Death row executions raise questions about competence

AUSTIN, TEX. – More than one-quarter of inmates executed during a recent 7-year period had a history confirming or suggesting they had a mental illness that might have called their competence for execution into question, according to new research.

Capital punishment remains legal in 31 U.S. states. In Ford v. Wainwright, the U.S. Supreme Court ruled in 1986 that executing a person lacking competence violates the Eighth Amendment, yet many people with a history of mental illness have been executed, said Paulina Riess, MD, of the BronxCare Health System in New York, and her colleagues.

The question of appropriately determining whether someone is competent enough to be executed also is controversial, Dr. Riess and her colleagues noted in their research abstract at the annual meeting of the American Academy of Psychiatry and the Law. “The decision of whether one is competent ultimately falls into the hands of a forensic evaluator whose opinion should represent a clear and detailed explanation of a prison’s understanding, awareness, and comprehension of the pending execution.”

The researchers sought to determine how many death row inmates executed between 2010 and 2017 had a mental illness or disability diagnosis, had received a psychotropic medication, or both. They also collected data on inmates’ age, race, instant offense, method of execution, and years spent on death row.

When the authors searched the literature for an evidence-based tool to provide “information regarding any history of mental illness pertaining to executed prisoners,” they found none and therefore relied on media coverage for their data on history of mental illness or disability or psychotropic medication treatment.

They found that 26% had a history of psychiatric illness, mental disability, or treatment with psychiatric medications.

Among 273 people executed from 2010-2017, all but 5 were men. Texas had the most executions at 80, followed by Florida (27), Georgia (23), Ohio (22), Oklahoma (21), and Alabama (17). Other states in the analysis included Arizona, Arkansas, Idaho, Louisiana, Mississippi, South Carolina, South Dakota, Utah, and Virginia.

Five of the inmates were aged older than 70 years, and seven were under 30 years old. Most were aged 31-40 years (73 inmates) or 40-50 years (108 inmates). The racial breakdown was 147 whites, 90 blacks, 35 Hispanics, and 1 Native American.

Lethal injection was the method of execution for all – except one who died by firing squad and two who died by electrocution. Seven inmates had been convicted for mass murder or serial killing (one of whom also had a robbery conviction). The others all had homicide convictions, 61 of whom had at least one other conviction in addition to homicide – predominantly robbery or rape.

Of those with information available, 117 inmates spent 11-20 years on death row, 64 spent 21-30 years, and 15 spent 31-40 years. Only five inmates spent fewer than 5 years on death row, and 49 inmates spent 5-10 years.

The need to rely on media reports for data collection is a limitation of the study. “While gathering demographic information, team members unanimously reported a history of trauma in a large portion of those executed during the 7-year span examined,” the authors reported. “This is another limitation as trauma history could have been included as a separate variable.”

No disclosures were reported.

AUSTIN, TEX. – More than one-quarter of inmates executed during a recent 7-year period had a history confirming or suggesting they had a mental illness that might have called their competence for execution into question, according to new research.

Capital punishment remains legal in 31 U.S. states. In Ford v. Wainwright, the U.S. Supreme Court ruled in 1986 that executing a person lacking competence violates the Eighth Amendment, yet many people with a history of mental illness have been executed, said Paulina Riess, MD, of the BronxCare Health System in New York, and her colleagues.

The question of appropriately determining whether someone is competent enough to be executed also is controversial, Dr. Riess and her colleagues noted in their research abstract at the annual meeting of the American Academy of Psychiatry and the Law. “The decision of whether one is competent ultimately falls into the hands of a forensic evaluator whose opinion should represent a clear and detailed explanation of a prison’s understanding, awareness, and comprehension of the pending execution.”

The researchers sought to determine how many death row inmates executed between 2010 and 2017 had a mental illness or disability diagnosis, had received a psychotropic medication, or both. They also collected data on inmates’ age, race, instant offense, method of execution, and years spent on death row.

When the authors searched the literature for an evidence-based tool to provide “information regarding any history of mental illness pertaining to executed prisoners,” they found none and therefore relied on media coverage for their data on history of mental illness or disability or psychotropic medication treatment.

They found that 26% had a history of psychiatric illness, mental disability, or treatment with psychiatric medications.

Among 273 people executed from 2010-2017, all but 5 were men. Texas had the most executions at 80, followed by Florida (27), Georgia (23), Ohio (22), Oklahoma (21), and Alabama (17). Other states in the analysis included Arizona, Arkansas, Idaho, Louisiana, Mississippi, South Carolina, South Dakota, Utah, and Virginia.

Five of the inmates were aged older than 70 years, and seven were under 30 years old. Most were aged 31-40 years (73 inmates) or 40-50 years (108 inmates). The racial breakdown was 147 whites, 90 blacks, 35 Hispanics, and 1 Native American.

Lethal injection was the method of execution for all – except one who died by firing squad and two who died by electrocution. Seven inmates had been convicted for mass murder or serial killing (one of whom also had a robbery conviction). The others all had homicide convictions, 61 of whom had at least one other conviction in addition to homicide – predominantly robbery or rape.

Of those with information available, 117 inmates spent 11-20 years on death row, 64 spent 21-30 years, and 15 spent 31-40 years. Only five inmates spent fewer than 5 years on death row, and 49 inmates spent 5-10 years.

The need to rely on media reports for data collection is a limitation of the study. “While gathering demographic information, team members unanimously reported a history of trauma in a large portion of those executed during the 7-year span examined,” the authors reported. “This is another limitation as trauma history could have been included as a separate variable.”

No disclosures were reported.

AUSTIN, TEX. – More than one-quarter of inmates executed during a recent 7-year period had a history confirming or suggesting they had a mental illness that might have called their competence for execution into question, according to new research.

Capital punishment remains legal in 31 U.S. states. In Ford v. Wainwright, the U.S. Supreme Court ruled in 1986 that executing a person lacking competence violates the Eighth Amendment, yet many people with a history of mental illness have been executed, said Paulina Riess, MD, of the BronxCare Health System in New York, and her colleagues.

The question of appropriately determining whether someone is competent enough to be executed also is controversial, Dr. Riess and her colleagues noted in their research abstract at the annual meeting of the American Academy of Psychiatry and the Law. “The decision of whether one is competent ultimately falls into the hands of a forensic evaluator whose opinion should represent a clear and detailed explanation of a prison’s understanding, awareness, and comprehension of the pending execution.”

The researchers sought to determine how many death row inmates executed between 2010 and 2017 had a mental illness or disability diagnosis, had received a psychotropic medication, or both. They also collected data on inmates’ age, race, instant offense, method of execution, and years spent on death row.

When the authors searched the literature for an evidence-based tool to provide “information regarding any history of mental illness pertaining to executed prisoners,” they found none and therefore relied on media coverage for their data on history of mental illness or disability or psychotropic medication treatment.

They found that 26% had a history of psychiatric illness, mental disability, or treatment with psychiatric medications.

Among 273 people executed from 2010-2017, all but 5 were men. Texas had the most executions at 80, followed by Florida (27), Georgia (23), Ohio (22), Oklahoma (21), and Alabama (17). Other states in the analysis included Arizona, Arkansas, Idaho, Louisiana, Mississippi, South Carolina, South Dakota, Utah, and Virginia.

Five of the inmates were aged older than 70 years, and seven were under 30 years old. Most were aged 31-40 years (73 inmates) or 40-50 years (108 inmates). The racial breakdown was 147 whites, 90 blacks, 35 Hispanics, and 1 Native American.

Lethal injection was the method of execution for all – except one who died by firing squad and two who died by electrocution. Seven inmates had been convicted for mass murder or serial killing (one of whom also had a robbery conviction). The others all had homicide convictions, 61 of whom had at least one other conviction in addition to homicide – predominantly robbery or rape.

Of those with information available, 117 inmates spent 11-20 years on death row, 64 spent 21-30 years, and 15 spent 31-40 years. Only five inmates spent fewer than 5 years on death row, and 49 inmates spent 5-10 years.

The need to rely on media reports for data collection is a limitation of the study. “While gathering demographic information, team members unanimously reported a history of trauma in a large portion of those executed during the 7-year span examined,” the authors reported. “This is another limitation as trauma history could have been included as a separate variable.”

No disclosures were reported.