Appraising Jackson-based unrestorability to competence to stand trial: The demonstration model.

Under United States law, criminal prosecution may not proceed against a defendant who is incompetent to participate in this process. The vast majority of defendants who are adjudicated incompetent to stand trial (IST) will subsequently regain sufficient capacities to be adjudicated competent to stand trial (CST). However, a small subgroup of defendants do not show sufficient improvement in clinical functioning and functional-legal capacities to regain CST. Under Jackson v. Indiana (1972), such individuals should be adjudicated unrestorably IST, with associated actions (e.g., dropping of criminal charges, civil commitment, transfer to a less restrictive environment or released) specified under the particular jurisdictional statutes. But the present practices associated with the evaluation of unrestorability do not appear well supported by research. In particular, statutorily specified evaluative procedures are overly dependent on prediction in some instances and allow an unnecessarily long restoration period in others. In the present article, we propose and describe an alternative approach-the Demonstration Model-that would address both challenges, providing a more consistent and standard approach to assessing CST and the possibility that a defendant may not recover needed capacities within the foreseeable future. Implementation of this approach can potentially guide restoration planning and intervention, decrease unsupported reliance upon prediction in favor of observing and documenting the results of selected interventions, and provide legal decision-makers with clearer and more transparent evidence, while acknowledging the liberty interests of IST defendants set forth in Jackson. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An agenda for advancing research on crisis intervention teams for mental health emergencies.

The popularity of crisis intervention teams (CITs) for law enforcement agencies has grown dramatically over the past decade. Law enforcement agencies and advocates for individuals with mental illness view the model as a clear improvement in the way the criminal justice system handles individuals with mental illness. There is, however, only limited empirical support for the perceived effectiveness of CITs. This Open Forum analyzes research needs in this area and offers recommendations. Two major gaps in CIT research are identified: verifying that changes in officers' attitudes and skills translate into behavioral change and determining how criminal justice-mental health partnerships affect officers' behavior. Research addressing these gaps could help set benchmarks of success and identify evidence-based practices for CIT, substantially increasing the empirical base of support for CIT.

Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness.

The Sequential Intercept Model provides a conceptual framework for communities to use when considering the interface between the criminal justice and mental health systems as they address concerns about criminalization of people with mental illness. The model envisions a series of points of interception at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system. Ideally, most people will be intercepted at early points, with decreasing numbers at each subsequent point. The interception points are law enforcement and emergency services; initial detention and initial hearings; jail, courts, forensic evaluations, and forensic commitments; reentry from jails, state prisons, and forensic hospitalization; and community corrections and community support. The model provides an organizing tool for a discussion of diversion and linkage alternatives and for systematically addressing criminalization. Using the model, a community can develop targeted strategies that evolve over time to increase diversion of people with mental illness from the criminal justice system and to link them with community treatment.

The use of criminal charges and sanctions in mental health courts.

OBJECTIVE: This study sought to describe the use of criminal charges, sanctions (primarily jail), and other strategies mental health courts use to mandate adherence to community treatment, and in doing so to elaborate on earlier descriptions of such courts. METHODS: Telephone interviews were conducted with staff of four mental health courts, located in Santa Barbara, California; Clark County, Washington; Seattle, Washington; and Marion County, Indiana. RESULTS: Mental health courts use one or more of three approaches to leverage the disposition of criminal charges to mandate adherence to community treatment: preadjudication suspension of prosecution of charges, postplea strategies that suspend sentencing, and probation. In no case are criminal charges dropped before the defendant becomes involved with the mental health court program. Each dispositional strategy includes adherence to community treatment as a condition. Courts report a wide variety of sanctions for failure to adhere to court-ordered conditions. CONCLUSIONS: Mental health courts use various creative methods of disposition of criminal charges to mandate adherence to community treatment. In contrast to drug courts, in which the use of jail and other sanctions for nonadherence is common, most mental health courts report rarely or occasionally using jail in this way.