Fitness or Competency to Plead or Stand Trial

Being present and able to participate in one's own trial is a basic constituent of legal procedure. In the United Kingdom, common law based on the definitive case R v. Pritchard has provided the basis for Anglo-American law. In the United Kingdom, fitness to plead is rarely raised because of the delays it causes. The easily available alternative of expeditious treatment in the civil mental health system is chosen instead. In Canada, legislation has codified the criteria for fitness to stand trial and the consequent admission to a forensic hospital. This is commonly used, resulting in the expeditious treatment to fitness in most cases. It's difficult to generalize in the United States, because there are 50 states and 2 territories, all of which have their own criminal legislation. Competence to stand trial is a common assessment for forensic psychiatrists and can cause admission to hospital and subsequent restoration of competence. In this chapter, we discuss these approaches and provide an overview and introduction to the law, theory, and practice of each approach.