The organization of pretrial forensic evaluation services: A national profile.

Abstract

A survey obtained standardized data to provide a dr of the approaches used in the 50 states and the District of Columbia for obtaining court-ordered competence to stand trial and criminal responsibility evaluations. Respondents were forensic mental health administrators and forensic mental health professionals. Data were obtained for variables describing the organizational characteristics of the states' pretrial forensic evaluation systems. A typology of the states' systems was developed, based on their predominant reliance on inpatient versus outpatient approaches and on service providers with court referral catchment areas that were statewide, regional, or local. Five types allowed classification of 43 states. The types are described on the major organizational and functional variables employed in the survey. The traditional practice of obtaining most court-ordered evaluations from a central inpatient facility has been replaced by a number of outpatient models in all but a minority of states. These models are more complex than past descriptions would suggest.Every state provides criminal courts with pretrial mental health evaluations of defendants, when their mental status raises legal questions of competence to stand trial or criminal responsibility. Nevertheless, little is known about the specific * This study was supported by a research grant from the National Institute of Mental Health (ROI-MH-44623). The authors gratefully acknowledge the National Association of State Forensic Mental Health Program Directors for its consultation in the planning phases of the study, as well as Paul Appelbaum for comments on an earlier draft. Reprints may be obtained from

Fitness to Stand Trial Evaluations: A Comparison of Referred and Non-Referred Defendants

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Integrating the criminal justice system into mental health service delivery: the worcester diversion experience

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