This means the defendant is currently incompetent to stand trial but can be restored to competency through in-patient or outpatient treatment. Sometimes, restoration is just a matter of the defendant staying up to date on their prescribed medications with a case manager. Other times, the defendant must be enrolled into a mental health facility.
What is competency restoration in a Florida criminal case?
Once a court orders that a defendant be evaluated for competency or that an incompetent person go through restoration, that individual typically remains in jail until those services are provided. Competency is a legal term, not a medical one, and competency restoration is not the same as mental health treatment.
What does it mean to restore competency?
What is competency restoration? When a defendant is found not competent, the state is ordered to provide services to bring them back to competency. Restoration services typically involve admission to a forensic services unit, where other people are participating in the program.
What is the legal and ethical context of competency restoration efforts?
This article summarizes the legal and ethical context of competency restoration efforts, the presenting problems that are typically the focus of treatment, treatment methods and programs, and the outcomes of restoration efforts. All U.S. jurisdictions provide for treatment of individuals found IST.
What is an outpatient competency restoration program?
The outpatient competency restoration program shall monitor the defendant during the defendant's placement in the program and report any noncompliance or significant changes with respect to the defendant to the department and, if applicable, the forensic navigator.
What is defendant competency?
Competency relates to the defendant's mental state after an offense, not before or during it. A person who isn't competent to stand trial can't be convicted of a crime. Courts require competency before defendants stand trial in order to preserve due process—that is, to make sure the proceedings are fair.
What happens when a defendant is found not competent to stand trial and treatment is not successful in restoring competence?
As a result, defendants found incompetent to stand trial may spend considerable counterproductive time in jails awaiting the availability of a hospital bed. In such cases, state governments may face civil action (e.g., contempt of court for delay in responding to a court's commitment order).
What is restoration treatment?
By. Therapeutic method whose aim is to reestablish both structure and function in any system which has been damaged or become deficient due to illness or injury. Achieving a prior level of function where a mental or emotional disorder is present.
What is meant by the defendant is competent to stand trial?
Competency to Stand Trial or Fitness to Stand Trial requires that a defendant understands the nature and purpose of the legal proceedings against him and be able to effectively cooperate with counsel in his defense.
What is competency restoration treatment?
Competency restoration is the process used when an individual charged with a crime is found by a court to be incompetent to stand trial, typically due to an active mental illness or an intellectual disability. A criminal defendant must be restored to competency before the legal process can continue.
How is someone restored to competency?
When a defendant is believed to be incompetent to stand trial, the court will order in-patient or outpatient treatment to attempt to restore competency. Typically, the court orders a defendant to complete a specific number of days in treatment and then reassess the individual.
Is a restoration the same as a filling?
In layman's terms, for me, a filling means I'm simply plugging a hole in the tooth. By contrast, a tooth restoration is restoring a tooth as close as possible to its original form and function; so the tooth not only looks great but it functions optimally again, and in harmony with the adjacent and opposing teeth.
What are restorations?
Restorations are the various ways your dentist can replace or restore your missing teeth or missing parts of your tooth structure, or structures that need to be removed to prevent decay that may cause you pain in the future.
What is a permanent restoration?
Dental restorations - What do we mean by 'permanent'? Dental restorations (fillings, crowns, bridges, implants etc) are often referred to as 'permanent' or 'temporary'.
What is the purpose of a competency hearing?
A competency hearing places the burden on your attorney to show that you are not competent to stand trial. However, unlike a criminal trial, the competency hearing is a civil proceeding. This means that your attorney does not need to prove beyond a reasonable doubt that you are incompetent.
What can I expect at a competency hearing?
The mental competency hearing is much like any other court hearing, but with this hearing, court appointed mental health experts will be examined and cross examined based on their findings. Prior to the actual hearing, a Forensic Psychologist or Psychiatrist will evaluate the defendant.
How does a court determine competency?
In determining whether the defendant is competent to stand trial, the court must determine "whether [the defendant] 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 ...
What happens when a defendant is not competent?
When a defendant is found not competent, the state is ordered to provide services to bring them back to competency. Restoration services typically involve admission to a forensic services unit, where other people are participating in the program. These services typically include educational, therapeutic and recreational activities.
What is the evaluation of a defendant?
The evaluation typically involves a review of the defendant’s mental health history, education and work history. The defendant participates in a clinical interview with a psychologist. Occasionally, psychological testing is conducted.
How long can a person be restorable?
There are cases when a person is found not to be restorable in a “reasonable period” (typically longer than six months). If this occurs, charges may be temporarily dismissed, and the person may be admitted to a civil psychiatric unit at a hospital for continued treatment.
What is a defendant referred for restoration?
Defendants referred for restoration can be broadly divided into those with primarily Axis I disorders and those with mainly cognitive limitations. In practice, many incompetent defendants exhibit multiple diagnoses, particularly involving personality disorders and substance abuse.
What is competency restoration?
While the clear majority of those examined are viewed as competent to proceed, those found incompetent to stand trial (IST) may be subjected to treatment and training to enable them to proceed to trial, typically referred to as competency restoration. These individuals constitute the largest group referred for mental health treatment under the auspices of the criminal justice system, with several thousand persons hospitalized in the United States at any given time. Despite the significant variability in treatment and education efforts, as many as 9 in 10 persons originally found unfit are eventually adjudicated competent and proceed to disposition of the charges against them. There is a dearth of systematic research on the methods used to accomplish this result. Restoration efforts typically require no more than 4 months, and an increasing number of jurisdictions allow for outpatient treatment and training to minimize pretrial deprivation of liberty. Medication is often a key component of treatment for defendants with psychiatric illness. Prognosis is more guarded for restoration of cognitively impaired defendants.
What is IST treatment?
jurisdictions provide for treatment of individuals found IST. Traditionally, this was presumed to involve commitment to a government-run facility for inpatient care. In Jackson v. Indiana (1972), the Supreme Court clarified that such commitment must be reasonably related, in duration and circumstances, to the purpose of restoring the individual to competency. Those found not restorable within the reasonably foreseeable future may be subjected to civil commitment. Surveys suggest that nearly half the defendants referred for restoration are placed in state hospitals and receive services typical for a civil patient population. Most of the remainder are confined in high-security facilities. In view of the significant deprivation of liberty entailed in inpatient restoration, a small number of jurisdictions have created provisions for outpatient competency restoration treatment. This innovation is also politically attractive, as the services are much less costly.
How long does it take to restore a person's liberty?
There is a dearth of systematic research on the methods used to accomplish this result. Restoration efforts typically require no more than 4 months, and an increasing number of jurisdictions allow for outpatient treatment and training to minimize pretrial deprivation of liberty.
Is non-medical treatment a litigation?
Nonmedication treatments have been viewed as less intrusive or objectionable and have not been a source of significant litigation. Some have argued that mental health practitioners play an ethically conflicting role as treater and evaluator in the restoration process. This view has not gained wide acceptance.
Is complete remission required for competency?
Complete remission of symptoms is typically not required to meet the practical requirements for competency. Educational programs appear more tailored to the needs of mentally retarded or otherwise cognitively impaired defendants.
Do special commitments apply to civil commitments?
While in some jurisdictions the procedures are identical to those in the regular civil commitment statute, in the majority of states and in federal courts, special commitment procedures apply, though these must provide due process protections similar in kind to those in the regular commitment statute.
How long can a court extend a commitment?
In the event that the court or jury makes such a finding, the court may extend the period of commitment for up to an additional six months. The six-month period includes only the time the defendant is actually at the facility and is in addition to reasonable time for transport to or from the facility.
How long does a defendant have to be incompetent to be charged?
(1) (a) (i) If the defendant is charged with a felony and determined to be incompetent, until he or she has regained the competency necessary to understand the proceedings against him or her and assist in his or her own defense, but in any event for a period of no longer than ninety days , the court shall commit the defendant to the custody of the secretary for competency restoration. Based on a recommendation from a forensic navigator and input from the parties, the court may order the defendant to receive inpatient competency restoration or outpatient competency restoration.
How long does it take for a court to review a change in placement?
The court shall schedule a hearing within five days to review the placement and conditions of release of the defendant and issue appropriate orders.
What is the term for a decline in functioning that warrants a return for additional restoration treatment before either trial or
It is well settled that defendants must be competent at each stage of adjudication, from arraignment through imposition of sentence. “Recidivism,” which consists of a decline in functioning that warrants a return for additional restoration treatment before either trial or sentencing, is of concern in a minority of cases.
What is IST treatment?
jurisdictions provide for treatment of individuals found IST. Traditionally, this was presumed to involve commitment to a government-run facility for inpatient care. In Jackson v. Indiana (1972), the Supreme Court clarified that such commitment must be reasonably related, in duration and circumstances, to the purpose of restoring the individual to competency. Those found not restorable within the reasonably foreseeable future may be subjected to civil commitment. Surveys suggest that nearly half the defendants referred for restoration are placed in state hospitals and receive services typical for a civil patient population. Most of the remainder are confined in high-security facilities. In view of the significant deprivation of liberty entailed in inpatient restoration, a small number of jurisdictions have created provisions for outpatient competency restoration treatment. This innovation is also politically attractive, as the services are much less costly.
What is competency restoration?
The optimization of trial competency restoration is a topic of growing interest and controversy in the fields of forensics, psychology, criminal law, and public policy . Research has established that adult defendants who have severe psychotic disorders and cognitive impairments are more likely than defendants without these conditions to be found incompetent to stand trial and are less likely to be restored to competency thereafter. Research has also identified some of the benefits of attempting restoration in hospitals, jails, or outpatient settings for defendants with different diagnoses or levels of cognitive functioning. Rates of restoration, length of stay necessary to achieve restoration, and, in some cases, how quickly defendants are found non-restorable are primary indicators of positive outcome. We sought to review the extant literature on competency restoration, with the goals of identifying implications for current practice and generating inquiries for future research. We found that there are significant advantages and disadvantages of attempting restoration in a hospital, jail, or outpatient setting on rates of restoration, length of stay necessary to achieve restoration, or length of time necessary to determine non-restorability, while controlling for several relevant factors (e.g., diagnosis, cognitive limitations).
What is competency to stand trial?
In the United States, competency to stand trial (CST) evaluations ensure that criminal defendants are capable of participating in their defenses, thus ensuring an important legal right. However, some research has suggested that the CST process may be impacted by legally irrelevant factors such as a defendant's race and cultural background. However, the majority of researchers examined factors that are predictive of CST recommendations and decisions. Few studies have focused on potential racial discrepancies in attorney referrals for CST evaluations and whether they are exacerbated by professional experience. The current study examined potential racial disparities in referrals for CST evaluations among 322 law students and 102 attorneys. Participants were randomly assigned to read vignettes describing either African American or Caucasian defendants who varied in their fitness to stand trial. The participants were asked to indicate whether they would refer the client for a CST evaluation and to describe their reasoning. The results indicated that both law students and attorneys were generally more likely to refer unfit rather than fit defendants, indicating an understanding of the legal criteria. Law students displayed a racial bias, only when referring the defendants who were unfit due to the lack of a rational understanding of the relevant legal case, χ2 (1) = 4.90, p = 0.03, Φ = 0.13. Fitness condition was the only significant predictor of attorney referrals. The generally encouraging results indicated that professional experience did not increase racial biases.
What is fitness to stand trial?
Fitness to Stand Trial is a critical concept in the adjudication of justice-involved persons. A retrospective study was conducted to examine criminal defendants' specific psychiatric symptoms and those symptoms' associations with expert opinions on Competence to Stand Trial. One hundred charts were reviewed: 50 Cases (opined as Not Fit) were compared against 50 Controls (opined as Fit) with respect to ratings on the Brief Psychiatric Rating Scale (BPRS). A significance level of 0.001 was selected a priori. Statistically significant differences were found in seven of the eighteen BPRS symptom constructs (with the highest differences in Conceptual Disorganization and Unusual Thought Content) and two of the four BPRS higher-order syndrome factors (Thinking Disorder and Hostile-Suspiciousness). Consistent with previous reports, psychotic symptoms are found in this study to be inversely associated with Fitness. Validity, reliability, and limitations of this study, as well as directions for future research, are discussed herein.
What is the validity of a guilty plea?
In theory, for guilty pleas to be valid, plea decisions should be made knowingly, intelligently, and voluntarily, and by defendants who are factually guilty. In this chapter, I examine the validity of pleading guilty. Validity here concerns (1) knowingness and intelligence—having sufficient information to make a decision, having the ability to understand and appreciate the information, and actually understanding, (2) voluntariness—having the choice to enter a guilty plea (as well as the knowledge that one has the choice), and (3) actual guilt—being factually guilty of the charges. Using judicial plea colloquies and tender-of-plea forms as the ‘test’ of knowing, intelligent, and voluntary decisions, the validity of the methods used to ensure that guilty pleas are valid (i.e., the extent to which a test measures what it purports to measure) is reviewed. It is tentatively concluded that the methods purported to assess valid plea decisions fall short of this goal. Pathways for research going forward are also identified.
How long can a person wait in jail for IST?
As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions. Methods The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1/1/2009 and 12/31/2016 were eligible for inclusion in the study. Results There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016. Conclusion Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation’s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.
How much does Florida spend on restoring competency?
In Florida, for instance, the Tampa Bay Times found that the state government spends at least $50 million annually restoring the competency of defendants whose nonviolent crimes are so minor they never spend a day in prison. Part of the issue is backlog.
Who can raise competency concerns?
Competency concerns can be raised by any court actor, judge, prosecutor, or defense attorney, at any stage of a hearing. Though a state-appointed physician assesses the defendant and provides a recommendation, a judge makes the ultimate determination of whether someone is competent to stand trial or not.
What case did the Supreme Court rule that defendants must be civilly committed or released?
Every state surveyed reported that courts sometimes found defendants unrestorable to competency. In 1972, the Supreme Court ruled in Jackson v. Indiana that defendants found unrestorable must be civilly committed or released, and that continued commitment for purposes of restoration would violate the Constitution.
How long did Tyler go to restoration?
After ten days in the restoration program, Tyler was told he was being referred for an early evaluation. The physician who evaluated him suggested that he was competent to stand trial. “Coincidentally,” Morgan said, he had a status court hearing scheduled for later that week.
Why is speedy trial not a delay?
But because postponements due to competency issues are outside the prosecutor’s control , they do not count as speedy trial delays.
What is the Fifth Amendment?
The Fifth Amendment right to due process has been interpreted to mean that in order for cases to progress, defendants must be competent to stand trial. That is, they must be capable of understanding the nature and the consequences of the charges brought against them and must be able to assist in their defenses.
Why are people with mental illness waiting so long in Colorado?
An investigation in December by the Denver Post found that people with mental illness who are accused of crimes in Colorado were waiting up to four times as long as legally permitted for evaluations and treatment because the system is so overwhelmed. Similar reports have come out of California.
Legal and Ethical Context
Focus of Restoration Treatment
- Competency restoration is often implemented on an individualized basis, though some inpatient centers offer highly structured programs. The most common model combines these elements and involves individual treatment of any underlying mental illness combined with group education and practice modules and individual coaching. There is consistent evide...
Restoration Success Versus Failure
- The clear majority of those referred for restoration are ultimately adjudicated competent, with some centers reporting success rates of 80% to 90%. Success appears most likely for individuals with functional psychiatric illnesses that are responsive to medication treatment. Not surprisingly, individuals who show clinically significant improvement in general psychopathology are more lik…
Legal and Ethical Context
- All U.S. jurisdictions provide for treatment of individuals found IST. Traditionally, this was presumed to involve commitment to a government-run facility for inpatient care. In Jackson v. Indiana (1972), the Supreme Court clarified that such commitment must be reasonably related, in duration and circumstances, to the purpose of restoring the individual to competency. Those fo…
Focus of Restoration Treatment
- Competency restoration is often implemented on an individualized basis, though some inpatient centers offer highly structured programs. The most common model combines these elements and involves individual treatment of any underlying mental illness combined with group education and practice modules and individual coaching. There is consistent evide...
Restoration Success Versus Failure
- The clear majority of those referred for restoration are ultimately adjudicated competent, with some centers reporting success rates of 80% to 90%. Success appears most likely for individuals with functional psychiatric illnesses that are responsive to medication treatment. Not surprisingly, individuals who show clinically significant improvement in general psychopathology are more lik…