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J Am Acad Psychiatry Law. 2019 Feb 8. pii: JAAPL.003819-19. doi: 10.29158/JAAPL.003819-19. [Epub ahead of print]

Competency Restoration for Adult Defendants in Different Treatment Environments.

Author information

1
Dr. Danzer is a licensed psychologist at Florida State Hospital, Tallahassee, FL. Dr. Wheeler is a former Director of the Forensic Evaluation Department at Central State Hospital and currently in private practice at Bay Forensic Psychology, Petersburg, VA. Dr. Alexander is a Clinical Assistant Professor, Graduate School of Professional Psychology, Denver Forensic Institute of Research, Service, and Training, University of Denver, Denver, CO. Dr. Wasser is an Assistant Professor of Psychiatry, Yale University School of Medicine, New Haven, CT. gdanzer@alliant.edu.
2
Dr. Danzer is a licensed psychologist at Florida State Hospital, Tallahassee, FL. Dr. Wheeler is a former Director of the Forensic Evaluation Department at Central State Hospital and currently in private practice at Bay Forensic Psychology, Petersburg, VA. Dr. Alexander is a Clinical Assistant Professor, Graduate School of Professional Psychology, Denver Forensic Institute of Research, Service, and Training, University of Denver, Denver, CO. Dr. Wasser is an Assistant Professor of Psychiatry, Yale University School of Medicine, New Haven, CT.

Abstract

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).

PMID:
30737294
DOI:
10.29158/JAAPL.003819-19

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