Criminal defendants have a fundamental right to a fair and speedy trial. However, individuals found incompetent to stand trial are unable to move forward in the adjudication process and are often mired in protracted legal proceedings. If competency restoration is statutorily permissible and can be conducted in the outpatient setting, we propose that it should be considered based on burgeoning empirical data. We present data from an outpatient forensic clinic in which individuals are conditionally released to receive competency restoration in the community. Results indicated that three variables, including being single/never married, having comorbid intellectual disability and mental illness, and having one's conditional release revoked, were negatively related to successful restoration. The final model explained approximately one-third of the variance in restorability and correctly classified 75% of cases. Results demonstrate that individuals can be safely released to the community and successfully restored to competency in the outpatient setting. Utilizing outpatient competency restoration would not only reduce strain on inpatient facilities, but would also reduce the cost of treatment. Copyright © 2017 John Wiley & Sons, Ltd.

Like other counties across the nation, Fulton County, GA, has seen a significant increase in the number of arrests of people with serious mental illness. While Fulton County has accountability courts, some defendants with mental illness are not able to take advantage of these options due to their mental illness rendering them incompetent to understand the expectations required by these courts. The WISE (Women's Initiative for Success with Early Intervention) pilot project created a pathway for incompetent women to be diverted out of jail and into mental health treatment that was faster than the traditional evaluation for competency to stand trial pathway. A total of 16 female misdemeanants with non-violent charges were referred to the program. All women in WISE received intensive case management services. Some women were sent to a psychiatric hospital for involuntary hospitalization, some were released back to the community, and some were sent to a state forensic hospital for competency restoration services. Compared with a similar group of female misdemeanants prior to inception of the pilot project, women in the WISE group spent significantly fewer days in jail (mean of 64.9 days versus 163.46 days). Thus, preliminary findings from the pilot project indicate that referral to the WISE program significantly reduced the burden of excess time in jail associated with having an untreated mental illness.

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I have been treating a 26-year-old woman for major depressive disorder, and she is currently in remission and stable on fluoxetine. She just found out she is 9 weeks pregnant. What is my liability in continuing to prescribe her psychiatric medication in pregnancy?