Jared Loughner: How to tell if shooting suspect is fit to stand trial?

The accused gunman in January's Tucson rampage showed signs of mental instability before the shooting. But his competence to stand trial is a different matter than whether he is mentally ill.

Is Jared Loughner, the accused shooter in the Jan. 8 rampage in Tucson, Ariz., that left six dead and 13 wounded, fit to stand trial?

His mental competency is the subject of a hearing Wednesday in federal court here, where a judge will consider written reports from two forensic mental-health professionals who evaluated Mr. Loughner at a US prison complex in Missouri. Loughner, now back in Arizona, faces charges stemming from a shooting spree at a political meet-and-greet event for US Rep. Gabrielle Giffords, who was seriously injured in the attack.

But psychologist Christina Pietz and psychiatrist Matthew Carroll are not expected to testify. The prosecution and defense have agreed to rely on the doctors’ written reports, a move that suggests to some experts that the evaluators probably came to the same conclusion about Loughner’s mental competency.

“Usually if there’s more than one evaluator and they agree, the judge almost without exception will simply rule in accordance with their recommendations,” says Joel Dvoskin, a forensic psychologist at the University of Arizona College of Medicine in Tucson.

The fact that the doctors won't testify at the hearing may point to a determination of incompetence, suggests Stephen Golding, a forensic psychologist and professor emeritus at the University of Utah in Salt Lake City.

The key point is whether Loughner can understand the legal proceedings against him and help his attorney mount a defense, a standard that derives from a 1960 US Supreme Court ruling known as Dusky v. the United States.

If Loughner is deemed incompetent, he would be committed to a mental hospital and a trial delayed until his competency is restored.

A finding of incompetence is uncommon, and when it happens, the competency of most defendants is usually restored with treatment that often involves drugs, Professor Golding says.

In instances where competency cannot be restored, he adds, charges against defendants may be dismissed without prejudice – meaning they can be reinstated later.

Loughner displayed erratic behavior that signaled mental instability months before the weekend shooting outside a supermarket. Pima Community College suspended Loughner late last year after taking notice of a video in which he calls the Tucson campus “my genocide school.”

“Pretty clearly, Mr. Loughner has serious mental problems,” Golding adds.

Still, a diagnosis of mental illness does not necessarily mean defendants are unable to understand the proceedings and cooperate with attorneys. But it almost always triggers a mental evaluation and hearing intended to avert potential problems during a trial, he says.

Golding figures competency is raised, at most, in 5 percent to 10 percent of serious felony cases under the Dusky ruling that most states follow, with slight variations. “When it’s raised, people are found competent about 80 percent of the time,” he says.

Competence and the insanity defense are often confused, says Edward Mulvey, a psychologist and professor of psychiatry at the University of Pittsburgh in Pennsylvania. While competence deals with mental illness in the present, insanity refers to mental illness when the crime occurred, which can be months or years in the past, he says.

The defendant faces 49 counts stemming from the mass shooting and has pleaded not guilty in federal court. The victims include John Roll, a federal judge, a congressional aide, and a 9-year-old girl, Christina Taylor Green. Representative Giffords, a Democrat, was shot in the head and continues her recovery in a Texas hospital.

The Wednesday hearing is before US District Judge Larry Burns.