Wеsley Griffin was convicted in an Arkansas state court of interference with a law enforcement officer with the use of a firearm. He appeals from the district court order dismissing his habeas corpus petition. See 28 U.S.C. § 2254 (1988). Griffin asserts that because there was sufficient doubt about his mental competency to stand trial, the state trial court deniеd him due process by not holding an eviden-tiary hearing to resolve the question. We reverse and remand.
I. BACKGROUND
Griffin was charged by information in June 1987 with interference with a law enforcement officer and criminal trespass (the latter charge was nolle prossed before trial). Before arraignment, Griffin filed a notice putting in issue his fitness to proceed and notifying the court of his intention to rely on the defense of mental disease or defect. Griffin also filed a motion requesting a court-ordered mental examination at the state hospital. The trial court held a hearing on Griffin’s motion, during which the court expressed concern about the two- or three-month delay involved with an examination at the state hospital. At the conclusion of the hearing, the court ordered that Griffin undergo a preliminary examination at a regional mental health center and stated that “if there is an indication there that he should be sent for further testing, the Court will direct him.” Trial Transcript and Documents vol. I, at 103.
The trial court’s order required that the director of the mental health center provide a written report and findings in accord with Arkansas Statutes section 41-605(4) (now codified at Ark.Code Ann. § 5-2-305(d) (Supp.1989)). This report was to include a finding on Griffin’s mental capacity at the time of the offense, a finding on his mental competency for trial, and a description of the nature of the mental health centеr’s examination, “including but not limited to, the names of any tests, medications administered and total length of interviews by the examining physician.” Trial Transcript and Documents vol. I, at 8-9.
Following the examination of Griffin, the director of the mental health center sent the following letter (excluding salutation and closing) in reply to the court’s order:
*928 Wesley Griffin was evaluated by James Vasilos, Ph.D. pursuant to court order on 07 14 87. His admitted use of alcohol and substances complicate the issue and make it difficult to answer the questions raised by the court. In staffing this case between myself [Neal Ritter, Ph.D.], James Vasilos, Ph.D., and Gene Water-mann, M.D., we were unable to come up with a consensus in answering these questions. For that reason, we recommend a complete evaluation at Rogers Hall [state hospital].
If you have any questions, please feel free to contact me.
Id. at 10.
At arraignment on August 6, 1987, Griffin complained to the court that he was sick, “in extreme pain,” and without his medication. Id. at 104-05. After the court explained to Griffin that the regional mental health center recommended a complete evaluation at the state hospital, Griffin responded, in part:
They started me on medication and I took it a whole month and they just completely stopped giving it to me. And that caused me to be addicted to that medicine. It wrecks my nerves and everything, you know. So, rather than going through all this to find if I’m crazy —I’m not crazy. I’d rather just go ahead and be judgеd....
Id. at 105. The court explained to Griffin that an examination at the state hospital would further delay his trial and that the question whether to withdraw his notice and motion regarding competency for trial was for him to decide after consultation with his attorney. Griffin responded:
I’m just in so much depression. I just sent them a letter yesterday stating that if they don’t try to get me to the hospital or something, you know, to try to get me some kind of medical treatment, I’m going to go ahead and hang myself off in that cell, because I’m going through too much pain not to have no medicine or somebody to give me x-rays and find out what’s causing the pain and the crippling, you know. So, that’s all I'm asking for. Is asking for the Court to judge mе, or the doctor to give me something to take away the pain.
Id. at 106-07. The court then gave Griffin an opportunity to consult with his attorney, after which Griffin (against his attorney’s advice) withdrew his notice and motion. Despite an objection by Griffin’s counsel, the court found that Griffin had “intelligently, knowingly, and voluntarily” withdrawn his “plea and notice as to mental diseаse or defect, and that in accordance with” section 41-601 of the Arkansas Statutes, he was “fit to proceed.” Id. at 109. (Section 41-601 is now codified at Ark.Code Ann. § 5-2-312 (1987)).
At a pretrial hearing on September 2, 1987, the day of trial, Griffin’s attorney again raised the subject of Griffin’s mental fitness. Griffin’s attorney stated that although he was prepared to go to trial thаt day he continued to object to the court’s ruling permitting Griffin to withdraw his motion. The following exchange then occurred between the trial judge and Griffin:
THE COURT: Do you understand what your attorney is saying, Mr. Griffin?
DEFENDANT GRIFFIN: Yeah. He felt that I should take the treatment.
THE COURT: Sir?
DEFENDANT GRIFFIN: He felt that I should take the treatment.
THE COURT: It is your desire not to? Is that what you’re saying?
DEFENDANT GRIFFIN: Yes, sir. I just — I’m wounded and have a few stiff parts оn my body, that’s all.
THE COURT: You have been able to cooperate with Mr. Becker [Griffin’s attorney] in your defense?
DEFENDANT GRIFFIN: Yes, sir.
THE COURT: Discussed the case with him, what witnesses might be called against you, what defenses you might have?
DEFENDANT GRIFFIN: (Affirmative nod).
Id. at 117. Shortly after this exchange, the court permitted the trial to proceed. Griffin was found guilty by a jury and sentenced by the court to ten years in prison.
*929
Thе Arkansas Court of Appeals affirmed Griffin’s conviction on direct appeal.
Griffin v. State,
II. DISCUSSION
Two underlying constitutional principles govern this case. First, the conviction of a mentally incompetent accused is a violation of due process.
1
See Drope v. Missouri,
If there is a sufficient doubt about the mental competency of an accused, a trial court has a responsibility to order a hearing
sua sponte. See Drope,
420 U.S. at
*930
181,
In a habeas lawsuit, we generally presume that a state court’s factual finding of competency is correct.
See Maggio v. Fulford,
In Griffin’s case, the most significant factor bearing on the question of his competency to stand trial was the letter from the director of the mental health center. Exactly what effect a letter of this type should have is not certain: there are no cases in our circuit involving similar incomplete and inconclusive evidence and the Supreme Court cases of
Pate
and
Drope
do not establish thе minimum requirements for sufficient doubt. Our circuit cases, however, reveal that a medical opinion on the mental competency of an accused is usually persuasive evidence on the question of whether a sufficient doubt exists.
See, e.g., Harkins v. Wyrick,
Our conclusion is further supported by the insistence of Griffin’s attorney, from the start of the criminal case, that Griffin required a more thorough examination than the regional mental health center could provide. Griffin’s attorney was particularly concerned about the mental effects of the “serious head injuries” Griffin suffered at the time of his arrest.
See, e.g.,
Trial Transcript and Documents vol. I, at 102. Furthermore, although a trial court is better able than we are to judge the demeanor of an accused, the transcript reveals statements by Griffin that contribute to a doubt about his competency (e.g., addiction to mediсation, depression, threatened suicide).
See, e.g.,
Trial Transcript and Documents vol. I, at 104-07. In addition, although Griffin’s decision to withdraw his motion and notice (against his attorney’s advice) presented a slight twist to the usual events before a trial court, it did not remove the doubt about Griffin’s competency. If Griffin was incompetent at the time, his decision may not hаve been knowingly and intelligently made.
Cf. Pate,
The state suggests that Griffin’s only concern (and his attorney’s) was “physical pain rather than mental disorder.” Brief for Appellee at 4. Several facts belie this assertion (e.g., Griffin’s motion to the court was for a
mental
evaluation, not a
physical
evaluation). But, more importantly, Griffin’s concern about his physical well-being does not preclude the possibility that he was also mentally incompetent. In addition, the state argues that Griffin appeared rational and competent before and during trial. This is irrelevant, for once a doubt about the competency of an accused exists, later behavior “ ‘cannot be relied upon to dispense with a hearing.’ ”
Rand v. Swenson,
Because we hold that a sufficient doubt about Griffin’s competency existed, we also must determine whether the state trial court conducted a full, fair, and adequate hearing on the subject of Griffin’s competency. The full extent of the state trial court’s inquiry into Griffin’s competency is quoted nearly completely in the background above. No witnesses were called; the only medical report on Griffin was the one paragraph letter from the mental health center; apparently no attempt was made to obtain a more complete report from the mental health center; and the trial court’s questioning of Griffin was very limited. It is likely, in fact, that the state trial court did not even believe it was conducting a hearing, since it approved Griffin’s request to withdraw his notice and motion putting in issue his competency. Although the Arkansas Court of Appeals held that Griffin’s “hearing” complied with due process, we conclude that it did not.
Having found that due process was violated by the state court’s failure to provide an adequate hearing, we must determine the proper remedy. According to the Supreme Court, an attempt to retrospectively determine the mental comрetency of an accused by means of a nunc pro tunc hearing, even “under the most favorable circumstances,” is hampered by “inherent difficulties.”
Drope,
*932 III. CONCLUSION
Accordingly, we reverse the judgment of the district court and remand for procеedings consistent with this opinion.
Notes
. The test for determining if an accused is mentally competent is "'whether he has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding— and whether he has a rational as well as factual understanding of the proceedings against him.'"
Dusky v. United States,
. No single, formulaic phrase has beеn set down by the Supreme Court to describe the quantum of doubt that compels an evidentiary hearing. Nor has any single, descriptive phrase emerged from the cases in other federal courts. Some cases in our circuit state that a “bona fide doubt” must exist.
See, e.g., Collins v. House-wright,
A few of these phrases, for one reason or another, seem unacceptable to us. “Substantial evidence of doubt,” for example, has never been used by the Supreme Court in the present context. And "bona fide doubt” appears to be a faulty construction of words. The locution came from thе Illinois statute under consideration in Pate and, unfortunately, it has reached a level of being standard legal idiom in mental competency cases. "Bona fide” has many applications in the law (e.g., bona fide purchaser, bona fide occupational qualification). See Black’s Law Dictionary 177 (6th ed. 1990); see also B. Garner, A Dictionary of Modern Legal Usage 90-91 (1987). In each application it is generally used accоrding to its dictionary definition — that is, meaning “[ajcting or done in good faith; sincere, genuine." Oxford English Dictionary (2d ed. 1989). For purposes of determining whether an evidentiary hearing should be held, however, "bona fide doubt," is a misnomer. It does not convey the correct sense of the test: the question whether an evidentiary hearing is required does not depend on the sincеrity, genuineness, etc. of the judge's doubt — we can assume any judge’s doubt has these qualities.
We believe that the best terms in which to couch the constitutional test are "sufficient doubt.” We acknowledge that the clarity or precision of this phrase has no clear advantage over some of the others. But sufficient doubt seems to be the phrase used most often by the Supreme Court.
See, e.g., Ford v. Wainwright,
. With these basic principles in mind, we should briefly review the widely varying decisions of the other courts in this case. The Arkansas Court of Appeals, in its affirmance of Griffin’s conviction, held that, although a "bona fide doubt" as to Griffin’s competency "may” have existed prior to trial, Griffin’s argument along this line was "misplaced” because the trial court conducted a hearing that complied with the requirements оf procedural due process.
Griffin v. State,
