The Content and Quality of Forensic Reports of Competency to Stand Trial Evaluations

Forensic report writing is a complex yet vitally important task for legal decision-makers who rely upon forensic examiners. Empirical evaluations of the content and quality of forensic reports have identified concerning deficiencies in forensic reports through many years and across several jurisdictions. A substantial portion of reports have failed to include proper documentation of the ethical requirement to notify the examinee of the purpose of the evaluation and limits to confidentiality. Another recurring theme is the variable use of third-party information rather than over-reliance on the defendant’s self-report. Further, evaluators tend to struggle in the substantiation of their psycholegal opinions and the discussion of competency-related abilities, even when required by statute. The current archival review examined the content and quality of 352 reports of competency to stand trial (CST) evaluations conducted from 2008 to 2016 in an urban jurisdiction of Texas. Reports were authored by 28 psychologists and psychiatrists from ten agencies, hospitals, or practices. Reports were coded by six doctoral-level graduate students with forensic evaluation training and experience. Raters coded the substantiation of clinical and psycholegal opinions, and reports were coded for the presence of factors required by state statute and Principles of Forensic Mental Health Assessment (Heilbrun, 2001). Relative to previous research, results revealed improvements in key areas of documentation of the forensic notification and use of third-party information. While the majority of reports addressed individual functional abilities of CST, comprehensive assessment of these areas was poor. Further, reports were deficient in connecting impairments in competency-relevant abilities to symptoms of mental illness. Implications for clinical forensic practice are discussed