Article Figures & Data
Tables
Time Limit on Original Commitment Conditional Release Process Internal Review Process for Release or Discharge Statutory Language Re Priority or Goals in Decision-Making Release from Hospital Decisions OR As ordered, not to exceed max prison sentence Internal review process grants “CR readiness” privilege prior to requesting that the Board order evaluation for CR by community MH agency; results in hearing before PSRB Internal review process grants “CR readiness” privilege prior to requesting that the Board order evaluation for CR by community MH agency From PSRB Work Group: “protect the public and balance the public’s concern for safety with the rights of the client” (Ref. 27, p 13); from ORS 161.351(3): “the board shall have as its primary concern the protection of society” PSRB CT As ordered, not to exceed max prison sentence Hospital or patient petition PSRB; results in hearing before PSRB Consulting forensic psychiatrists and forensic review committee Safety of public and well-being of patient PSRB AZ Committed for length of possible sentence Court and community treatment provider must agree on CR plan; court orders CR and conditions State hospital, community provider, and court agree on plan for CR Public safety and protection are primary Court WA Not to exceed max prison sentence Hospital or patient petition court; hospital's materials, recommendations sent to PSRP for review and recommendation, which is sent to the court and designee of Secretary of DSHS Forensic evaluator from OFMHS, hospital-based care coordinator, and hospital-based Risk Review Board Safety of the public primary; petitioner must show by a preponderance of the evidence Court CA Max possible sentence (for inpatient commitment); conditional release program (CONREP) portion indeterminate Hospital medical director recommends CONREP; court decides Hospital medical director or community program director, as applicable Danger to the health and safety of others Court GA Court may order commitment for six mos; chief medical officer may apply for order of continued hospitalization Team drafts CR plan; reviewed by hospital forensic director, external FRC (if serious violent felony), then FRC, then clinical director, then hospital administrator, then to court for hearing and review Team drafts CR plan; reviewed by hospital forensic director, external FRC (if serious violent felony), then FRC, then clinical director, then hospital administrator Civil commitment criteria Court HI No After 90 days, hospital director or patient may apply Three concurrent, independent forensic evaluations completed as part of CR involving felony charges (including at least one psychiatrist)53 Danger to persons or property Court MA Six mos; then one yr recommitments None Medical director or superintendent, after independent forensic risk assessment Likelihood of serious harm Court MD Indeterminate Hospital requests release hearing with ALJ, who makes recommendation to criminal court. Initial CR is five yrs, can be extended Forensic Review Board for inpatients; “Central Admissions Office” for those on CR Danger to self, others, or property Court ME No Psychiatrist files report to Comm’r as soon as person may be released; Comm'r applies to court. In practice, patient encouraged to apply through attorney to facilitate a court date Treatment team or psychiatrist to Comm'r; review by State Forensic Service Likelihood of injury to self or others Court MN Indeterminate SRB and Comm’r make decision; called “provisional discharge” SRB and Comm’r Reasonable degree of safety for the public; will enable person to adjust successfully to community SRB and Comm’r MO54 Indeterminate Treatment team to facility FRC, to COO, to state forensic director, to court. Courts generally grant release when DMH supports it. Patient may also request Treatment team to FRC of facility, to COO, to state forensic director Not now or likely in reasonable future to commit another violent crime because of mental illness; has capacity to conform behavior to requirements of law in future Court NC Indeterminate None; 1st release hearing at 50 days, then 90, then 180, then one yr Periodic discharge panel meetings No longer dangerous or no longer mentally ill Court NY One yr for hospital commitment Comm’r applies to court; hearing held. CR order for five yrs, may be renewed for five yrs indefinitely Treating clinicians and OMH staff; court rarely disagrees with OMH recommendation Presence of dangerous mental disorder Court OH Max prison sentence; almost always committed for full time Review by FRT, Forensic Center, and trial court FRT and Forensic Centers review LRA consistent with public safety and welfare of person; preference to public safety Trial court SC Max possible sentence Hospital director requests of court Not specified in state interagency protocol Likelihood of serious harm; lacks insight or capacity to make responsible decisions re treatment Court TN No Reviewed by COO and RMRC; court may hold hearing, where COO decision presumed correct but may be challenged RMRC, COO Likelihood of harm unless under court-ordered treatment, other factors RMRC ± court VA Indeterminate; first hearing re continued commitment at one yr; for misdemeanors, max one yr Petition by Comm'r, with CR plan jointly prepared by hospital and community service board If one examiner (psychologist or psychiatrist) recommends release, 2nd examiner appointed; if 2nd agrees, recommend release to court and detailed CR plan created with community Does not need inpatient, needs outpatient monitoring to prevent deterioration, appropriate outpatient available and significant reason to believe acquittee would comply with conditions and CR will not present “undue risk to public safety” (VA Code § 19.2-182.7) Court ALJ, administrative law judge; Comm’r, Commissioner; COO, Chief Operating Officer; CR, conditional release; DMH, Department of Mental Health; DSHS, Department of Social and Health Services; FRC, forensic review committee; FRT, forensic review team; LRA, least restrictive alternative; MH, mental health; mos, months; OFMHS, Office of Forensic Mental Health Services; OMH, Office of Mental Health; ORS, Oregon Revised Statutes; PSRB, Psychiatric Security Review Board; RMRC, Risk Management Review Committee; SRB, Special Review Board; yr, year.
We have noted where we used statutes or additional references outside the survey.
Average Length of Hospitalization % Acquittees in Hospital Rehospitalization Rate Rearrest Rate under Supervision Rearrest Rate after Discharge from Monitoring OR27 4.1 yrs 36% In 2020, 0.63% were revoked and returned to hospital; separately, 25% of court-ordered CR fail within six mos 3.6% (felonies and misdemeanors) over seven yrs; annual recidivism rate 0.87% Over seven yrs, 37.8% total (21.9% for felonies; 16% for misdemeanors); n.b. 29% of discharges still in hospital at time of discharge (i.e., no CR time) CT28 10.7 yrs for those not arrested after discharge from PSRB; 5.8 yrs for those arrested after discharge 73% 31% 2.3% (half dismissed; half for misdemeanor; none for violence) 16.3% over avg of 12.5 yrs community exposure (11% for those on CR at time of discharge; 27.9% for those not on CR at discharge) AZ41 — 83.5% — — — WA — 71% Over 5.5 yrs, 30 conditional release returns (variety of reasons) — — CA6 4.3-8.2 yrsa — 9%16 8.2%-44% during avg of 4.8 yrs follow-upa — MD55 — — 31% per yr 0.53% for violent crimes; 2.5% per yr for all arrests over five yrs community exposure — MO54,56 7+ yrs at min security; 75.3 mos mean for most serious felonies in those who achieved CR, 92.3 mos for same crimes in those who did not achieve CR 54% (1997) 2016: 7% per yr (most voluntarily); 2023: 1% (3% highest in recent yrs) — — NC2 8.1 yrs for those in hospital; 4.9 yrs for those released 100%; once released, no monitoring 28% (after final discharge) na 15% reconviction (4.9% for violent offenses) NY1 6.33 yrs 60% (1/2 in forensic hospitals, 1/2 in civil hospitals) — 21% over avg 14 yrs community exposure (11% for violent offense); nearly half during 1st two yrs, 2/3 by yr five — VA57 61.6 mos — 24.4% had CR revoked over three yr period — — Blank cells represent data that were unavailable. No data available for GA, HI, MA, ME, MN, OH, SC, and TN.
avg, average; CR, conditional release; mos, months; PSRB, Psychiatric Security Review Board; yr, year.
↵aDepending on conditions of release.
Additional Files
Supplemental material
- Text s01, PDF - Text s01, PDF
