Abstract
Many factors influence restoration of competence to stand trial: age, IQ, severity of mental illness, criminal history, treatment history, and others. This commentary poses the question of whether competency to stand trial is also influenced by the setting in which restoration treatment occurs. Jail-based competency-restoration programs, which are in their infancy and have yet to produce large-scale data demonstrating their efficacy, are examined. Several factors related to jail-based restoration are considered: choosing the right candidates for the program, impact of treatment in a punitive setting, ability to maintain separation between treaters and forensic evaluators, procedures for involuntary medication, aggregation of incompetent defendants in regional jails, effect on malingering, and cost savings.
Footnotes
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The author acknowledges salary support from the Connecticut Department of Mental Health and Addiction Services (DMHAS) and from the University of Connecticut Correctional Managed Health Care (CMHC).
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Disclosures of financial or other potential conflicts of interest: None.
- © 2011 American Academy of Psychiatry and the Law