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Restoration of Competency to Stand Trial

February 22, 2011
The majority of the research to date has focused on the evaluation of competency to stand trial, while ignoring the issue of restoration of competency to stand trial. Two areas that have been research regarding restoration are: the prediction of restorability and the investigation of various treatment programs for restoration.

Prediction of Restorability
  • Hubbard and Zapf (2003) found two significant predictors of restorability: current violent charge and previous criminal history. Defendants predicted to not be restorable were more likely to be older and had impairment in the ability to understand information about the legal process. Defendants predicted to be restorable were more likely to have less serious diagnoses (i.e., nonpsychotic mental disorders) and more serious violent criminal histories.
  • Mossman (2007) reported two significant predictors of low probability of restoration: if the defendant had a long standing psychotic disorder that had resulted in lengthy psychiatric hospitalizations and if the defendant had an irremediable cogntive disorder (i.e., mental retardation). 
  • Morris and Parker (2008) found that defendants with mood disorders were more likely to be restored to competence than those diagnosed with psychotic disorders. Defendants with mental retardation were significantly less likely to be restored than defendants with any other psychiatric disorder. Female defendants and defendants with affective disorders were most likely to be restored, whereas defendants who were older, mentally retarded, or had a psychotic diagnosis were less likely to be restored.
  • In summary, most defendants are restored within 6 months and 3 characteristics have been consistently found to reduce the chances of restoration: older age, mental retardation, and/or psychotic disorder.
Treatment for Competency Restoration
  • Treatment of competency restoration has typically focused on mental disorder/cognitive impairment and competency related abilities. The most common form of treatment involves psychotropic medication. However, some jurisdictions have also implemented educational programs to increase a defendant's understanding of the legal process.
  • Anderson and Hewitt (2002) found that only 18% of defendant's with mental retardation were restorable. 
  • Other researchers have found mixed results regarding educational treatment programs (Siegel & Elwork, 1990; Bertman et.al., 2003).
  • In Summary, successful restoration is related to how well the defendant responds to psychotropic medications. The benefits of adding educational treatment programs needs further research.
References
Zapf, P.A. & Roesch, R. (2011). Future directions in the restoration of competency to stand trial. Current Directions in Psychological Science, 20, 43-47.


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