Tipping the scales of justice: the role of forensic evaluations in the criminalization of mental illness

Abstract

An unprecedented number of individuals with mental illness are represented in the criminal justice system. The unending growth of mentally ill populations in the justice system has led to jails and court dockets being increasingly overwhelmed with cases involving mental illness, state hospitals devoting far more beds and resources to forensic cases, and people without a criminal commitment left waiting for mental health services as forensic cases are prioritized. Although a forensic mental health evaluation is only one component of this larger system, common problems with forensic mental health evaluations can exacerbate the criminalization of persons with mental illness in many ways. This article reviews the current literature regarding issues of quality, reliability, and validity of forensic mental health evaluations, discusses the broader impact of these issues, and offers potential solutions for the field.

Child and adolescent forensic evaluations: Challenges amid scientific and technological advancements.

“…The gravity of the recommendation by Young (2016), in terms of juvenile forensic reports, cannot be overstated when considering judges often follow the evaluator’s opinion; in fact, psychological recommendations were shown to be followed in approximately 75% of cases (Day et al, 2000; Hecker & Steinberg, 2002). However, evidence of poor-quality competency to stand trial reports is replete in the literature (McCallum & Gowensmith, 2020; Robbins et al, 1997; Robinson & Acklin, 2010; Skeem & Golding, 1998; Skeem et al, 1998). This variation in quality may be due to only half the states requiring training for individuals conducting competency assessments coupled with the inconsistency across these training requirements (Gowensmith et al, 2015).…”

Forensic evaluators’ opinions on the use of videoconferencing technology for competency to stand trial evaluations after the onset of COVID-19.

“…Lengthy delays before transferring acutely ill defendants to a psychiatric hospital can have tragic outcomes, such as increased risks for suicide, self-harm, victimization (Daniel, 2007; Hayes, 1995; Tullis, 2019), and increasingly severe psychiatric symptoms (Gowensmith, 2019). Thus, many states have experienced class action lawsuits intended to reduce wait times for competence evaluation and restoration services (Gowensmith, 2019; McCallum & Gowensmith, 2020). For instance, in 2015 a federal judge determined that Washington state was violating due process rights of defendants with long wait times ( Trueblood v. Washington State Department of Social and Health Services [DSHS] , 2015), while Arkansas, Louisiana, Colorado, and Oregon have experienced similar litigation (Gowensmith, 2019; Luxton et al, 2019).…”

Common flaws in forensic reports.

“…Robbins et al (1997) noted that many competency reports were legally irrelevant, insufficient to meet the task, and unstandardized in format. McCallum and Gowensmith (2020) have identified various harmful consequences of poorly conducted competency assessments and the associated reports.…”