NASMHPD research arm reviews community-based outpatient competency restoration programs across the states
The paper by NRI's Amanda Wik, first in a two-paper series on alternatives to inpatient restoration, starts from the pressure on state psychiatric hospitals: forensic admissions have grown, especially for defendants found incompetent, and long waits have led some states to be held in or threatened with contempt. States have responded by creating programs for defendants who can be treated in the community.
The review finds statutes in at least 35 states that allow outpatient restoration as an alternative to inpatient care, and at least 16 states with formal restoration programs based outside a hospital, among them Arkansas, California, Colorado, Connecticut, Florida, Georgia, Louisiana, Ohio, Oregon, Texas and Virginia. It profiles individual programs, reporting restoration rates drawn largely from a 2016 study by Gowensmith and colleagues, with figures that include roughly 35 percent restored in California's program and about 95 percent in Hawaii's.
The author cautions that data on many programs is thin and not publicly available. The paper's main contribution is a state-by-state inventory that policymakers could use when considering outpatient models as a way to shorten restoration waitlists.
Source: Alternatives to Inpatient Competency Restoration Programs: Community-Based Competency Restoration Programs — NRI (NASMHPD Research Institute), by Amanda Wik
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