As a result, the Court ruled by a 7-2 vote that states may insist that mentally ill defendants be represented by counsel when “they are not competent to conduct trial proceedings by themselves.”

Justice Stephen Breyer said the traditional test for competence to stand trial — the ability to consult with counsel and to assist in preparing the defense — does not weigh the additional skills needed to represent oneself. Someone competent to stand trial, Breyer wrote, may nonetheless “be unable to carry out the basic tasks needed to present his own defense without the help of counsel.”

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