ABSTRACT
When criminal defendants have symptoms of mental illness severe enough to interfere with participation in criminal legal proceedings, courts may find them incompetent to stand trial and order competence restoration services to provide treatment until they can meaningfully understand proceedings, assist counsel, and make legal decisions. Thus, competence restoration is a form of public mental health treatment ordered by criminal courts. But recently, as more criminal defendants are found incompetent, the public mental health system struggles to meet demands for restoration services. This “competency crisis” requires new approaches. Fortunately, a new evidence base of best practices is emerging. Systems must triage services, providing traditional inpatient hospitalization only to defendants who need it urgently, but shift towards community-based and jail-based restoration services for those who do not. Finally, defendants with minor charges and serious illness should be diverted away from criminal justice competency services into robust public mental health services.
