competence to stand trial mapping - systems mapping

Competence to Stand Trial Mappings

Building solutions to decrease waitlists and length of stay
competence to stand trial mapping - systems mapping

Competence to Stand Trial Mappings

Building solutions to decrease waitlists and length of stay

What’s
at Stake

Costly, long stays
in psychiatric
hospitals or jails

Courts can raise concerns around a person’s competence to stand trial (CST) during the trial process. They do this when individuals exhibit signs of conditions that can impair their ability to understand the charges brought against them and assist their attorney in preparing their defense. The signs and symptoms of such conditions vary. The conditions can include serious mental illness, intellectual and developmental disabilities, or disorders affecting neurocognition and behavior. When these concerns arise, the court can order a competence examination requiring forensic evaluation and systems.  Often it is a lengthy and expensive process.

Individuals that may require CST  evaluation are rarely considered for diversion, though they tend to be ideal candidates for community-based services. Instead, they become detainees for long periods in jails or state psychiatric hospitals while waiting for an evaluation. This can have harmful results. Potential negative outcomes include reentry into the forensic or criminal justice system—a misuse of resources. This misallocation has overburdened the mental health system in many places and has been the subject of class-action lawsuits brought against states.

Our Solution

At every point in the CST process, there is a gatekeeper who has the ability to divert an individual to community-based treatment. But the different parts of the CST system are often poorly connected. This prevents gatekeepers from seeing the bigger picture and coordinating with one another. The Competence to Stand Trial Mapping catalyzes these needed connections. It helps communities identify decision-makers, critical stakeholders, and programs within the CST/competence restoration (CR) system. Systems Mapping Center facilitators work with communities to identify these people and resources and incorporate them into a map. This map helps stakeholders see duplication and gaps.

Working together, Systems Mapping Center facilitators can help communities improve their CST processes. The mapping process aims to implement solutions to decrease waitlists and shorten a defendant’s length of stay in a hospital or jail setting. Strategies could include, but are not limited to:

  • Establishing bail considerations to allow for release with support
  • Ensuring rapid access to brief clinical or forensic evaluations
  • Installing screening protocols to determine the needed level of care
  • Training forensic evaluators on potential community-based services to identify alternatives to traditional inpatient restoration
  • Creating positions for forensic navigators who can provide support to people in the competence system and share information with stakeholders on potential diversion programs

Our Model

The Competence to Stand Trial flowchart focuses on Intercepts 2 (Initial Detention/Initial Court Hearings) and 3 (Jails/Courts) of the Sequential Intercept Model. These are key decision points in the CST process. They provide an opportunity for justice and behavioral health professionals to consider and create unique diversion opportunities.

CST is typically raised after arraignment and before case adjudication and sentencing. Intercepts 2 and 3 offer a broad range of diversion opportunities for individuals for whom CST is raised and those who have been ruled incompetent to stand trial (IST) with the potential for restoration. They even present opportunities to divert those found not restorable.

The Competence to Stand Trial flowchart outlines a series of common decision points within the CST process. Some examples of these events are evaluation, restoration, and disposition. Each decision point highlights possible outcomes and places where individuals could be referred. These include hospitals, jails, community-based treatment services, supportive services, and courts.

Competence to Stand Trial Mappings Image

Stakeholders

The stakeholders involved in the Competence to Stand Trial Mapping include the following:

  • Advocates
  • Behavioral health providers
  • Community-based services
  • Courtroom and legal professionals
  • Families of individuals for whom CST has been raised
  • Forensic evaluators
  • Healthcare providers
  • Jail staff
  • Law enforcement
  • People with lived experience