Factors Associated with Negative Outcomes in Competency Restoration

This study investigated the associations between demographic, clinical, and legal variables with negative outcomes in competency restoration (CR), which included ultimate findings of incompetence to stand trial (IST), extensions to length of stay (LOS), and recommitment to CR pre-adjudication. Correlates between competency prong level findings in evaluation reports were examined for associations with defendant measures of performance in treatment. A sample (n = 250) was composed of archival data of discharged state hospital patients committed for competency restoration. Average LOS for patients in this sample was 137 days. Commitments were extended for 34% of patients at least once (n =86), and 8% (n = 20) were recommitted for CR pre-adjudication. Lower educational attainment and poor participation in competency education were predictive of IST findings and extensions to LOS. Individuals charged with violent crimes were more likely to face extensions to CR commitments. Those who had a history of CR admissions for prior criminal charges, and those who were restrained for dangerous or disruptive behavior during their current admission, were more likely be recommitted to CR prior to adjudication of their index charge(s). An evaluator opinion of a defendant’s inability to comport themselves appropriately in court was significantly linked to poor medication compliance. The implications of these findings are discussed in the context of the existing body of competency related literature, with suggested considerations offered for future studies exploring correlates and predictors of recommitment for competency restoration.