An estimated 60,000 competency evaluations are court-ordered each year. Approximately 20 percent of these evaluations lead to findings of incompetence—roughly 12,000 defendants are found incompetent to stand trial in the United States each year. Major mental illness, intellectual disability or other cognitive limitations are the most frequent causes of adjudicative incompetence. This means, of course, that roughly 80 percent of the court-ordered evaluations result in findings of competence—a figure that, in and of itself, suggests there is room for dramatic improvement. Not only is the competency evaluation process costly to the jurisdiction, but it may unnecessarily lengthen the time a defendant is involved in the criminal justice system.
The purpose of the Mental Competency—Best Practices Model is to present a body of practices deemed to be most effective and efficient for handling mental incompetency issues in the criminal justice and mental health systems. The practices are designed to complement one another to “serve both the interests of fairness . . . and of sound judicial administration.” Drope v. Missouri, 420 U.S. 162, 176-77 (1975) (citations omitted). For instance, one of the best practices is for the court to advance the date for a hearing on the issue of the defendant’s competency to the day after the competency report is filed for a misdemeanor charge(s), and to within 10 days for a felony charge(s)—and to likewise advance the date for a plea hearing or trial. If the court adheres to this best practice, the positive, cascading effect will likely be felt system-wide—saving the court, jurisdiction, city, county, and/or state the funds to maintain restored defendants—and reducing the amount of time the mentally ill individuals are detained, awaiting further proceedings.
The model presents best practices from the initial competency hearing through discharge or referral for civil commitment; it also suggests practices to further education and collaboration within the jurisdiction, county, and state. The model presents protocols for competency hearings; practices relative to competency evaluations and reports, treatment, and restoration; and practices for establishing a competency court or docket. Those practices may significantly decrease the percentage of unnecessary referrals for competency evaluations while increasing the percentage of referrals that result in the court finding that the defendant is incompetent. The model suggests practices to maintain the competency of restored defendants which may lower the overall costs and help to prevent restored individuals from decompensating. The model also addresses practices relative to the involuntary administration of medication pursuant to the United States Supreme Court opinion in Sell v. United States, 539 U.S. 166 (2003).
The best practices include a brief discussion, related issues, and resources. You will also find on this website the list of experts who contributed to the model; a resources section with articles and books on the subject, cases, forms, guides and published standards, state competency statutes, and related studies. Additionally, you will findvideos of mock competency hearings and a competency assessment presented by experts on the panel, and a section on other system components, such as diversionary practices.
Beginning later this year, the website will also feature webinars on how to incorporate best practices into your court or jurisdiction. Note that the Mental Competency—Best Practices Model is also available in portable document format (PDF) on this website for ease of printing and with additional citations.