognitive, or other qualifying impairments that interfere with adjudicative competence. However, a finding of incompetence does not necessarily mean that a defendant can be restored, nor does it establish that restoration is likely to occur within a reasonable period.
Under Utah Code § 77-15-6, defendants found incompetent to proceed are generally committed to the Utah Department of Health and Human Services for restoration treatment, subject to statutory exceptions. Restoration services must be sufficient to either restore competency or determine whether competency can reasonably be attained in the foreseeable future.
The nature of restoration treatment depends on the conditions contributing to incompetence. For defendants experiencing psychiatric symptoms, treatment may include medication management, psychiatric stabilization, and psychoeducation. For individuals with intellectual or cognitive limitations, restoration efforts may emphasize individualized competency education, repetition, accommodations, and strategies designed to improve comprehension and participation.
Importantly, competency restoration is not simply a matter of teaching defendants legal terminology. A defendant may learn to identify courtroom participants or describe basic legal procedures without developing the rational understanding or ability to assist counsel required for competency.
Determining whether a defendant is likely to attain competency requires consideration of the nature of the underlying impairment, response to treatment, available restoration services, and observed changes in adjudicative functioning.
A comprehensive restoration assessment may consider:
Nature of the underlying condition: Whether incompetence is associated with a potentially treatable psychiatric disorder, intellectual disability, neurocognitive impairment, or multiple contributing conditions.
Treatment response: Whether psychiatric stabilization, medication, or other interventions have produced meaningful improvements in functioning.
Rational and factual understanding: Whether the defendant has developed an adequate understanding of the proceedings and can apply that knowledge to their own circumstances.
Ability to assist counsel: Whether improvements in communication, reasoning, and behavioral functioning support meaningful participation in defense preparation.
Learning capacity: Whether the defendant can acquire, retain, and apply competency-related information through education or other interventions.
Stability of functioning: Whether improvements are sustained or fluctuate with psychiatric symptoms, environmental changes, or treatment adherence.
Availability of appropriate treatment: Whether the restoration setting can provide interventions reasonably suited to the defendant’s identified impairments.
Prognosis and limitations: Whether the available evidence supports a reasonable expectation of restoration within the foreseeable future.
Under Utah Code § 77-15-6, progress evaluations must address the treatment provided, the defendant’s progress toward competency, the likelihood of restoration, and the anticipated time necessary to restore competency or determine whether restoration is reasonably achievable. The statute also permits additional forensic evaluations under specified circumstances.
The constitutional limitations on competency restoration were established in Jackson v. Indiana, 406 U.S. 715 (1972). The United States Supreme Court held that a defendant committed solely because of incompetence to stand trial cannot be confined indefinitely without adequate justification.
The Court explained that such confinement is limited to a reasonable period necessary to determine whether there is a substantial probability that the defendant will attain competency in the foreseeable future. If restoration is not reasonably achievable, the state must pursue appropriate civil commitment proceedings or release the defendant from the competency-based commitment. Continued restoration confinement must be justified by progress toward competency.
These constitutional principles are reflected in Utah’s statutory restoration framework, which establishes procedures for progress evaluations, competency review hearings, and limitations on continued restoration commitments. The applicable procedures and permissible duration of commitment vary depending on the defendant’s circumstances and the charged offenses.
The distinction between current incompetence and restorability is therefore critical. A defendant may presently lack the abilities required for trial but have a substantial probability of attaining those abilities through treatment. Conversely, a defendant may demonstrate significant impairment for which available interventions are unlikely to produce sufficient improvement.
The use of involuntary medication for competency restoration raises additional constitutional and clinical considerations.
In Sell v. United States, 539 U.S. 166 (2003), the United States Supreme Court addressed the circumstances under which the government may involuntarily administer antipsychotic medication for the purpose of restoring a defendant’s competency to stand trial.
The Court identified four principal requirements:
Important governmental interests: The prosecution must involve sufficiently important governmental interests, considering the particular circumstances of the case.
Likelihood of restoration: Medication must be substantially likely to restore competency and substantially unlikely to produce side effects that would significantly interfere with the defendant’s ability to assist counsel.
Necessity: Less intrusive alternatives must be unlikely to achieve substantially the same objectives.
Medical appropriateness: The proposed medication must be medically appropriate in light of the defendant’s condition.
The Sell framework applies specifically to involuntary medication sought for trial competency purposes. Other legal standards may govern involuntary treatment justified by dangerousness or other recognized grounds.
These considerations illustrate why the likelihood of restoration cannot be evaluated solely by determining whether medication might reduce psychiatric symptoms. The relevant question is whether treatment is reasonably expected to improve the defendant’s legally required functional abilities without creating impairments that would undermine meaningful participation in the proceedings.
Forensic psychologists play an important role in evaluating restoration progress, identifying persistent barriers to competency, and providing opinions regarding the likelihood of future restoration. These opinions may involve assessing whether observed improvements represent meaningful gains in adjudicative functioning, whether additional interventions are likely to be beneficial, and whether the available evidence supports continued restoration efforts.
Although forensic evaluators may offer opinions concerning restoration potential, the ultimate decisions regarding competency, continued commitment, and the legal permissibility of involuntary treatment rest with the court.
At Utah Center for Psychological Services, our forensic psychologists approach competency restoration questions with an emphasis on functional assessment, careful consideration of treatment response, and recognition of the constitutional and statutory limitations governing restoration. Our objective is to provide scientifically grounded opinions that assist attorneys and courts in distinguishing temporary incompetence from impairments that may be unlikely to resolve sufficiently for criminal proceedings to continue.
Forensic competency evaluations provide courts with specialized psychological information regarding a defendant’s ability to understand criminal proceedings and meaningfully participate in their defense. However, the relationship between clinical findings and legal competency determinations requires careful consideration. Although forensic psychologists may offer opinions regarding a defendant’s adjudicative abilities, competency to stand trial is ultimately a legal determination made by the court.
The foundational standard established in Dusky v. United States, 362 U.S. 402 (1960) requires sufficient present ability to consult with counsel with a reasonable degree of rational understanding, as well as a rational and factual understanding of the proceedings. Accordingly, the forensic psychologist’s responsibility extends beyond identifying psychiatric symptoms or cognitive deficits. The evaluator must explain how those findings relate to the defendant’s specific functional abilities under the applicable legal standard.
Under Utah Code § 77-15-5, forensic evaluators must address the relationship between mental illness or intellectual disability and the defendant’s adjudicative capacities. The statute also establishes requirements for written reports, including identification of assessment procedures, clinical observations, sources of information, and the basis for the evaluator’s opinions.
These requirements underscore an important principle: a competency opinion must be supported by a transparent explanation of how the available evidence informs conclusions about the defendant’s legally relevant abilities.
Under Utah Rule of Evidence 702, expert testimony must satisfy requirements concerning the expert’s qualifications, the reliability of the underlying principles and methods, the sufficiency of the supporting facts or data, and the application of those methods to the facts of the case.
Although competency proceedings are governed by specific statutory procedures, these evidentiary principles provide an important framework for understanding the scientific foundation of forensic psychological opinions.
A scientifically defensible competency opinion should consider:
Adequacy of assessment methods: Whether the evaluation procedures were appropriate for examining the defendant’s factual understanding, rational appreciation, and ability to assist counsel.
Relationship between symptoms and functioning: Whether identified psychiatric or cognitive impairments meaningfully interfere with legally relevant abilities.
Consistency across evidence: Whether clinical interviews, behavioral observations, psychological testing, and available records support the evaluator’s conclusions.
Response validity: Whether exaggerated symptoms, inconsistent responding, or other response patterns affect confidence in the assessment findings.
Alternative explanations: Whether observed difficulties may reflect limited education, language differences, unfamiliarity with legal proceedings, unwillingness to cooperate, or other factors.
Temporal considerations: Whether the defendant’s functioning has changed since previous evaluations and whether current findings adequately reflect present abilities.
Limitations of the available information: Whether missing records, incomplete assessment data, or other methodological constraints limit the certainty of the opinions offered.
Importantly, structured competency assessment instruments do not independently determine legal competence. Although standardized measures may provide useful information about adjudicative abilities, their findings must be interpreted within the broader clinical and legal context.
Competency evaluations may produce conflicting opinions, particularly when defendants present with complex psychiatric symptoms, fluctuating functioning, intellectual limitations, or disputed response validity findings.
A disagreement between forensic psychologists does not necessarily indicate that either evaluation is scientifically inadequate. Different conclusions may arise from changes in the defendant’s condition, differences in available information, or differing interpretations of the relationship between clinical findings and adjudicative functioning.
Under Utah Code § 77-15-5, conflicting competency opinions may be addressed through testimony at a competency hearing. The statute provides that when forensic evaluators disagree, they should be called to testify if reasonably available. However, conflicting opinions do not automatically require the appointment of another evaluator.
In such circumstances, careful examination of the reasoning underlying each opinion may be particularly important. Attorneys and courts may need to consider whether the evaluators applied the appropriate legal standard, adequately examined functional abilities, considered relevant evidence, and clearly explained the basis for their conclusions.
The distinction between expert opinions and judicial determinations is fundamental to competency proceedings.
In Pate v. Robinson, 383 U.S. 375 (1966), the United States Supreme Court held that due process was violated when the trial court failed to conduct an adequate competency inquiry despite evidence raising sufficient doubt about the defendant’s competence. The decision reinforces the constitutional importance of judicial consideration of competency concerns rather than treating competency as a matter resolved solely through clinical observation.
Similarly, Drope v. Missouri, 420 U.S. 162 (1975) emphasized that competency concerns may arise throughout criminal proceedings and that courts must remain attentive to evidence suggesting a defendant may be unable to proceed.
These decisions illustrate why forensic competency evaluations must communicate not only an ultimate opinion, but also the clinical findings, functional impairments, and limitations that inform that opinion.
A forensic psychologist may conclude that the available evidence supports competence or incompetence under the applicable legal standard. However, the court retains responsibility for weighing the evidence, resolving disagreements, and making the ultimate legal determination.
Forensic psychologists must also distinguish their professional responsibilities from the interests of the party requesting the evaluation. Whether appointed through the court or retained independently by defense counsel or prosecutors, the evaluator’s responsibility is to provide an objective assessment grounded in the available evidence.
Competency opinions should not be influenced by the seriousness of the alleged offense, the anticipated consequences of prosecution, or a preference for a particular legal outcome. Similarly, the presence of unusual behavior, psychiatric symptoms, or poor legal decision-making should not be equated with incompetence without demonstrating how those factors impair legally relevant functional abilities.
At Utah Center for Psychological Services, our forensic psychologists emphasize scientifically grounded assessment, transparent reasoning, and careful consideration of the limits of competency evidence. Our objective is to provide courts and attorneys with independent opinions that clearly distinguish clinical findings from legal conclusions and meaningfully address the defendant’s ability to participate in criminal proceedings.
Competency evaluations are private pay. Insurance does not cover the cost of these evaluations.
For additional payment information, visit our Fees & Insurance page.
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Contact UCPS to discuss a competency to stand trial evaluation in Salt Lake City. We can review the referral questions, any court requirements, and your timeline, then clarify the next steps.
Schedule a competency evaluation or contact our office to learn more.
A competency evaluation examines a person’s current ability to understand criminal proceedings and assist their attorney in their defense. It considers how psychological symptoms or cognitive difficulties may affect those abilities.
No. A diagnosis alone does not establish incompetence. Instead, the evaluation examines how the person’s current symptoms and functioning affect their ability to understand the proceedings and participate in their defense.
No. Competency concerns a person’s present ability to participate in legal proceedings. Criminal responsibility concerns their mental state at the time of the alleged offense. These evaluations address different legal questions.
Competency evaluations usually take 2–4 weeks to complete. However, the timeline depends on the case’s complexity, the volume of records to review, and timely access to records and collateral sources. If you have a court deadline, please discuss it with us when making the referral.
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