Judge Thomas O’Keefe Jr. ruled yesterday that alleged murderer Lishan Wang is not competent to stand trial.

Wang, who has been accused of murdering former Yale-New Haven Hospital postgraduate fellow Vajinder Toor in 2010, has been representing himself in court until today. In 2010, Wang was ruled competent to stand trial, but due to the prolonged nature of the case and concerns about Wang’s ability to continue to represent himself, O’Keefe ordered a competency exam in early February. The competency exam was conducted later that month by the New Haven Office of Court Evaluations, which is part of the Connecticut Mental Health Center. The psychiatrists who conducted the exam found that he was not competent to stand trial.

“Can someone who has a lot of symptoms of a psychotic disorder … represent themselves in a murder trial? Probably not,” O’Keefe said in court.

However, the psychiatrists added that through the course of restoration, there is a high probability that he could be restored to competency.

The report submitted by the psychiatric team found that Wang suffers from paranoia, reactive emotional states, patterns of disorganized thinking and perseveration — the inability to transition from one idea to the next in a socially appropriate way. The psychiatrists also found that Wang is subject to making statements that suggest grandiose thinking, which is typically seen in patients diagnosed with bipolar disorder or schizophrenia.

O’Keefe stressed in court that, though Wang is clearly highly intelligent and very respectful, between the findings of the psychiatric team and Wang’s behavior in court, it is clear that he suffers paranoid thinking.

“I have to balance his rights to represent himself with his right to a fair trial,” O’Keefe said.

According to Sec. 54-56-d of the Connecticut code, for a defendant to be considered competent to stand trial, he or she must be able to understand the proceedings of the case against him or her and must be able to assist in his or her own defense.

As a part of standard exam procedures, to gauge Wang’s competency, the psychiatrists said they tried to get a sense of the defendant’s mood, abstract reasoning skills, attention and concentration skills, and a history of his mental health.

“We are concerned that he doesn’t have an overarching understanding of the proceedings,” Alexander Westphal, one of the psychiatrists who conducted the report, said in court. “His thinking about it is distorted.”

The competency exam also included testing of Wang’s factual and rational understanding of the case. Madelon Baranoski, another one of the psychiatrists involved in drafting the report, said in court that one’s rational understanding is their ability to apply their factual understanding to their own case. This, according to Baranoski, was where Wang faced significant difficulty. Baranoski said that often people who suffer paranoia show a discrepancy between their factual understanding and their rational understanding.

In the wake of O’Keefe’s ruling, Wang will be transferred to Connecticut Valley Hospital. He will be treated by a group of doctors, separate from those who tested his competency, who will work towards mentally preparing Wang for trial. A third group of doctors from the hospital’s Whiting Forensic Division will then conduct yet another competency exam to deem whether he is ready to stand trial.

Towards the end of the trial, Thomas Ullman — supervisor of the public defender’s office for the Judicial District of New Haven — was appointed by the judge as Wang’s attorney. Ullman had been serving as Wang’s standby attorney after his previous standby counsel, Jeffrey LaPierre, recently left the public defender’s office.

After Ullman was appointed as counsel, Wang expressed confusion as to why his pro se right had been revoked, given that the report was only intended to cover his ability to stand trial. O’Keefe responded that a person who is deemed incompetent to stand trial is also incompetent to represent himself and speak on their own behalf.

O’Keefe said he believes that the issue of whether or not Wang is competent to represent himself will continue to be an issue, even if it is ultimately decided that he is competent to stand trial. O’Keefe also said in court that usually competency exams are fairly straight forward, but that there was nothing straight forward about this case.

“He’s very intelligent, he can follow instructions. In many, many ways he’s different from most people who go through a competency exam,” O’Keefe said.

The Connecticut General Assembly last amended the laws regarding competency to stand trial in 2011.