Analyzing the Successful Incompetent to Be Executed Cases in the United States: A First Pass

More than three decades ago, the Supreme Court of the United States (SCOTUS) ruled that individuals who are not competent (alternatively referred to by the Court as insane) at the time of their scheduled execution cannot be put to death. Despite the years that have passed since the Court's decision and the literal life-or-death stakes involved, competency for execution (CFE) remains underexplored in the psychological, psychiatric, and legal literature. A number of important legal and ethical issues that arise when a person on death row maintains they are not competent to be executed are still unresolved even after the landmark Supreme Court cases such as <i>Ford v. Wainwright</i> (1986), <i>Panetti v. Quarterman</i> (2007), and <i>Madison v. Alabama</i> (2019). In this first-of-its-kind descriptive study, we analyzed the demographic and case characteristics of the 28 successful <i>Ford</i> claimants-individuals in the United States who have been found to be incompetent to be executed and compared them to the general death row population and homicide cases nationwide. Our findings reveal some similarities but also some differences between these claimants and the general death row population and homicide cases: the successful <i>Ford</i> claimants are exclusively male (in keeping with the general prison population on death row), relatively older, and underrepresented among White and Latinx inmates (i.e., Black claimants are more successful than their White and Latinx counterparts at evading execution). Nearly all (96%) suffer from schizophrenia, with 79% experiencing psychiatric comorbidity, yet only 54% received any significant treatment before or after the criminal offense. The claimants' cases also involve a higher proportion of child victims, male family members, and female non-family member victims, as well as more multiple-victim cases (not indiscriminate) and fewer intraracial homicides. Fewer victims are male, and more are female. However, the cases do not align with typical male-on-male violent crimes or femicide patterns, such as those involving sexual or domestic violence. Additionally, systematic psycho-legal deficiencies are prevalent, including a low rate of mental health evidence (61%) presented at trials and some cases lacking psychiatric involvement in CFE evaluations. Temporal influence and drastic state variations on CFE evaluation are also noted. Although the small sample size limits generalizability, this small-scale descriptive study offers a number of important insights into the complexities of CFE decisions and lays the groundwork for future research and policy development.