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Ask the Mental Health Expert Archives 2001-2004

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Ask the Expert - ADHD Case

Q. Recently a local judge saw a case where a 16-year-old charged with several serious offenses also happened to have ADHD. The judge determined that the youth was incompetent to stand trial because of his mental illness (ADHD being the only diagnosis). I have the opportunity in 2 weeks to talk with this judge in his chambers regarding ADHD. What advice can you give me regarding my approach? Is there any case law supporting or refuting the judge's position?

A. I'm afraid that without knowing more about your professional involvement in the case, it's hard for me to give you any direct advice. However, I can offer some resources and a few comments. First off, I did not find any literature citations specifically addressing the competency of ADHD youths to stand trial. However, there is an article by Dr. E.M. Ouelette entitled, "Legal issues in the treatment of children with attention deficit hyperactivity disorder" (J Child Neurol 1991;6 Suppl:S68-75) that may be of help in your preparations. I would also consider contacting the Bazelon Center of Mental Health Law (http://www.bazelon.org/) to see if they are aware of any case law in this area.Other potentially helpful resources are the ADD/LD Online Resource Center (http://www4.interaccess.com/add/) and the National Attention-Deficit Disorder Association at http://www.ad.org.

Regarding competency to stand trial, it is surprising to me that a child would be adjudicated incompetent on the basis of ADHD alone. The threshold for competency to stand trial is usually so low that only individuals with a grossly disturbed sense of reality (e.g., acutely manic individuals, those with schizophrenia or severe psychotic depression, etc.) would be unable to meet the usual criteria for competency to stand trial; i.e., ability to understand the charges; to understand the function of the judge, jury, and attorneys; and the ability to cooperate with counsel. You may want to read more on this in the excellent book by Dr. Robert Simon, entitled, "Psychiatry and Law for Clinicians" (American Psychiatric Press, 1998).

Good luck with your meeting. Other Resources

January 2002

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