What are Psychotropic Medications and How are they used in Criminal Trials?

June 7, 2022 News & Announcements

Psychotropic medications are prescribed to have an affect on behavior, mood, thoughts, or perception. There are five major categories of psychotropic medications: anti-anxiety agents, antidepressants, antipsychotics, mood stabilizers, and stimulants. Some of the mental conditions that psychotropic medications are prescribed for are anxiety, depression, schizophrenia, bipolar disorder, and sleep disorders.

In 2020, the Substance Abuse and Mental Health Services Administration found that 52.9 million (about 1 in 5 adults) Americans reported a mental illness and 14.2 million (about one in 20 adults) people reported a severe mental illness.

Psychotropic medications may be ordered in criminal trials to restore the defendant’s competency to stand trial and understand the proceedings. Learn more about the use of psychotropics medications and the implications of using them in this blog.

Psychotropic Medications and Competency to Stand Trial

The defendant’s competency to stand trial is extremely important to our justice system. The basic principle is that the justice system wants criminal defendants to be aware of the proceedings and be able to participate in the proceedings. This includes not only the ability to stand trial but to be put to death.  Florida Statute Section 916.12, states that the criminal defendant is incompetent to proceed when:

  • The defendant is currently lacking the ability to consult with their attorney with a reasonable degree of rational understanding, or
  • The defendant has no ration and factual understanding of the proceedings that are occurring against him.

When there are questions about whether a defendant’s competency is at issue, then the law requires that an expert examine the defendant and determine whether the defendant has the capacity to continue in criminal proceedings. The following areas must be addressed in the expert’s report.

  • The defendant’s ability to appreciate the charges or allegations against them.
  • The defendant’s ability to appreciate the range and nature of the possible penalties that they may be facing during the proceedings.
  • The defendant’s ability to understand the adverse nature of the legal process.
  • The defendant’s ability to disclose to their attorney important facts about the current proceedings.
  • The defendant’s ability to manifest appropriate courtroom behavior.
  • The defendant’s ability to testify relevantly.

Additionally, the expert may include other facts that they deem relevant in their report.

In addition to an evaluation of competency, the expert also has to include how effective medical treatment would be to restore the defendant’s competency. The following areas must be addressed in the expert’s report if they deem the defendant to be incompetent to proceed.

  • Identify the mental illness causing the incompetence;
  • Explain the possible treatments available for the mental illness and any alternative treatments;
  • The availability of acceptable treatment and, if treatment is available in the community, the expert shall so state in the report; and
  • The likelihood of the defendant attaining competence under the treatment recommended an assessment of the probable duration of the treatment required to restore competence and the probability that the defendant will attain competence to proceed in the foreseeable future.

Learn more about the competency to stand trial here.

The mere fact that the defendant is on psychotropic medication in order to understand the criminal proceedings does not mean that the defendant is incompetent to proceed. If the psychotropic medication restores their competency, then they are “restored” and able to proceed.

Florida Statute Section 916.105, states that the Department of Children and Families (DCF) and the Agency for Persons with Disability (the Agency) have the duty to establish, locate, and maintain forensic facilities and programs to treat defendants found to be incompetent. The defendants either have to be in the care of DCF, the Agency, or a civil facility if the facility is deemed to be appropriate. Once a defendant has been found to be incompetent, then they are to be involuntarily committed to DCF or the Agency. 

What are the Defendant’s Rights

Defendants have rights after they have been deemed incompetent and have been committed to a facility for treatment. Florida Statute Section 916.107 covers the defendant’s rights in this situation.

First and foremost, the defendant has a right to individual dignity, and they have the same rights as other individuals who are committed to these facilities.

The defendant has a right to treatment, even if the defendant does not have the ability to pay for their treatment. The defendant also has a right to know what their individual treatment plan is.

The defendant has the right to express and informed content. There are specific procedures that the court and facility have to follow if the defendant refuses treatment. Treatment may be provided in certain circumstances when the defendant has refused and the defendant’s multidisciplinary treatment team deems the treatment necessary and essential.

In the case of an emergency where there is an immediate danger to the safety of the defendant or others, the treatment may be provided for 48 hours until an emergency petition can be heard in the court. In cases where there is no emergency for safety, the facility must petition the court for an order authorizing necessary and essential treatment of the client.

At the hearing, the court has to find clear and convincing evidence for the following:

  • The defendant has a mental illness, intellectual disability, or autism;
  • The defendant did not consent to the treatment;
  • The treatment is essential to the care of the defendant; and
  • The treatment is not experimental and does not present an unreasonable risk or serious hazardous, or irreversible side effects.

In Louisma v State, the defendant was deemed incompetent to stand trial. The defendant then refused treatment, DCF requested that the court order treatment using psychotropic medication. The trial court approved the treatment so that the defendant could regain their competency to stand trial. The appeals court reversed the treatment order because the trial court did not hear from the multidisciplinary team, the psychologist that testified at the hearing was not a part of the defendant’s team. In order for treatment to be given against the consent of the defendant, the defendant’s multidisciplinary team must deem the treatment to be necessary and essential.

Psychotropic Medications and the Insanity Defense

The Florida Rules of Criminal Procedure state that a defendant who, because of psychotropic medication, is able to understand the proceedings and assist in the defense may motion the court to read an instruction to the jury about the medication.

Florida Jury Instruction 2.1(d) reads:

Defendant currently is being administered psychotropic medication under medical supervision for a mental or emotional condition. Psychotropic medication is any drug or compound affecting the mind or behavior, intellectual functions, perception, moods, or emotion and includes anti-psychotic, anti-depressant, anti-manic, and anti-anxiety drugs. You shall not allow the defendant’s present condition in court or any apparent side effect from the medication that you may observe in court to affect your deliberations.

This instruction may be very important to the defendant’s case, especially if the defendant wants to use the insanity defense. The insanity defense is used when the defendant is trying to excuse their actions by showing that they are not guilty of the crime due to their mental health issues. An individual acquitted due to insanity will be committed to a mental institution. Florida Statute Section 775.027 explains that defendants are presumed to be sane, and it is the burden of the defendant by clear and convincing evidence (which means that the evidence shows that it is more likely than not that the fact is true) to establish that:

  • They have a mental illness, disease, infirmity, or defect, and
  • Due to the condition
    • The defendant did not know what they were doing, or the consequences involved, or;
    • The defendant knew what they were doing and the consequences but could not grasp that the actions were wrong.

Read more about the insanity defense and the process in our blog here.

In insanity defense cases, it may help the jury to know that the defendant is on a psychotropic medicine, so defense counsel can request that jury instruction 2.1(d) be read to the jury. In Rosales v State, the appeals court held that it was an error for the trial court to fail to read the jury instruction on psychotropic medication even though the defense requested the instruction. The error was so harmful that the conviction of the defendant was overturned, and the case was set for retrial.

In Adams v State, the defendant was on psychotropic medications and took the stand to testify. The defendant’s counsel failed to request the court to read psychotropic medication instructions to the jury. The appeals court overturned the conviction, finding that the defendant’s counsel was ineffective. There were a few reasons why the defense counsel was deemed to be ineffective but one major reason is that the defense counsel failed to request the jury instruction be read. When a defendant’s attorney is deemed ineffective under the Strickland test, the court reverses the conviction for a new trial. Read more about ineffective assistance of counsel here.

Finding a Defense Attorney in Tallahassee, Florida

If you or a loved one have been accused of a crime and believe that they may lack the competency to stand trial or that the insanity defense could be used, it is important to seek out the legal advice of a skilled defense attorney in Tallahassee, Florida. Navigating the legal world is extremely stressful already and a possible mental illness is only going to make things more difficult. Do not let this stop you from receiving the top-quality legal help you or your loved one deserve.

Don Pumphrey and his team at Pumphrey Law Firm have experience representing clients across the state of Florida for various cases. They understand the importance of strategizing a strong defense and are prepared to stand in your corner to fight for your freedom. Don’t hesitate to call (850) 681-7777 or leave an online message to receive a free consultation.

Written by Melissa MacNicol

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