An overview of jail-based competency restoration

CNS Spectrums ◽  
2019 ◽  
Vol 25 (5) ◽  
pp. 624-629
Author(s):  
Scott E. Kirkorsky ◽  
Mary Gable ◽  
Katherine Warburton
Keyword(s):  
United States ◽  
State Hospital ◽  
Mentally Ill ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Competency Restoration ◽  
State Hospitals ◽  
Hospital Beds ◽  
Incompetent To Stand Trial ◽  
County Jails

Forensic populations in the United States are increasing, driven largely by a rise in individuals determined to be Incompetent to Stand Trial (IST). Across most states, including California, the number of mentally ill inmates awaiting competency restoration has increased dramatically in recent years. Traditionally, competency restoration has taken place in state hospitals, but incompetent inmates often experience a significant wait for state hospital beds because of the rising demand for beds in such facilities. The resulting waitlists, which range from days to months, have led to states being held in contempt of court for violating limits placed on how long incompetent defendants can be held in jail. Therefore, alternatives to state hospitalization for IST patients have been developed, including jail-based competency (JBCT) restoration programs. JBCT programs provide restoration services in county jails, rather than in psychiatric hospitals. The following article will review the nature of JBCT programs and will emphasize the structure and evolution of such programs within California.

The indistinguishables: determining appropriate environments for justice involved individuals

CNS Spectrums ◽  
2019 ◽  
Vol 25 (2) ◽  
pp. 122-127
Author(s):  
Sean E. Evans ◽  
Shannon M. Bader
Keyword(s):  
United States ◽  
Mental Illness ◽  
Mentally Ill ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Situational Factors ◽  
Diversion Programs ◽  
Controversial Topic ◽  
Recent Trends ◽  
Psychiatric Facilities

Criminalizing those with mental illness is a controversial topic with a long and complex history in the United States. The problem has traditionally been dichotomized between criminals (i.e., “bad”) in need of placement in jails and prisons and the mentally ill (i.e., “mad”) who are need of treatment in psychiatric facilities. Recent trends demonstrate significant increases in the rates of mental illness in jails and prisons, as well as increased rates of violence within psychiatric hospitals. This would suggest that there are a group of justice involved individuals who are “indistinguishable” within the traditional dichotomous categories of dangerousness and mental illness. The authors argue for a more nuanced model that dimensionally conceptualizes dangerousness and mental illness; increased attention to situational factors that create facilities appropriate for those who are dangerous and mentally ill and more diversion programs for those inappropriate for incarceration or hospitalization.

scholarly journals Homelessness, outreach and advocacy: Current themes in North American community psychiatry

1988 ◽  
Vol 12 (7) ◽  
pp. 286-288
Author(s):  
Graham Thornicroft
Keyword(s):  
United States ◽  
New York ◽  
Mentally Ill ◽  
Community Psychiatry ◽  
Psychiatric Hospitals ◽  
The United States ◽  
Patient Treatment ◽  
Annual Conference ◽  
Community Based ◽  
Homeless Mentally Ill

With the process of closing psychiatric hospitals and establishing community-based alternatives more than 20 years old in the United States, psychiatric practice there is in the post-deinstitutionalisation age. In Britain we are now starting on this same path. Against this background, I attended the annual conference convened by the journal Hospital and Community Psychiatry in October 1987. Held in Boston, in the same week that Major Koch of New York sanctioned the compulsory reinstitutionalisation of homeless mentally ill people from the streets of Manhattan, the conference emphasised four themes: homelessness, outreach programmes, systems of case management, and compulsory out-patient treatment.

“This is Not Who We Are:” Progressive Media and Post-Race in the New Era of Overt Racism

2019 ◽  
Vol 12 (1) ◽  
pp. 1-17
Author(s):  
Katherine M Bell
Keyword(s):  
United States ◽  
Mentally Ill ◽  
News Coverage ◽  
The United States ◽  
Right Wing ◽  
New Era ◽  
Cable Network ◽  
History Of ◽  
Ideological Stance ◽  
News Outlet

Abstract This analysis explores how a liberal mainstream news outlet—MSNBC—grapples with the overt racism of the current right-wing populist presidential administration in the United States. With a plethora of “good” conservatives and its stable of liberal pundits, the cable network has painted the president as mentally ill or declining, an incompetent purveyor of chaos. In perpetuating a mantra of “this is not who we are” in coverage of overt racism, MSNBC pivots to a more comfortable mainstream space of post-race, an ideological stance that places racism as a fringe anomaly. The post-race pivot belies the country’s ongoing racist legacy, and potentially lulls viewers toward acceptance of official antiracisms that serve hegemonic interests. Thus, the news coverage of the current presidency plays a role in forestalling a meaningful reckoning with the country’s ongoing history of institutional and everyday racism.

A survey of national trends in psychiatric patients found incompetent to stand trial: reasons for the reinstitutionalization of people with serious mental illness in the United States

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 245-251
Author(s):  
Katherine Warburton ◽  
Barbara E. McDermott ◽  
Anthony Gale ◽  
Stephen M. Stahl
Keyword(s):  
Psychiatric Patients ◽  
National Level ◽  
District Of Columbia ◽  
The United States ◽  
Community Treatment ◽  
Specific Information ◽  
General Mental Health ◽  
Forensic Patients ◽  
State Hospitals ◽  
Incompetent To Stand Trial

Objective.Recent information indicates that the number of forensic patients in state hospitals has been increasing, largely driven by an increase in patients referred to state hospitals as incompetent to stand trial (IST). This survey was intended to broaden the understanding of IST population trends on a national level.Methods.The authors developed a 30-question survey to gather specific information on IST commitments in each state and the District of Columbia. The survey was administered to all 50 states and the District of Columbia via email. Specific individuals identified as primary administrators responsible for the care and evaluation of IST admissions in each state were contacted.Results.A total of 50 out of the 51 jurisdictions contacted completed the survey. Fully 82% of states indicated that referrals for competency evaluation were increasing. Additionally, 78% of respondents thought referrals for competency restoration were increasing. When asked to rank factors that led to an increase, the highest ranked response was inadequate general mental health services in the community. Inadequate crisis services were the second ranked reason. Inadequate number of inpatient psychiatric beds in the community was the third highest, with inadequate assertive community treatment services ranking fourth.Conclusions.Understanding the national trend and causes behind the recent surge in referrals for IST admissions will benefit states searching for ways to remedy this crisis. Our survey indicates most states are facing this issue, and that it is largely related to insufficient services in the community.

scholarly journals Contested Jurisdictions: Psychiatry, Psychoanalysis, and Clinical Psychology in the United States, 1940–2010

2011 ◽  
Vol 55 (3) ◽  
pp. 401-406 ◽  
Author(s):  
Andrew Scull
Keyword(s):  
United States ◽  
Great Depression ◽  
Mentally Ill ◽  
The United States ◽  
Turn Of The Century ◽  
Pearl Harbor ◽  
Fiscal Crisis ◽  
Total War ◽  
The Great Depression ◽  
American Psychiatry

American psychiatry on the eve of Pearl Harbor was a small, stigmatised, and isolated specialty, for the most part confined as surely inside the high walls of its barrack-asylums as the patients over whom it exercised near-autocratic powers. The number of mentally ill patients incarcerated in state and county mental hospitals had grown sharply, from 150,000 at the turn of the century to 445,000 in 1940. The fiscal crisis of the states that accompanied the Great Depression had produced a steady deterioration of conditions in these institutions, a deterioration that would intensify as a result of the exigencies of total war. In the immediate aftermath of that prolonged conflict, conditions had degenerated to such a parlous state that a number of outside observers compared America's asylums to Nazi death camps.

Confronting 60 Minutes’ “Imminent Danger”: The Evidence on Schizophrenia and Psychotropic Medications, Violence, and Forced Orders to Treat

2014 ◽  
Vol 16 (1) ◽  
pp. 51-62 ◽  
Author(s):  
Toby T. Watson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
The United States ◽  
Psychotropic Medications ◽  
Television Show ◽  
Imminent Danger ◽  
The World

Recently, considerable attention has been given to individuals labeled “mentally ill,” with the possibility that they too often go untreated with psychotropic medications and in turn, commit disproportionally higher rates of violence. The world-known television show60 Minutesbroadcasted a special on this topic in the United States on September 29, 2013; however, they created a disturbingly inaccurate picture of those who suffer with what some label as “mental illness.” There are decades of peer-reviewed research demonstrating that individuals diagnosed with severe mental illness, labeledschizophrenia,and given psychotropic medications are in fact less likely to recover from their disorder and more likely to be rehospitalized. Additionally, although mental health commitments, often calledforced orders to treat,are quite common and now being supported more so due to such programming, the research on mental health commitments has not shown they are actually effective.

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