Restoration to Competency Practice Guidelines

• DOI: 10.1177/0306624X01453007
• Published date: 01 June 2001
• Date: 01 June 2001
• Subject Matter: Journal 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

him.”

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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