Literature review weighs hospital, jail and outpatient settings for restoring competency
Danzer, Wheeler, Alexander and Wasser review the published research on competency restoration, which they call a topic of growing interest and controversy for forensic practice, law and public policy. They look at how restoration rates, length of stay and the time needed to determine that someone is non-restorable differ among hospitals, jails and outpatient programs, while controlling for factors such as diagnosis and cognitive limitations.
The review reports significant advantages and disadvantages for each setting and notes that adults with severe psychotic disorders or cognitive impairments are more likely to be found incompetent and less likely to be restored. It also reports that requests for competency evaluations have risen from roughly 25,000 to 36,000 a year in the 1960s to about 50,000 to 60,000 in recent years, citing earlier estimates.
The authors frame their goal as identifying implications for current practice and generating research questions, a useful map of the evidence behind states' choices among inpatient, jail-based and community restoration.
Source: Competency Restoration for Adult Defendants in Different Treatment Environments — Journal of the American Academy of Psychiatry and the Law, by Graham S. Danzer, Elizabeth M.A. Wheeler, Apryl A. Alexander and Tobias D. Wasser
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