Dr. Danzer is a licensed psychologist at Florida State Hospital, Tallahassee, FL. Dr. Wheeler is a former Director of the Forensic Evaluation Department at Central State Hospital and currently in private practice at Bay Forensic Psychology, Petersburg, VA. Dr. Alexander is a Clinical Assistant Professor, Graduate School of Professional Psychology, Denver Forensic Institute of Research, Service, and Training, University of Denver, Denver, CO. Dr. Wasser is an Assistant Professor of Psychiatry, Yale University School of Medicine, New Haven, CT.
J Am Acad Psychiatry Law. 2019 Mar;47(1):68-81. doi: 10.29158/JAAPL.003819-19. Epub 2019 Feb 8.
The optimization of trial competency restoration is a topic of growing interest and controversy in the fields of forensics, psychology, criminal law, and public policy. Research has established that adult defendants who have severe psychotic disorders and cognitive impairments are more likely than defendants without these conditions to be found incompetent to stand trial and are less likely to be restored to competency thereafter. Research has also identified some of the benefits of attempting restoration in hospitals, jails, or outpatient settings for defendants with different diagnoses or levels of cognitive functioning. Rates of restoration, length of stay necessary to achieve restoration, and, in some cases, how quickly defendants are found non-restorable are primary indicators of positive outcome. We sought to review the extant literature on competency restoration, with the goals of identifying implications for current practice and generating inquiries for future research. We found that there are significant advantages and disadvantages of attempting restoration in a hospital, jail, or outpatient setting on rates of restoration, length of stay necessary to achieve restoration, or length of time necessary to determine non-restorability, while controlling for several relevant factors (e.g., diagnosis, cognitive limitations).
在法医学、心理学、刑法和公共政策领域，恢复审判能力的优化是一个日益引起关注和争议的话题。研究表明，患有严重精神障碍和认知障碍的成年被告比没有这些条件的被告更有可能被判定为无能力接受审判，而且此后恢复能力的可能性也较小。研究还确定了在医院、监狱或门诊环境中尝试恢复对具有不同诊断或认知功能水平的被告的一些好处。恢复率、实现恢复所需的停留时间以及在某些情况下，被告被认定为不可恢复的速度是积极结果的主要指标。我们试图回顾关于恢复能力的现有文献，目的是确定对当前实践的影响，并为未来的研究提出问题。我们发现，在医院、监狱或门诊环境中尝试恢复在恢复率、实现恢复所需的停留时间或确定不可恢复性所需的时间方面存在显著的优势和劣势，同时控制了几个相关因素（例如，诊断、认知限制）。
