Restoration to Competency Practice Guidelines

Published date01 June 2001
Date01 June 2001
Subject MatterJournal Article
International Journal of Offender Therapy and Comparative Criminology
Restoration to Competency
Restoration to Competency
Practice Guidelines
Stephen G. Noffsinger
Abstract: Courts frequentlyadjudicate criminal defendants as incompetent to stand trial and
order defendants to psychiatric hospitals for treatmentand education designed to restore the
defendant to competence. However,little information is available on effective restoration to
competency techniques. This article summarizes the existing literatureon restoration to com-
petency programs, describes a competency restoration program at one Ohio hospital, and
offers basic restorationto competency practice guidelines that may be applied to any facility
performing competency restoration.
In 1960, the U.S. Supreme Court articulated the legal standard for competence to
stand trial in the landmark mental health case Dusky v. United States. The
Supreme Court said the proper standard for determining competence to stand trial
is “whether the defendant has sufficient present ability to consult with his lawyer
with a reasonable degree of rational understanding, and whether he (the defen-
dant) has a rational as well as factual understanding of the proceedings against
From 25,000 to 36,000 competence-to-stand-trial evaluations are performed
annually in the United States, resulting in approximately 9,000 defendants’ being
adjudicated by criminal courts as incompetent to stand trial (McGarry,1973). The
vast majority of those criminal defendants found incompetent are court-ordered
into psychiatric hospitals for treatment and education designed to restore them to
competence, so that they may proceed to trial at a later date. Approximately
15,000 criminal defendants are hospitalized at any giventime in the United States
after being adjudicated incompetent to stand trial (Winnick, 1977). Most of these
defendants are incompetent due to psychotic disorders and/or mental retardation,
with a smaller number incompetent due to mood disorders.
The U.S. Supreme Court ruled in 1972 (12 years after Dusky v. United States)
in the case of Jackson v. Indiana that indefinite commitment for competency res-
toration was a violation of due process and allowed confinement to determine
whether the defendant was restorable to competence only for a reasonable period
of time. The Jackson v. Indiana ruling put pressure on forensic hospitals to
developefficient and effective programs for competency restoration to be compli-
ant with the limited time frames for restoration to competency.
Restoration to competence to stand trial usually involves two simultaneous
processes. First, the underlying mental disorder must be treated. This, in itself, is
International Journal of Offender Therapy and Comparative Criminology, 45(3), 2001 356-362
2001 Sage Publications

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