A Public Health Perspective to Reform the Competence to Stand Trial System

• Published in: Psychiatric services (Washington, D.C.) Vol. 74; no. 12; pp. appips20230079 - 1290
• Main Authors: Kois, Lauren E, Murrie, Daniel C, Gowensmith, W Neil, Packer, Ira K
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Publishing, Inc 01-12-2023
• Subjects: Arrests; Mental health care; Psychiatric research; Trials; Forensic psychiatry; Mental health services; Competence to stand trial; Criminal justice; Jails and prisons; Public health
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/appi.ps.20230079

Investigations by Compton et al demonstrate an astounding rate of arrests among individuals with serious mental illness and those receiving inpatient psychiatric care. Findings from one of the studies showed that approximately 71% of individuals with psychotic or mood disorders who received treatment at one of three inpatient psychiatric facilities in GA between 2014 and 2018 had at least one arrest. Disproportionate and reoccurring arrest among those with serious mental illness is a driving force behind the national competence to stand trial (CST) crisis, a challenge that demands better research attention. Here, Kois et al describe how Compton and others' findings can inform solutions to an urgent problem facing the public mental health system. CST is a constitutional protection intended to uphold the due process rights of criminal defendants and the dignity of the legal process.