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Research ArticleRegular Articles

Correlates of Competency to Stand Trial Among Youths Admitted to a Juvenile Mental Health Court

Eraka Bath, Lauren Reba-Harrelson, Robyn Peace, Jie Shen and Honghu Liu
Journal of the American Academy of Psychiatry and the Law Online September 2015, 43 (3) 329-339;
Eraka Bath
Dr. Bath is Director, Child Forensic Services and Assistant Professor, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, CA. Dr. Reba-Harrelson is Adjunct Assistant Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, and Forensic Psychologist, West Central Georgia Regional Hospital, Columbus, GA. Ms. Peace was formerly with Department of Social Welfare, Luskin School of Public Affairs, and Dr. Shen and Dr. Liu are Professors, Division of Public Health and Community Dentistry, School of Dentistry, University California Los Angeles. Dr. Liu is also Professor, Department of Medicine, David Geffen School of Medicine and Professor, Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles. This research project was supported by intramural funding from the UCLA School of Medicine, Semel Scholar Award for Junior Faculty Career Development.
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Lauren Reba-Harrelson
Dr. Bath is Director, Child Forensic Services and Assistant Professor, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, CA. Dr. Reba-Harrelson is Adjunct Assistant Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, and Forensic Psychologist, West Central Georgia Regional Hospital, Columbus, GA. Ms. Peace was formerly with Department of Social Welfare, Luskin School of Public Affairs, and Dr. Shen and Dr. Liu are Professors, Division of Public Health and Community Dentistry, School of Dentistry, University California Los Angeles. Dr. Liu is also Professor, Department of Medicine, David Geffen School of Medicine and Professor, Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles. This research project was supported by intramural funding from the UCLA School of Medicine, Semel Scholar Award for Junior Faculty Career Development.
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Robyn Peace
Dr. Bath is Director, Child Forensic Services and Assistant Professor, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, CA. Dr. Reba-Harrelson is Adjunct Assistant Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, and Forensic Psychologist, West Central Georgia Regional Hospital, Columbus, GA. Ms. Peace was formerly with Department of Social Welfare, Luskin School of Public Affairs, and Dr. Shen and Dr. Liu are Professors, Division of Public Health and Community Dentistry, School of Dentistry, University California Los Angeles. Dr. Liu is also Professor, Department of Medicine, David Geffen School of Medicine and Professor, Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles. This research project was supported by intramural funding from the UCLA School of Medicine, Semel Scholar Award for Junior Faculty Career Development.
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Jie Shen
Dr. Bath is Director, Child Forensic Services and Assistant Professor, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, CA. Dr. Reba-Harrelson is Adjunct Assistant Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, and Forensic Psychologist, West Central Georgia Regional Hospital, Columbus, GA. Ms. Peace was formerly with Department of Social Welfare, Luskin School of Public Affairs, and Dr. Shen and Dr. Liu are Professors, Division of Public Health and Community Dentistry, School of Dentistry, University California Los Angeles. Dr. Liu is also Professor, Department of Medicine, David Geffen School of Medicine and Professor, Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles. This research project was supported by intramural funding from the UCLA School of Medicine, Semel Scholar Award for Junior Faculty Career Development.
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Honghu Liu
Dr. Bath is Director, Child Forensic Services and Assistant Professor, Department of Psychiatry, UCLA Neuropsychiatric Institute, Los Angeles, CA. Dr. Reba-Harrelson is Adjunct Assistant Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, and Forensic Psychologist, West Central Georgia Regional Hospital, Columbus, GA. Ms. Peace was formerly with Department of Social Welfare, Luskin School of Public Affairs, and Dr. Shen and Dr. Liu are Professors, Division of Public Health and Community Dentistry, School of Dentistry, University California Los Angeles. Dr. Liu is also Professor, Department of Medicine, David Geffen School of Medicine and Professor, Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles. This research project was supported by intramural funding from the UCLA School of Medicine, Semel Scholar Award for Junior Faculty Career Development.
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    Figure 1.

    Process by which a youth is found eligible for the LAJMHC.

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    Table 1

    Age and Demographic Characteristics by Competency Status

    CST n = 150IST n = 174χ2p
    Age*16.5 (2.26)15.6 (2.78)10.5†.0013
    Age Groups7.38.0066
        <111 (9)10 (91)
        11–1313 (33)26 (67)
        14–1533 (45)41 (55)
        16–1767 (53)60 (47)
        ≥1836 (49)37 (51)
    Ethnicity/identity6.5.09
        Caucasian/white14 (67)7 (33)
        Black /AA53 (50)53 (50)
        Hispanic/Latino71 (41)103 (59)
        Other8 (53)7 (47)
    Gender10.0.0015
        Male108 (42)150 (58)
        Female42 (64)24 (36)
    Born in the United States0.03.87
        Yes142 (46)164 (54)
        No8 (44)10 (56)
    • Data are expressed as n (%). The percentages are based on the total n in each row. Unless otherwise indicated, all probabilities were derived from chi-square tests.

    • ↵* Means (SD), with F-test statistic.

    • ↵† F-test statistic.

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    Table 2

    Psychiatric Diagnosis by Competency Status

    DiagnosisCST (n = 150)IST (n = 174)χ2pRelative Risk (95% CI)
    Intellectual disability57.3.00017.35 (4.28, 12.6)
        No125 (62)75 (38)
        Yes25 (20)98 (80)
    PDD5.61.0183.39 (1.10, 10.4)
        No146 (48)158 (52)
        Yes4 (21)15 (79)
    ADHD0.01.930.87 (0.53, 1.43)
        No103 (47)118 (53)
        Yes47 (46)55 (54)
    Learning disability0.98.321.64 (9.66, 4.08)
        No142 (47)159 (53)
        Yes8 (36)14 (64)
    Disruptive behavior disorder0.0003.990.86 (0.30, 2.48)
        No143 (46)165 (54)
        Yes7 (47)8 (53)
    Substance use disorder5.4.02 (.035)*0.38 (0.15, 0.97)
        No134 (45)166 (55)
        Yes16 (70)7 (30)
    Mood disorder47.8<.00010.21 (0.13, 0.35)
        No41 (27)113 (73)
        Yes109 (64)60 (36)
    Anxiety disorder1.52.220.54 (0.22, 1.34)
        No137 (46)164 (54)
        Yes13 (59)9 (41)
    Psychotic disorder17.4<.0001 (.0064)*0.40 (0.24, 0.66)
        No92 (39)142 (61)
        Yes58 (65)31 (35)
    Impulse control disorder—.73†1.34 (0.30, 5.99)
        No147 (47)168 (53)
        Yes3 (38)5 (62)
    Adjustment disorder0.35.551.37 (0.45, 4.17)‡
        No145 (47)165 (53)
        Yes5 (38)8 (62)
    Organic disorder0.91.341.68 (0.59, 4.76)
        No144 (47)162 (53)
        Yes6 (35)11 (65)
    • Data are expressed as n (%). Percentages are based on the total n in each row. Unless otherwise indicated, all probabilities are derived from chi-square tests.

    • ↵* Significance obtained from additional comparisons of disorder by CST status across age groups. Finding refers to comparison for the 16- to 17-year age group.

    • ↵† By Fisher's exact test (used due to small sample).

    • ↵‡ Breslow-Day test result for homogeneity of the odds ratios is significant for adjustment disorder, nonsignificant for all other variables.

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    Table 3

    Mental Health Treatment and Competency Status

    DiagnosisIST (n = 174)CST (n = 150)Total (n = 324)χ2p
    Medication use at intake8.40.0037
        No93 (62)56 (38)149
        Yes81 (46)94 (54)175
    Past medication use3.20.075
        No145 (56)113 (44)258
        Yes29 (44)37 (56)66
    Psychotherapy: lifetime10.70.001
        No124 (61)80 (39)204
        Yes50 (42)69 (58)119
    Any treatment18.2<.0001
        No77 (70)33 (30)110
        Yes97 (45)117 (55)214
    • Data are expressed as n (%). Percentages are based on the total n in each row.

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Journal of the American Academy of Psychiatry and the Law Online: 43 (3)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 43, Issue 3
1 Sep 2015
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Correlates of Competency to Stand Trial Among Youths Admitted to a Juvenile Mental Health Court
Eraka Bath, Lauren Reba-Harrelson, Robyn Peace, Jie Shen, Honghu Liu
Journal of the American Academy of Psychiatry and the Law Online Sep 2015, 43 (3) 329-339;

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Correlates of Competency to Stand Trial Among Youths Admitted to a Juvenile Mental Health Court
Eraka Bath, Lauren Reba-Harrelson, Robyn Peace, Jie Shen, Honghu Liu
Journal of the American Academy of Psychiatry and the Law Online Sep 2015, 43 (3) 329-339;
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