Outpatient/Community-Based Fitness Restoration Programs Survey

Gowensmith, W. Neil; Frost, Lynda E.; Speelman, Danielle W.; Therson, Danielle E.

doi:10.1037/t54140-000

Cited by 5 publications

(16 citation statements)

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“…Emerging research also indicates that OCR success is enhanced when participants receive hospital-level care before being placed in an outpatient program (Musgrove, Gowensmith, Hyde, & Wallerstein, 2018). Still, little consistency exists across OCR operations, staffing, and policies (Gowensmith et al, 2018). Empirical investigation on OCR is in its infancy, and more is needed.…”

Section: Potential Solutionsmentioning

confidence: 99%

Resolution or resignation: The role of forensic mental health professionals amidst the competency services crisis.

Gowensmith

2019

Psychology, Public Policy, and Law

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Competency-related services are rising at an unprecedented rate in the United States. Many states are in the midst of lawsuits and legal maneuvering to deal with long wait lists for defendants awaiting competency evaluations and admission to competency restoration services. As a result, many solutions have been proffered and implemented. However, solutions vary in their adherence to existing empirical research and applied experience. Forensic mental health professionals are uniquely qualified to shape the evolution of competency-related services into a humane and effective system. Promising policy implications can be rooted in emerging knowledge about the timing of competency evaluations, certification of evaluators, alternatives to inpatient restoration, and changes to evaluations and the associated reports. However, forensic professionals have typically given minimal attention to these issues, instead giving more focus to narrower issues of optimizing competency evaluations and restoration procedures. In so doing, forensic professionals are at risk of abdicating their expertise regarding competency-related services to other professions, as well as compromising their ethical commitments of beneficence and nonmaleficence in regard to incompetent defendants.

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Section: Potential Solutionsmentioning

confidence: 99%

Resolution or resignation: The role of forensic mental health professionals amidst the competency services crisis.

Gowensmith

2019

Psychology, Public Policy, and Law

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“…Mental Health Courts have been shown to reduce recidivism rates not only for individuals who have completed the program, but also individuals who have only partially participated (Hiday & Ray, 2010). Relevant to the present study, evaluations of CST are also located in the third intercept, with several states providing outpatient competency restoration programs that have favorable results (Gowensmith et al, 2016;Mikolajewski et al, 2017). Further, some states, including Florida and New York, have eliminated competence restoration treatment for less serious offenses altogether (Gowensmith, 2019).…”

Section: Diversion Strategies For Mentally Ill Defendantsmentioning

confidence: 89%

Characteristics and outcomes for defendants charged with misdemeanors referred for court-ordered competency evaluations.

Tansey¹,

Brown²

2022

Psychological Services

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Recent research has suggested nationwide increases in the rates of referral for competence to stand trial (CST) evaluations across the United States. Many of these evaluations are for defendants charged only with misdemeanor offenses and for whom diversion programs are most appropriate. The present study was designed to analyze the characteristics of, and re-arrest outcomes for, defendants charged with misdemeanors ordered to undergo CST evaluations in a large metropolitan area. Overall, there was a high base rate of incompetent to stand trial (IST) opinions (over 70% of defendants) in this sample, with the greatest impairments in rational understanding and ability to assist counsel. Defendants opined IST were more likely to have a psychotic disorder, a history of psychiatric hospitalization, and greater abnormalities in thought content relative to their competent counterparts. Of concern, defendants opined IST, and especially those referred for crisis evaluations upon dismissal of the charges, were significantly more likely to be re-arrested than their counterparts. These data support the criminalization hypothesis, suggesting that criminal justice involvement for this subset of defendants inappropriately reflects psychiatric instability, supporting the need for more options for inpatient and outpatient treatment to effectively intervene in this process. Impact StatementDefendants who are charged with low-level offenses and evaluated for competency to stand trial are among the most psychiatrically unstable and severely mentally ill defendants. The increased rates of incompetency findings, higher re-arrest rates for repeat low-level offenses, and recommendations for crisis evaluations provide support for the criminalization of mental illness.

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“…Ancillary referrals to various services (e.g., case management, substance abuse treatment, therapeutic support) that address individual barriers to competency may also be made (Noffsinger, 2001). Although some states offer restoration in an outpatient or community setting, most competency restoration still occurs in inpatient psychiatric hospitals Gowensmith et al, 2016). On average, defendants receiving competency restoration services are then reevaluated every 90 days based on the typical timeframe it takes to restore defendants to competency (Pirelli & Zapf, 2020).…”

Section: Competency Restorationmentioning

confidence: 99%

“…Requests for evaluations of competency to stand trial have significantly increased in recent years. Since the early 1960s, the requests for evaluations have increased from around 25,000 to 36,000 per year to 50,000 to 60,000 every year (Colwell & Gianesini, 2011;Gowensmith et al, 2016;Miller, 2003). Current estimates suggest that the total number is likely at least 84,000 evaluations per year (Kois, 2020).…”

Section: Competency Restorationmentioning

confidence: 99%

“…The growing need for competency restoration services made prompt delivery of competency-related services difficult, inciting lawsuits, consent decrees, statutory revisions, and court-appointed monitors around the country (Center for Legal Advocacy, d/b/a Disability Law Colorado v. Barnes, M. & Marshall, J., 2019;Locklair, 2016;Trueblood et al v. Washington State DSHS, 2014). Hospitals remain the most common setting for defendants to receive competency restoration services, but forensic inpatient capacity is insufficient in most states (Gowensmith et al, 2016;Torrey et al, 2010). Jail-and community-based restoration services were developed to decrease the need for forensic hospital beds.…”

Section: Competency Restorationmentioning

confidence: 99%

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Ethical considerations of competency restoration: The risk of decompensation in correctional settings.

Martin¹,

Bailey²,

Gowensmith³

2023

Psychology, Public Policy, and Law

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Competency restoration is the process of restoring a defendant to competency by the means of addressing a defendants' barriers to competency through psychotropic medication, legal education, and referrals to additional resources. Research has been conducted related to the process, effectiveness, and a variety of other aspects of competency restoration, but little is known about the rates of decompensation after defendants have been restored to competency. Decompensation, or the deterioration of an individual's mental health, is not only psychologically distressing to the individual experiencing it, but in this context, it has a significant impact on the speed of court proceedings. Although little research has been conducted, it is reasonable to predict that decompensation in correctional settings is high due to empirical findings that correctional settings often exacerbate inmates' already existing mental health difficulties (Fellner, 2006;Jordan, 2011;. The purpose of this article is to discuss ethical considerations related to the risk of decompensation in correctional settings after a defendant has been restored to competency, based on the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2017) and the Specialty Guidelines for Forensic Psychology (APA, 2013). This article also highlights the scarcity of data related to decompensation postrestoration and provides suggestions for psychologists to advocate and support defendants in the maintenance of their competency, as well as suggests future directions for the criminal legal system as a whole.

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Outpatient/Community-Based Fitness Restoration Programs Survey

Cited by 5 publications

References 0 publications

Resolution or resignation: The role of forensic mental health professionals amidst the competency services crisis.

Resolution or resignation: The role of forensic mental health professionals amidst the competency services crisis.

Characteristics and outcomes for defendants charged with misdemeanors referred for court-ordered competency evaluations.

Ethical considerations of competency restoration: The risk of decompensation in correctional settings.

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