Assessing Mental Capacity for Legal, Medical, and Civil Decision-Making
Ubuntu Psychological Services conducts comprehensive competency evaluations for adults and older adolescents in medical, civil, and criminal contexts. Our licensed clinicians apply evidence-based assessment techniques and a trauma-informed approach to help answer critical questions about an individual’s capacity to make decisions and understand the consequences of those decisions.
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What Is Competency
Competency, or decision-making capacity, refers to an individual’s mental ability to make voluntary, reasonable, and informed choices. This includes the capacity to:
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- Understand relevant information
- Appreciate the implications of that information within a given context
- Reason through options and consequences
- Communicate a clear and consistent choice
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Competency can be questioned in legal, medical, or civil settings and is often a determining factor in decisions involving consent, contracts, legal testimony, or criminal responsibility.
Areas of Competency Evaluation
We work collaboratively with families, physicians, attorneys, and other stakeholders to ensure that evaluations are thorough, respectful, and clearly aligned with the referral question.
Evaluations determine whether an individual can:
- Provide informed consent for medical treatment or procedures
- Understand risks, benefits, and alternatives to care
- Make consistent, reasonable health-related choices
These evaluations are often required in cases involving:
- Execution of legal documents (e.g., wills, trusts, power of attorney)
- Assignment of conservatorship or guardianship
- Consent to financial agreements or settlement offers
- Long-term care decisions and medical directives
We assess whether the individual can understand and appreciate the legal or financial decisions being made and whether they are acting of their own free will.
In criminal court, a defendant must be competent to:
- Understand the nature and consequences of the legal proceedings
- Participate meaningfully in their defense
- Communicate effectively with their attorney
These evaluations are often court-ordered and must meet specific jurisdictional standards. Ubuntu Psychological Services provides forensic evaluations that address both psychological fitness to stand trial and, when requested, criminal responsibility (sanity evaluations).
When Is a Competency Evaluation Needed?
Competency evaluations can be used to initiate conservatorship proceedings, determine fitness to manage financial affairs, or support court proceedings involving civil, family, or criminal law. You may seek a competency evaluation when an individual’s ability to make rational or inf
- Cognitive decline (e.g., Alzheimer’s or other dementias)
- Traumatic brain injury or neurological conditions
- Serious mental illness (e.g., psychosis, bipolar disorder)
- Developmental disabilities
- Intellectual disability
- Substance use disorders
- Recent hospitalization, injury, or trauma affecting cognitive capacity
What to Expect from a Competency Evaluation
Competency is multifaceted and cannot be determined by observation alone. Our comprehensive evaluations are designed to assess both psychological and cognitive functioning through a structured process that typically includes:
We interview the individual being evaluated and, when appropriate, family members or caregivers. This helps us gather background information regarding:
- Mental health history
- Medical conditions
- Social functioning
- Cognitive concerns or impairments
- Current level of functioning and decision-making capacity
We collaborate with referring parties—such as attorneys, physicians, or public guardians—to clarify:
- The specific legal or clinical question
- The scope and purpose of the evaluation
- Contextual factors (e.g., pending litigation, medical interventions, risk)
We review all relevant records, including:
- Medical charts and medication history
- Prior psychological or psychiatric evaluations
- School or vocational records (when applicable)
- Legal filings or court orders
Depending on the referral concerns, assessments may include:
- Cognitive testing (IQ, executive functioning, processing speed)
- Academic achievement (reading, writing, math)
- Attention and memory functioning
- Language and communication skills
- Social-emotional and behavioral evaluations
- Autism spectrum screening
- Adaptive functioning
- Sensory processing assessments (if needed)
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Once the evaluation is complete, we provide:
- A detailed, written report integrating interview findings, test results, and record review
- A clear, objective opinion regarding the individual’s competency
- Recommendations for treatment, supervision, or court-related decisions when applicable
- Reports are sent to the referring party (e.g., attorney, physician, or court) and discussed upon request
ADHD Testing Accommodations and Workplace Support
Ubuntu Psychological Services works collaboratively with families, schools, and employers to help implement these supports. A formal diagnosis of ADHD can open the door to supportive accommodations at school and work:
Why Choose Ubuntu Psychological Services?
Ubuntu Psychological Services offers:
- Board-certified and licensed clinicians with training in forensic, neuropsychological, and clinical assessment
- Court-ready reports that meet legal standards and are written in clear, defensible language
- Fast turnaround times and responsive communication
Compassionate and culturally informed evaluations, ensuring dignity for all clients, including those with complex or marginalized identities