The National Mental Health Association's position on the death penalty and people with mental illness

Policy Position: P-44
DEATH PENALTY AND PEOPLE WITH MENTAL ILLNESS
Background: Over the past thirty years, the number of people with mental illness and other mental disabilities on death row has steadily increased.
(1) Although precise statistics are not available, it is estimated that 5-10 percent of people on death row have a serious mental illness.
(2) NMHA believes that mental illness can influence an individual’s mental state at the time he or she commits a crime, can affect how "voluntary" and reliable anindividual’s statements might be, can compromise a person’s competence to stand trialand to waive his or her rights, and may have an effect upon a person’s knowledge of the criminal justice system.

The process of determining guilt and imposing sentence is necessarily more complex for individuals with mental illness. A high standard of care is essential with regard to legal representation as well as psychological / psychiatric evaluation for individuals with mental illness involved in death penalty cases. NMHA believes mental illness should always be taken into account during all phases of a potential death penalty case. Moreover, the assessment of competency to stand trial as well as competency to be executed should be conducted by a multi-disciplinary team of qualified professionals, including professionals with expertise in the defendant’s particular mental illness.

Some states require a prediction of future dangerousness in order to impose a death sentence. However, research has shown predictions of future dangerousness to be unscientific and frequently inaccurate. Therefore, such predictions are highly suspect as a basis on which to impose the death penalty. Moreover, there is a danger that the wholly unwarranted perception that mental illness is associated with violence could bias such predictions. In fact, research shows that people with mental illness pose no greater risk of violence than the average person.

(3) Unfortunately, however, the misperceived link between mental illness and violence drives both legal policy and criminal justice system practice with respect to people with mental illness.
In 1986, the Supreme Court ruled that people with mental illness can be executed if they understand the punishment that awaits them and why they are being put to death. This ruling has prompted some states to provide psychiatric treatment to offenders with mental illness on death row in order to "restore their competency." Consistent with the code of ethics of the American Medical Association, NMHA is opposed to the practice of having a psychiatrist or other mental health professional treat a person in order to restore competency solely to permit the state to execute that person. Similarly, NMHA is opposed to the practice of medicating defendants involuntarily in order to make them competent either to stand trial or to be executed. Great care must be taken to assure informed consent for treatment / no treatment options.

NMHA believes that our current system of fact-finding in capital cases fails to identify who among those convicted and sentenced to death actually has a mental illness. Thus, there is reason to believe that individuals with mental illness are being executed without the criminal justice system knowing of the existence of that illness and, therefore, without the requisite consideration of whether that mental illness may be a mitigating factor in these cases. Our current system of justice does not adequately address the complexity of cases involving defendants with mental illness. Therefore, NMHA calls upon states to suspend use of the death penalty until more just, accurate and systematic ways of determining a defendant’s mental status are developed. This position supports the American Bar Association’s (ABA) call for a moratorium on the imposition of the death penalty because, in its judgment, "fundamental due process is systematically lacking" in capital cases.