What the evaluation is for
The widely used Dusky framework concerns a defendant’s rational and factual understanding of the proceedings and ability to assist counsel. The examiner provides an opinion to the court. Washington’s forensic service describes this framework and its evaluators’ use of treatment, educational, criminal, and social histories. See Washington DSHS: Competency Evaluations.
The applicable legal standard, appointment requirements, and report instructions depend on the jurisdiction. Begin with the actual order and current local requirements; this page is a general record-preparation guide.
What the examination considers
AAPL’s practice guideline describes an evaluation that integrates the referral, clinical interview, mental status findings, collateral information, and assessment of abilities relevant to the proceedings. A diagnosis by itself does not settle the competency question. The reasoning needs to connect the person’s symptoms or limitations with the abilities being evaluated.
The evaluator should clarify the forensic role and limits of confidentiality. Competency concerns present participation in the case; criminal responsibility at the time of an alleged offense is a separate question. Structured instruments may inform an evaluation, but they do not replace the examiner’s reasoning. See AAPL’s practice guideline on competence to stand trial.
Prepare a focused record packet
For your working index, separate the legal referral from the clinical history. Include only material you are authorized to obtain and review for the assignment.
Keep a visible distinction between material supplied, material requested, and material unavailable. This makes the limits of the record review easier to describe later.
Separate history from current evidence
A useful preparation note has three parts: the source statement, its date and context, and the question it raises for the examination. For example, a past note about difficulty following a conversation can prompt further inquiry; it does not establish the person’s present ability to work with counsel.
Record disagreements without smoothing them into one account. A clinician, family member, and correctional observer may describe different settings and periods. Preserve those differences so the examiner can evaluate their significance.
Before writing, return to the referral question and identify which conclusions rely on direct examination, which rely on collateral information, and where the available evidence remains limited.
Where PsyReview fits
PsyReview can help organize authorized medical records into a chronology and source-linked review before the forensic interview. Use it to find relevant passages and prepare questions for further inquiry.
Check every generated summary you intend to use. PsyReview does not assess competency, select a legal standard, or replace the forensic interview and professional opinion. The court determines competency.
Sources and scope
- AAPL: Practice Guideline for the Forensic Psychiatric Evaluation of Competence to Stand Trial, 2007. Used for general evaluation principles, not its historical state-law tables.
- Washington DSHS: Competency Evaluations. A state-service example; Washington procedures do not apply nationwide.
Sources checked November 4, 2026. This editorial guide describes preparation, not a complete forensic protocol or legal advice.