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Contents
- Abstract
- Robust Focus on Competency to Stand Trial Evaluations
- Need for Focus on Competency Restoration
- Outpatient Competency Restoration
- Method
- Survey
- Size and longevity of OCRPs
- Demographics of OCRP participants
- Clinical status of OCRP participants
- Admission procedures for OCRPs
- Jail-based competency restoration
- Agencies providing OCRP services
- Location, staffing, and scope of restoration services
- Outcomes
- Exclusionary Criteria
- Results
- Statutory Review
- States Operating OCRPs
- Comparing and Contrasting Existing OCRPs
- Size and longevity of OCRPs
- Demographics of OCRP participants
- Clinical status of OCRP participants
- Admission procedures for OCRPs
- Agencies providing OCRP services
- Location, staffing, and scope of restoration services
- Jail-based competency restoration
- Outcomes
- Competency restoration
- Public safety
- Financial costs
- Discussion
- Scope of OCRPs
- Efficacy of OCRPs
- Restoration to competence
- Financial savings
- Increased hospital bed capacity
- Maintenance of public safety
- Public Policy and Ethical Considerations
- Eligibility criteria
- Scope of mandated services in OCRPs
- Funding sources
- Limitations
- Future Directions
- Appendix A
Figures and Tables
Abstract
In response to consistently increasing numbers of individuals found incompetent to stand trial, some states have identified community-based or “outpatient” competency restoration programs (OCRPs) as a viable alternative to inpatient restoration. This study used a multistep approach to capture information about OCRPs nationwide. We reviewed states’ competency statutes to determine which states have provisions that allow for outpatient competency restoration, and we then corroborated this review with a brief preliminary survey that was disseminated to each representative of the Forensic Division of the National Association of State Mental Health Program Directors. We received responses from 48 of 51 U.S. jurisdictions (47 states and the District of Columbia). We conducted in-depth interviews with forensic representatives in those 16 states that identified having operational OCRPS. The current study presents our analysis of state statutes and then compares and contrasts current OCRPs. In summary, OCRPs are a recent but rapidly developing alternative to traditional inpatient restoration. Through a comparison of existing OCRPs, we believe OCRPs show preliminary but promising outcomes in terms of high restoration rates, low program failure rates, and substantial cost savings.
Localities across the United States are struggling with the growing number of individuals with serious mental...