Competency and Criminal Responsibility in Massachusetts

By Kevin R. Collins, Esq.

July 2025

The intersection of mental health and criminal law presents one of the most complex challenges in the Massachusetts judicial system. Massachusetts’ approach to competency and criminal responsibility reflects centuries of legal evolution, balancing the fundamental principles of justice with the recognition that mental illness can profoundly affect an individual’s culpability and ability to participate in legal proceedings. If you or a loved one struggles with a serious mental health condition and are facing criminal charges, this guide will enable you to determine how the case will proceed through the system.

Competency to Stand Trial

Legal Standard

In Massachusetts, competency to stand trial is governed by Massachusetts General Laws (“M.G.L.”) Chapter 123, Section 15, and has been refined through decades of case law. The fundamental two questions are 1) whether defendants have a sufficient ability to consult with counsel to assist in their defense and 2) whether they understands the nature of the proceedings against them.

Evaluation Process

When competency is questioned, the court may order a psychological evaluation under M.G.L. c. 123, § 15(a). The evaluation must be conducted by qualified mental health professionals typically psychiatrists or psychologists with forensic training. The Department of Mental Health maintains a roster of approved evaluators who can conduct these assessments.

The evaluation process typically includes a clinical interview, review of medical and legal records, psychological testing when appropriate, and assessment of the defendant’s understanding of legal proceedings. Evaluators must address specific competency-related abilities including understanding of charges, potential penalties, legal defenses, and the roles of court personnel.

Burden of Proof

The prosecution bears the burden of proving the defendant competent by a preponderance of evidence. The defense may request a hearing, call witnesses and experts to testify, and ultimately the judge determines whether the defendant is competent to stand trial.  

Restoration of Competency

If a defendant is found incompetent, Massachusetts law provides for treatment aimed at restoration of competency. Under M.G.L. c. 123, § 15(b), the court may commit the defendant to a state hospital or approve outpatient treatment. The treatment period is limited, and periodic reviews are required to assess progress.

The Supreme Judicial Court has emphasized that restoration efforts must be actively pursued and cannot continue indefinitely. In cases where competency cannot be restored within a reasonable time, the court must consider alternative dispositions including civil commitment proceedings if the defendant poses a danger to themselves or others.

A defendant’s criminal case cannot be postponed indefinitely while he or she is awaiting restoration to competency. Under M.G.L. c. 123, § 16(f), any charges pending against a defendant must be dismissed upon the date of eligibility for parole, or one-half of the maximum potential sentence for the most serious crime with which the defendant has been charged. Other defendants may have their charges dismissed where it is believed that they will never regain competency and “maintaining the charges does not serve the compelling State interest of protecting the public.” Sharris v. Commonwealth (2018). While defendants’ crimes may eventually be dismissed, they may be required to remain at their facility until their commitment expires.

Criminal Responsibility: The Insanity Defense

While competency relates to the defendant’s mental state at the time of the court proceedings, criminal responsibility raises the issue of the defendant’s mental state at the time the crime was committed.

Legal Standard

Under M.G.L. c. 123, § 16, defendants are not criminally responsible if, at the time of the alleged offense, they were mentally ill and, as a result of that mental illness, lacked substantial capacity either to appreciate the criminality of their conduct or to conform their conduct to the requirements of law.

The Massachusetts formulation recognizes that mental illness can impair judgment in ways that extend beyond simple moral understanding. But while a psychiatrist may diagnose a condition as a mental disease, disorder, or defect, this is not the end of the analysis for criminal responsibility. The condition must be of a nature that society deems sufficient to relieve defendants from responsibility as a result of its effect on their capacity to appreciate the wrongfulness of their conduct.

Burden of Proof

Criminal responsibility is a defense presented at trial. The defendant bears the burden of proving insanity by a preponderance of the evidence. The prosecution may present evidence to rebut the insanity defense, and the ultimate determination rests with the jury. Judges must provide careful instructions to ensure that jurors understand the legal standard and their role in making this determination.

Consequences of an Insanity Finding

A finding of not guilty by reason of insanity does not result in immediate release. Instead, the defendant is typically committed to a state hospital for treatment and evaluation. The commitment process is governed by M.G.L. c. 123, § 16, which requires periodic review of the individual’s mental condition and dangerousness.

Release from commitment requires a showing that the individual is no longer mentally ill or dangerous. The court may impose conditions on release including outpatient treatment, medication compliance, and regular reporting requirements.

Practical Considerations

Raising competency or criminal responsibility requires a careful consideration and consultation with qualified mental health professionals. Raising competency issues may result in significant delays in case resolution and potential pretrial detention. The decision should be made thoughtfully, considering the client’s best interests and the strength of the evidence supporting incompetency.

How an Attorney Can Help

Massachusetts’ approach to competency and criminal responsibility is a complex network of statutory rules and case law which requires an experienced attorney to navigate. Attorney Kevin R. Collins has represented numerous individuals with serious mental health diagnoses and has successfully obtained results which have preserved clients’ criminal record and restored dignity to the process.

If you or a loved one are struggling with a serious mental health diagnosis and are in need of a criminal defense attorney, contact Attorney Kevin R. Collins today.