Supporting the Nation's Judicial System & the Public it Serves


Mental Health Competency Hearings Need Reform

About 4 out of 10 people in custody have been diagnosed with a mental illness. At some point, they ended up in court, where a judge determined whether they were competent to stand trial. While they waited for their competency hearings, they often languished in jails. In Texas alone, more than 1,500 people are waiting for a competency determination, and one out of seven of those defendants were charged only with a misdemeanor crime.

This nationwide problem – a crisis, according to mental health advocates – is decades old, but it’s getting renewed attention from state court leaders.
This month, the executive committee for the National Judicial Task Force to Examine State Courts’ Response to Mental Illness approved a new report that examines mental health competency systems nationwide.

“The crisis in the competency system is the canary in the coal mine for the crisis at the intersection of our behavioral health and criminal justice systems,” said Oregon District Court Judge Nan Waller, a task force member. “Too many mentally ill people end up in the criminal justice system for lack of other options and are then funneled through the clogged competency process.”
Mental health experts and court leaders say the courts need to follow the report’s 10 recommendations:

  • Divert cases from the criminal justice system.
  • Restrict which cases are referred for competency evaluations.
  • Develop clinically appropriate evaluation sites.
  • Find treatment sites that go beyond psychiatric hospitals.
  • Revise restoration protocols.
  • Impose rational timelines for the competency process.
  • Address operational inefficiencies.
  • Address training, recruitment and retention of staff.
  • Coordinate and use data.
  • Develop robust community-based treatment and support for diversion and re-entry.

“The solutions,” Judge Waller said, “require increasing community mental health supports and services, developing points of defection and diversion from the criminal justice system and streamlining the competency process.”

The report from National Center for State Courts (NCSC) is intended to be an immediate resource for state court leaders, and it will serve as a framework as the task force develops additional tools for courts and their partners and forwards future recommendations to the Conference of Chief Justices and the Conference of State Court Administrators.