Developing a Forensic Service Delivery System for Juveniles Adjudicated Incompetent to Stand Trial

Abstract

Our study examines the experiences of 563 youth ordered into restoration services after a judicial finding of adjudicative incompetence. Among this group, 72% were determined to be restored to competence usually within 90 to 120 days of services provided in the least restrictive environment allowed by the courts. These outcomes were achieved using an individualized psycho-educational intervention that combined intensive case management, developmentally informed interactive educational tools, and case integration and mentoring by specially trained restoration counselors. These individualized services were provided to each youth on average three times a week by the restoration counselor contracted to provide services in the location where the youth was residing. No juveniles were admitted for inpatient hospitalization for the purpose of restoration only. Five percent were hospitalized based upon civil commitment criteria or for further psychiatric evaluation or stabilization. Chi-square Automated Interaction Detector (CHAID) analyses were used to create decision trees of the restoration pathways demonstrated by four subgroups of youth: Mental Illness Only (MIO), Mental Retardation Only (MRO), Mental Illness and Mental Retardation (MI-MR), and No Mental Illness and No Mental Retardation (NMI-NMR). The interaction of individual characteristics and interventions varied across the four groups with the highest rates of restoration being achieved by youth in the NMI-NMR group (91%) and the lowest rate among youth in the MRO group (47%). These rates of restoration are comparable to those achieved using residential treatment for youth and inpatient hospitalization for adults.

Jail‐based competency treatment comes of age: Multi‐site outcomes and challenges to the implementation of an evidence‐based forensic continuum

“…The results showed that young adults aged < 20 years had the highest rate of restoration (at 74%) in an average of 46.6 days. This high rate of restoration is consistent with three studies of juvenile restoration, which found a restoration rate of 71–76% in an average of 90–120 and 217 days (McGaha, Otto, McClaren, & Petrila, 2001; Warren et al., 2010, 2019). The notable difference is that this JBCT study achieved the same rate of restoration in a fraction of the time.…”

“…-85 programs that provide intensive daily treatment with both individual and multiple group-based rehabilitative activities, while limited programs (coded as "L") are constrained to one-to-one counseling in the jail on a lessthan-daily frequency. In rough chronological order of implementation, these JBCT programs include Virginia (F: 1997-2002; L: since 2011), Louisiana (L since 2007); Arizona (four Fs: county programs starting in 2003 in Maricopa, 2007 in Pima, and2010 in Yavacai and Yuma counties); California (12 Fs: starting in 2011 in San Bernardino County); Georgia (F: since 2011 in Fulton County); Colorado (F: since 2013); Washington (two Fs: since 2015); Minnesota (L: since 2015); Utah (L: since 2015); Wisconsin (L: since 2016); Texas (F: in development since 2017); Pennsylvania (F: authorized in 2018, not implemented) and Tennessee (L: years unknown). Florida has attempted mental health diversion programs for ISTs since 1999 (Florida Substance Abuse and Mental Health Corporation and Florida Partners in Crisis, 2009).…”

Ten Year Research Update (2001–2010): Evaluations for Competence to Stand Trial (Adjudicative Competence)

“…As noted earlier, McGaha et al () analyzed data for all youths adjudicated incompetent and referred for competence remediation in specialized secure facilities in Florida during a three‐year period. Warren et al () reported on over 500 youth in Virginia's program, which accomplishes its juvenile incompetence remediation services while youth are in the community or in detention centers. Several results were similar for the two studies.…”

A Community‐Based Model for Remediating Juveniles Adjudicated Incompetent to Stand Trial: Feedback from Youth, Attorneys, and Judges

“…Warren et al. () examined the restoration outcomes of 563 youth referred by the courts for restoration services in Virginia. After receiving an average of 61 to 90 days of services, 73 percent of youth were determined to be competent.…”

“…Warren et al. () found that the highest rate of achieved competence was among youth who were not mentally ill or mentally retarded (91 percent) and the lowest rate of achieved competence was among youth with mental retardation (47 percent). In Florida, McGaha, Otto, McClaren and Petrila () examined over 400 youth deemed incompetent to stand trial (excluding youth transferred to adult court or considered incompetent because of developmental immaturity) and referred for restoration services.…”