Whilst the United States retains the death penalty, it has established limitations
on its use. In Ford v. Wainwright
(1986), the Supreme
Court prohibited the execution of the mentally insane and required an adversarial
process for determining mental competency. Historically those with a severe
mental illness have been determined to lack the full mental capacity to
be held fully culpable for their actions. International law also prohibits
the imposition of the death penalty on those persons suffering from a mental
However, as seen in the parallel issue of mental retardation, the prohibition on executing the mentally ill has not prevented people with mentally illness from being both sentenced to death and executed. Indeed, it has been clearly documented that the converse is true. The interrelationship between medicine and the law is inherently problematic. Legal definitions and concepts of insanity and competency do not necessarily coincide with medical opinion. The imposition of legal concepts on medical diagnoses can result in perversity.
The case of Thomas Provenzano highlights the deficiencies within the legal system. Mr. Provenzano was executed in June 2000 despite a lengthy and recorded history of serious mental illness. A Florida judge ruled him competent for execution despite finding "clear and convincing evidence that Provenzano has (had) a delusional belief that the real reason he is being executed is because he is Jesus Christ" In ruling thus, the judge however expressed grave concern at the "minimal standard" for competency determinations that allowed the state to kill Thomas Provenzano.
The mentally ill continue to face a myriad of problems within the criminal justice system, from diagnosis, effective representation and treatment to the continued imposition of the death penalty. The concept of mental illness is still surrounded by myth, fear and a general lack of understanding, both in the general population and within the legal system. Each of these problems must be deconstructed and fully understood before those with mental illness achieve justice.