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Competency Restoration February 11, 2012

Posted by Crazy Mermaid in mental illness.
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Competency restoration is the practice of medicating a person who has committed a crime to the point where they can stand trial for their crime.  This doesn’t mean that they automatically are incompetent because they’re mentally ill. It means that they understand the charges against them and can assist their defense attorney in their defense.  If they are competent to stand trial, the insanity defense is still open to them if they believe that their mental illness was the cause of their crime.

 

The way it works in Washington State is this:  Say a man beats his grandmother on the head until she’s dead because he believes she’s part of a conspiracy to murder him.

After he’s caught, he’s interviewed by his public defender.  If the public defender believes he suffers from a mental illness that makes him incompetent to stand trial, the public defender orders an evaluation. The State has up to fifteen days to perform that evaluation.  The reality, though, is that the man sits in jail for six to eight weeks, waiting for a bed to free up at Western State Hospital so an evaluation can be performed.  Unfortunately, what used to be two weeks is now eight weeks because of two factors. The first factor is that the number of beds at Western (and other locations) has been reduced significantly within the past two years due to lack of funding. The second problem is that the Veteran’s Administration is stealing doctors who would have worked at Western because the Federal Government is now competing with the State for the same doctors because of the new national focus on PTSD in war veterans.

As part of the evaluation, the doctor uses a data base to track the subject’s history of mental illness as well as review the subject’s criminal history and medical records. The doctor interviews the subject for one to two hours.  After all of this is done, the doctor writes a report that makes a determination of whether the man is competent to stand trial.

If the man is competent to stand trial, he proceeds to the next process through the court system.  If he is found to be incompetent to stand trial and mentally ill, he proceeds to Western State Hospital for up to 90 days in the hope that he will have his competency restored.  If, after 90 days, he is still found to be incompetent, he can be held for an additional 180 days.  If he still isn’t competent to stand trial, he can be held for up to 180 more days if it is a felony case or the charges can be dismissed against him, with the understanding that he will spend a lot of time at Western State Hospital in their forensic  (criminal) section.

It seems logical that if someone is being evaluated for competency restoration, they are by definition mentally incompetent, but this is not the case. After competency restoration, they can still plead insanity as a defense, but they have to be able to assist in their own defense. Most of the people who are evaluated decline to pursue the insanity defense, because of the stigma of that defense.

As an extreme example of the competence versus insanity, there was a man who was tried for the murder of his grandmother by way of beating her to death with a rock because he believed she was part of a conspiracy by the Federal Government against him.   But the delusion that she was part of the conspiracy was not enough to deem him incompetent.  He declined a public defender, instead deciding to represent himself.  On the stand, he readily admitted to his crime, but declined the insanity defense. He was sentenced to prison.

At the end of the day, the entire competency restoration issue is driven by money- sort of.  There is no mandate that people with serious mental illness be given proper treatment prior to their committing crimes.  The State waits until the mentally ill have been accused of committing a crime before much effort is expended in giving them a mental health evaluation.

Jail and Prison are expensive- more expensive than treatment for mental illness. And then there are the costs that are difficult to put a price on, like loss of life. We simply can’t afford for our mentally ill population to be stored in our prisons and jails, which is what happens now.  Treatment prior to criminal acts being committed is far less expensive than housing them in jail or prison.  And yet the dollars for mental health care are shrinking more with each passing year.  Hospital beds are being eliminated, to the point where Washington State has the fewest mental hospital beds in 50 States.

If you care about this issue, please contact your legislative representatives and tell them to properly fund mental health. It could save someone’s life.

 

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Comments»

1. Ruby Tuesday - February 20, 2012

This is completely unbelievable. Or at least it should be. So theoretically, someone (okay, by ‘someone’ I’m thinking me, of course) who is taking all of the advised steps to manage their illness has a psychotic episode, a complete and total break from reality, in spite of total treatment compliance, and they go out and commit a violent crime. The system then says, “Let’s get them back in touch with reality (competent) so we can hold them responsible for an act they committed when they had no grasp of reality (incompetent), and adequately and appropriately punish them for something they had no idea was wrong when they did it. But it’s okay to punish them now, because now they realize what they did was wrong!”

To me that’s equivalent to spanking a full-grown man for hitting his sister when he was two, because now he knows better!

If these people can be restored to sanity, that’s great (although maybe not for them, because they’ll then have to come to grips with whatever they did), but that doesn’t for a moment mean that they had a concept of their actions when they weren’t clinically sane.

And I guess each and every one of us deserves a good thrashing, because I do not believe there is an adult alive today who never did something they shouldn’t have as a child, simply because they weren’t psychologically able to distinguish right from wrong.


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