Guidelines for determining restorability of competency to stand trial and recommendations for involuntary treatment.

Over 50,000 defendants are referred for competency to stand trial evaluations each year in the United States (Psychological evaluations for the courts: A handbook for mental health professionals and lawyers, New York, NY: The Guildford Press; 2018). Approximately 20% of those individuals are found by courts to be incompetent and are referred for "restoration" or remediation (Psychological evaluations for the courts: A handbook for mental health professionals and lawyers, 4th edn. New York, NY: The Guildford Press; 2018; Bull Am Acad Psychiatry Law.

The Sell effect: involuntary medication treatment is a "clear and convincing" success.

The Supreme Court ruling Sell v. United States in 2003 (539 U.S.

Involuntary medication treatment for competency restoration of 22 defendants with delusional disorder.

There are no published data on the rates of competency restoration for adjudicated incompetent felony criminal defendants diagnosed with delusional disorder. A retrospective record review was conducted of all incompetent defendants with the principal diagnosis of delusional disorder who had undergone involuntary medication treatment for competency restoration during a 13-year period at a federal psychiatric prison hospital. Of the 181 defendants who were involuntarily medicated for competency restoration during this period, 22 had delusional disorder.