Expedited Diversion of Criminal Defendants to Court-Ordered Treatment.

The authors propose a formal statutory diversion process for offenders with serious mental disorders: expedited diversion to court-ordered treatment (EDCOT). As a civil commitment proceeding accompanied by dismissal of criminal charges, EDCOT would not entail a waiver of criminal trial rights and could be invoked even if the defendant lacked trial competence. EDCOT would also be available to authorize civil hospitalization of offenders who are not immediately able to function successfully in the community.

A New Commitment Pathway for Offenders With Serious Mental Illness: Expedited Diversion to Court-Ordered Treatment.

The authors propose a new form of civil commitment that would benefit individuals with serious mental illness involved with the criminal justice system. This population has complex needs rooted in comorbid conditions, alienation from treatment and support systems, and poor access to care. Although many dollars are spent on costly assessments and hospitalization of jail detainees with serious mental illness to ensure that they are competent to stand trial, these detainees typically do not receive adequate services during incarceration or after release and recidivate at high rates.

Competence to stand trial: An overview.

The legal concept of competence to stand trial has ancient roots. The history of this legal construct in Anglo-Saxon law will be reviewed. A competent defendant is a requirement of the criminal justice system because it reflects interests related to the dignity of the process, the accuracy of adjudication, and respect for the autonomy of defendants.

Restoration of Firearm Rights in New York.

The National Instant Criminal Background Check System (NICS) Improvement Amendments Act of 2007 encouraged states to create processes by which individuals who have lost their rights to firearm possession for mental-illness-related reasons could receive relief from restrictions. Over 20 states have created relief processes for this sub-group, but there still exists considerable state-by-state heterogeneity. The spectrum ranges from states that require a physician's opinion regarding appropriateness for restoration to those that rely solely on judicial proceedings without input from psychiatrists or other mental health professionals.

Ethics and neuropsychiatric genetics: a review of major issues.

Advances in neuropsychiatric genetics hold great hopes for improved prevention, diagnosis and treatment. However, the power of genetic testing to identify individuals at increased risk for disorders and to convey information about relatives creates a set of complex ethical issues. Public attitudes are inevitably affected by the shadow of eugenics, with its history of distorting scientific findings to serve socio-political ends.

Commentary: Resistance to Jackson v. Indiana--civil commitment of defendants who cannot be restored to competence.

Levitt and colleagues provide empirical data and qualitative information that indicate that unrestorable, incompetent defendants are treated differently from ordinary patients in the civil commitment process. This report contributes to the literature suggesting that mentally ill defendants' rights under Jackson v. Indiana are not being respected.

Parole revocation among prison inmates with psychiatric and substance use disorders.

Objective: This retrospective cohort study examined the association between co-occurring serious mental illness and substance use disorders and parole revocation among inmates from the Texas Department of Criminal Justice, the nation's largest state prison system.

Methods: The study population included all 8,149 inmates who were released under parole supervision between September 1, 2006, and November 31, 2006. An electronic database was used to identify inmates whose parole was revoked within 12 months of their release.

Mental health performance measurement in corrections.

Correctional facilities have become, by default, one of the largest providers of mental health care for patients with serious mental illness. In its 2002 Report to Congress, the National Commission on Correctional Health Care has reported that most facilities do not provide quality mental health care, nor do they conform to nationally accepted guidelines for mental health screening and treatment. This article describes the product of a consensus panel of correctional health care experts, charged to develop performance measures, based on nationally accepted standards, for selected elements of psychiatric treatment behind bars, aimed to improve the quality of care.

Competence to consent to research among long-stay inpatients with chronic schizophrenia.

Objective: Questions have been posed about the competence of persons with serious mental illness to consent to participate in clinical research. This study compared competence-related abilities of hospitalized persons with schizophrenia with those of a comparison sample of persons from the community who had never had a psychiatric hospitalization.

Methods: The study participants were administered the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), a structured instrument designed to aid in the assessment of competence to consent to clinical research.