The impact of misdemeanor arrests on forensic mental health services: A state-wide review of Virginia competence to stand trial evaluations.

Abstract

Across the United States, court orders for competence to stand trial evaluations and competence restoration services have been increasing much more rapidly than many states can provide these services, prompting what has been called a national "competency crisis." Though many factors contribute to this crisis, one that has received little attention is the potentially disproportionate role of misdemeanor arrests on competency services. Therefore, we reviewed a state-wide sample of court-ordered competence evaluation reports in Virginia (N ϭ 1,126) to compare defendants facing only misdemeanor charges to defendants facing felony charges. Overall, defendants facing only misdemeanors were more often opined incompetent to stand trial than were defendants facing only felony charges (44.0% vs. 31.2%), perhaps due to the greater prevalence of psychotic symptoms among defendants facing only misdemeanor charges (34.5% vs. 15.9%). Indeed, hierarchical regression analyses suggested that incompetence opinions were primarily explained by the presence of psychotic symptoms. A simple fiscal analysis also revealed that defendants facing only misdemeanor charges are disproportionately costly to Virginia, due in part to a greater need for inpatient restoration services. These findings suggest the national competency crisis could be reduced, to at least some degree, by mental health diversion or treatment strategies specific to mentally ill defendants facing only misdemeanor charges.

Reporting potentially irrelevant information—Defendant race/ethnicity, criminal history, and substance use—in competence to stand trial reports: A statewide study.

“…Evaluators provided an inconclusive opinion or failed to provide a competency opinion in 26 reports (2.3%). More detailed information about competency rates in this sample is provided by Murrie, Gardner, and Torres (2022). However, the overall rate of incompetence in this sample is broadly consistent with the trend of increasing incompetence rates across the United States in recent years (Gowensmith & Murrie, 2022; Murrie, Gardner, & Torres, 2022).…”

“…The CST reports coded in this sample do not overlap with Virginia CST reports described in earlier studies (e.g.,Murrie et al, 2020; Warren et al, 1991 Warren et al, , 2006. However, the CST reports in this sample do overlap with those described in a recent study addressing the ways competence findings relate to charge severity(Murrie, Gardner, & Torres, 2022). The foci of these studies differ greatly, and other than basic sample descriptives, we present novel analyses with no overlap in studies.4 Coders also coded whether the evaluator indicated that substance use directly interfered with the defendant's competence to stand trial (yes or no).5 For analytic purposes, CST opinion was dichotomized as competent versus not competent; "not competent" included both incompetence opinions and opinions that were inconclusive or unclear.…”

“…3The CST reports coded in this sample do not overlap with Virginia CST reports described in earlier studies (e.g., Murrie et al, 2020; Warren et al, 1991, 2006). However, the CST reports in this sample do overlap with those described in a recent study addressing the ways competence findings relate to charge severity (Murrie, Gardner, & Torres, 2022). The foci of these studies differ greatly, and other than basic sample descriptives, we present novel analyses with no overlap in studies.…”

“…CST evaluation reports were coded for multiple variables as part of a larger project (Murrie, Gardner, & Torres, 2022) that examined the characteristics of the defendant, the CST evaluation process, the resulting report, and the forensic conclusions offered within the report. Reports were coded by one of five independent coders.…”

Forensic evaluators’ opinions on the use of videoconferencing technology for competency to stand trial evaluations after the onset of COVID-19.

“…Some participants expressed concerns about evaluating defendants with active psychosis (16%) or intellectual disability (13%). There were more concerns about evaluating competence to face more serious charges (30% were concerned about capital cases) and no concerns about less serious charges (0% concern about misdemeanor cases, although defendants facing misdemeanor charges are more often psychotic and opined incompetent; Murrie et al, 2020a). Quite understandably, there were many concerns related to administering psychological testing via videoconference, given the practical challenges and deviation from standard administration procedures this would require.…”