1. PROBLEMS and SOLUTIONS

2. Problems Competency is a complex issue
Defendants are often referred for competency when other concerns represent the real questions
Restoration of competence
Disposition is a more complex issue
Providing treatment for the consenting MI defendant
Mandating treatment for the involuntary MI defendant

3. The Real Question Assessment of risk
Complex assessment requiring social hx and rechecks
Mandated recommendations
Inpatient commitment
Outpatient commitment
Mandated conditions of bond or probation. Who track this?

4. Offenders/defendants with substance abuse MISA defendants/defendants
Sexual offenders
Difficulties with placement
Problems with mandated reporting
Offenders/defendants with substance abuse
Mandated SA treatment
MISA defendants/defendants
Mandated dual dx treatment

5. The community nuisance offender
Often the chronically and/or severely MI offender
How much can be mandated when there is no risk of harm?
Sometimes incompetence provides an avenue for mandated treatment

6. Restoration of competence
402 commitment
Certain defendants are not restorable. The defendant who is diagnosed with ID or brain trauma
Certain defendants require 24/7 evaluation (malingering/ sovereign citizen defense)
Certain defendants do not require inpatient restoration
Wait for transfer 90 days v 1 year in eastern part of state
JRS treatment plan and recheck
JRS and/or caseworker education and recheck

7. Treatment plan For the high risk MI defendant
For the nuisance MI defendant
For the hard to place defendant. Sexual offender or defendant with history of arson or assault
The traveling MI defendant
Encompasses many factors including dual dx needs, housing, medication compliance

8. SOLUTIONS

9. Restoration of competnce
In jail competency restoration
Accreditation
Staff
Psychiatrists
Nurse/nurse practitioners or PA
Mental health worker
Social workers
Program
Assessment
Testing
Treatment
Competency education groups

10. Competency restoration clinics
Again considerations for accreditation, staff, and program
Address the MI defendant who can be treated as an outpatient. Will require monitoring for compliance and abstinence
Address the ID defendant with competency education
Least restrictive
Take the burden off the state hospital/ decrease the wait time
Lowers the cost

11. Disposition Enhancement of existing programs
Facilitate community inpatient treatment
Protocol for involuntary commitment (302/303)
Mandated condition for bond or probation
Voluntary commitment (201)
Cooperate with all treatment recommendations
Cannot sign out
Mediation compliance
Comply with after care plan

12. Forensic clinics Bond stipulation Conditions for probation
Clinicians understand defendant’s/offender’s charges and legal status
Defendants/offenders can be tracted
Clinical status communicated to court address only
Defendant’s/offender’s attendance
Defendant’s/offender’s treatment compliance

13. THOUGHTS?