What is it about?
Mental health concerns are a pressing issue in today's criminal legal system. Competence evaluations, which assess whether defendants can understand court proceedings and assist in their defense, are crucial for ensuring fair trials. This study investigated how often US courts order these evaluations. By analyzing data from multiple states, the researchers found that over 140,000 evaluations likely occur annually - more than double previous estimates. The study also revealed major inconsistencies in how courts track this information, with many unable to provide accurate data. These findings highlight an urgent need for better data collection to address the well-documented overrepresentation of mental illness in the criminal legal system. Improved tracking could help courts and mental health systems better prepare for and address this high demand for competence evaluations and the underlying treatment needs of defendants.
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Why is it important?
This study is timely and important because it quantifies the extent of the "competency crisis" facing the U.S. criminal legal system. With over 140,000 competence to stand trial evaluations conducted annually - more than double previous estimates - our findings reveal an overwhelming demand that strains both court and mental health systems. This crisis has led to thousands of defendants with serious mental illness languishing in jails for months or even years while awaiting long-delayed evaluation and treatment, prompting allegations of civil rights violations and lawsuits in at least 16 states. Our research highlights the urgent need for systemic reform, including alternative approaches such as jail diversion programs and community-based restoration services. These changes could address the overrepresentation of individuals with mental illness in the criminal legal system, reduce costly litigation, and ensure timely, appropriate care for those in need.
Perspectives
Conducting this research has been eye-opening. The data gaps we encountered reflect more than just administrative oversights; they symbolize how easily marginalized populations - in this case, individuals with mental illness who are accused, but not convicted, of crimes - can slip through the cracks of our systems. While those of us working in forensic mental health are acutely aware of this crisis, I worry that the broader public may not fully grasp its magnitude or implications. This study underscores the importance of rigorous, data-driven approaches in addressing complex societal issues. However, it also highlights the continued need to examine why individuals with serious mental illness are overrepresented in the criminal legal system in the first place. We must take a hard look at the root causes of this issue and consider how improved general mental health treatment and social services might prevent many of these arrests. These findings underscore the need for further research and informed discussions on how to address the complex interactions between mental health, social welfare, and the legal system. Our goal should be to maintain the principles of a just legal system for all individuals involved, while exploring how we can best deliver effective treatment to this population in our communities, rather than in jails.
Lauren Kois
University of Virginia
Read the Original
This page is a summary of: Court-reported competence to proceed data across the United States., Law and Human Behavior, June 2024, American Psychological Association (APA),
DOI: 10.1037/lhb0000565.
You can read the full text:
Resources
A Public Health Perspective to Reform the Competence to Stand Trial System
Article published by Kois et al. regarding the public health significance and possible solutions to the "competence crisis."
Evaluations of Competence to Stand Trial are Evolving amid a National “Competency Crisis”
Article published by Murrie, Gowensmith, Kois, and Packer (2023) regarding innovations in competence evaluations and restoration programming amidst the competence crisis.
"Fractured"
PBS FRONTLINE brief documentary depicting the experiences of defendants with mental illness found incompetent to stand trial and awaiting treatment from jail.
Standing Tall: A New Stage for Incompetency Cases
Article published by the American Psychological Association regarding the growing number of people with serious mental illness entangled in the legal system, often for minor crimes. Psychologists are figuring out how to get them essential mental health care instead.
Correctional Officer Mental Health Training: Analysis of 52 U.S. Jurisdictions
Article published by Kois, Hill, Gonzales, Hunter, and Chauhan demonstrating that correctional officers only receive approximately eight hours of mental health training in total, despite the overwhelming numbers of inmates with serious mental health needs.
University of Virginia School of Medicine's Institute of Law, Psychiatry, and Public Policy
The Institute of Law, Psychiatry, and Public Policy (ILPPP) at the University of Virginia (UVA) is an interdisciplinary program in forensic psychology, forensic psychiatry, forensic neuropsychology, and mental health law. ILPPP faculty activities include empirical and theoretical research, forensic clinical evaluations, academic programs, professional training, and public policy consultation and review.
Contributors
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