Judd Seth, Parker George F
Dr. Judd is a Fellow in Forensic Psychiatry, University of South Carolina School of Medicine. Dr. Parker is a Professor of Clinical Psychiatry and Director of Forensic Psychiatry, Indiana University School of Medicine, Indianapolis, IN.
J Am Acad Psychiatry Law. 2018 Mar;46(1):52-62.
Mental health courts (MHCs) have been in existence for more than 20 years, but little is known about the demographics, clinical features, and court outcomes of MHC defendants court-ordered for competence to stand trial (CST) evaluations. We examined these items in defendants who underwent CST evaluations for the Marion County, IN, MHC. The MHC defendants were significantly more likely than defendants referred from other courts to be male, black, unemployed, and on disability, and have a history of prior arrests and psychiatric treatment. MHC defendants found incompetent to stand trial (ICST) were significantly more likely to have a psychotic disorder and a high school education than MHC defendants found CST, and they were significantly less likely to have a mood disorder, to be on psychiatric medication, or to cooperate in forensic interviews. Evaluator concordance of primary diagnoses was linked to concordance of CST opinion. There were no significant differences in the outcome of charges between CST and ICST MHC defendants. This study highlights several important findings. First, evaluator concordance of diagnoses is linked to evaluator concordance of opinion. Second, the Marion County MHC functioned in a non-adversarial manner by not discriminating against defendants who were found ICST at the time of final judgment.
心理健康法庭（MHCs）已经存在了20多年，但对于因受法庭命令接受接受审判能力（CST）评估的MHC被告的人口统计学特征、临床特征和法庭判决结果却知之甚少。我们对印第安纳州马里恩县MHC接受CST评估的被告的这些情况进行了调查。与从其他法庭转来的被告相比，MHC被告更有可能是男性、黑人、失业者和领取残疾津贴者，并且有先前被捕和接受精神治疗的历史。被认定无接受审判能力（ICST）的MHC被告比被认定有接受审判能力（CST）的MHC被告更有可能患有精神障碍且只有高中学历，而他们患情绪障碍、正在接受精神科药物治疗或在法医面谈中合作的可能性则显著更低。主要诊断的评估者一致性与CST意见的一致性相关。CST和ICST的MHC被告在指控结果上没有显著差异。本研究突出了几个重要发现。第一，诊断的评估者一致性与意见的评估者一致性相关。第二，马里恩县MHC以非对抗性方式运作，在终审时不歧视被认定为ICST的被告。
