What is the Difference Between Competency and Sanity?

August 15, 2022 by Anthony Riccio

Any time an outrageous crime happens, the first question the public asks – Was the perpetrator in his right mind? Were they insane? On television, some police procedural shows throw around words like incompetent and insane like they are interchangeable. In fact, they are quite different. Often, cases when a defendant’s competency and insanity are questioned grab the headlines.

In the summer of 2021, 24-year-old Khaled Awad approached 41-year-old Rabbi Shlomo Noginski as he stood on the steps of the Shaloh House—a 60-year-old Jewish day school in Boston’s Brighton neighborhood. About 100 elementary school kids were inside the summer camp program. 

Noginski has a thick beard, black coat, and a kippah. 

Awad pulled out a pistol and demanded the keys to his van. As Noginski tried to give him the keys, Awad drew a knife and yelled for the Rabbi to get into the van. Noginski ran, racing away from the camping children. 

But Awad caught him and plunged the knife into him several times—in his arms and legs, stabbing him in the chest, millimeters from his heart.

When Boston police arrived, they convinced Awad to throw down the gun. But he still resists arrest, kicking and screaming.

Noginski was rushed to the hospital. Treated and released the next day, he still has not regained the full use of one of his arms. 

After public outcries, Boston prosecutors decided to treat Awad’s felony assault of a Rabbi as a hate crime.

The Long Wait to Determine Competency

From day one, Awad’s court-appointed attorney called attention to his mental health and requested a competency hearing. A bipolar diagnosis came back from the court clinician, adding that when the attack occurred, he had not been taking his prescribed medication that usually stabilized him. 

Awad was ordered by the judge to be held at Bridgewater State Hospital for observation. Bridgewater houses the criminally insane and individuals under mental evaluations by the court. Awad returned to court with a preliminary diagnosis of schizophrenia and/or schizoaffective disorder.

This is not Awad’s first unprompted violent act. A look into his recent past shows a steady degradation of his mental health. The timeline breaks down like this:

  • 2016-2017 – Awad comes to America, studies at the University of Toledo, returns to Egypt.
  • Early 2019 – Using a student visa, he enrolls in the University of South Florida.
  • October 2020 – He attacks his Jewish roommate and receives a restraining order.
  • March 2021 – He is evicted from his off-campus apartment. 
  • November 2020 – He physically fights with strangers in Tampa, Florida and steals an electronic credit card reader worth $180, arrested for petty theft.
  • November 2020 – He is arrested again at another Tampa store for eating and drinking items without paying. The items are worth less than $12.
  • November 2020 – His competency is questioned at his court hearing. 
  • January 2021 – Florida judge finds him incompetent to stand trial, orders him to be treated at a mental health facility. 
  • April 2021 – After treatment, he is still found incompetent. The misdemeanors are dismissed.
  • Sometime from April to June – He moves to Boston, admits antisemitic ideation to friends, family, and acquaintances.
  • July 2021 – He attacks Rabbi Noginski.
  • August 2021 – Massachusetts’ judge orders his observation at Bridgewater.
  • Currently – His mental health evaluation continues as the Massachusetts Superior Court waits to determine his competence to stand trial. 

Sorting Out the Disparities in Competency and Sanity

Conceptually, competency and sanity play distinct roles in a courtroom. The ability to understand the court process determines competency. Sanity deals with both the defendant’s mental health at the time of the crime and their understanding of culpability in the face of a guilty verdict.

In the case of competency, a representative of a defendant can raise the issue during a hearing or before a trial, or a judge may observe behaviors that cause concerns about a defendant’s competency.  When competency is in question, it is the duty of the court to order an evaluation. 

A judge informed by the results of an evaluation determines a defendant’s ability to understand the court process and their competency to stand trial. Competency adheres to federal law, specifically the Constitution’s due process clause.

Defendants use insanity as a defense when pleading, as in “not guilty by reason of insanity.” Insanity defenses depend on various state laws as to who carries the burden to prove or disprove insanity.

To simplify the terminology: 

  • Competency = A judge determines before a trial begins. 
  • Sanity = A jury determines at the end of a trial with the verdict.

In Massachusetts, the burden of disproving an insanity plea falls on the prosecution. One of only 11 states that do not place the onus of proof on the defense for insanity pleas.

In most cases, prosecution and defense teams bring in conflicting mental health experts to answer several questions regarding competency like:

  • Does Awad understand he is being charged with a crime and what those charges are?
  • Does he understand how the court process works and the roles of the judge, jury, prosecution, and defense attorneys?

If found competent and a trial with an insanity defense is underway, juries usually hear arguments containing questions like:

  • Did Awad understand the implications of his wrongful act when he stabbed Noginski?
  • Could he control his criminal urges or resist breaking laws? 

Tracing back to Freud, many psychologists consider antisemitism a form of societal mental illness. Mental health professionals would now include crimes emitting from obsessive racism or bigotry into this condition.

Others would argue that a successful competency continuance or sanity plea need to show how pervasive the mental condition is. Defenses may illustrate the ubiquity of the condition, associating the mental illness with symptoms like internal voices that cannot be ignored, disturbing visions, obsessions that lead to impulsive actions, an inability to control impulses. 

Boston grows frustrated awaiting the ruling on Awad’s competency, but a hasty decision that results in Awad gaming the system and getting away with this heinous act would only heighten the aggravation and outrage.

Typically, defendants found not guilty by reason of insanity are committed to psychiatric facilities, but the duration of their commitments are not usually set sentences. Sometimes, the committed are declared cured and released. Other times, defendants have spent lifetimes in mental health facilities.