Reimagining competency & restoration: From practice to possibility

Competency to stand trial refers to whether a defendant can understand court proceedings and meaningfully assist their attorney at the present time. It does not assess guilt or mental state at the time of the offense.

Competency restoration is a legal process intended to help a defendant regain the ability to understand court proceedings and assist their attorney so the case can move forward. Restoration typically focuses on legal education and stabilization, not long-term treatment of mental illness or cognitive conditions.

Defendants found incompetent can spend up to four times longer in detention than competent defendants charged with similar offenses due to delays in evaluations, restoration services, and limited forensic mental health capacity.

Courts should consider limiting competency referrals when diversion or community-based treatment is appropriate and when the public interest in prosecution does not justify lengthy evaluation or restoration timelines. 

Outpatient evaluation and restoration can reduce delays, preserve inpatient bed capacity, and maintain individuals' connection to community-based services while still meeting legal and public safety requirements. Fewer people entering competency unnecessarily, through diversion and better screening, can reduce backlogs and reserve intensive resources for the highest-need cases.

Courts can improve the competency process by implementing person-centered strategies, including: diversion to treatment, stricter criteria for ordering evaluations, outpatient-by-default evaluation/restoration policies, active judicial oversight with meaningful review hearings, standardized evaluation templates, use of competency dockets, and improved data reporting.

A competency docket consolidates cases into a consistent courtroom process, improving scheduling predictability, reducing confusion, and enabling specialized coordination among judges, attorneys, evaluators, and providers.

Competency alternatives are approaches that help courts address cases involving serious mental illness or cognitive impairment without relying solely on traditional competency evaluation and restoration. Alternatives include diversion programs, specialized dockets, and civil commitment or assisted outpatient treatment pathways, when legally appropriate.

Assisted Outpatient Treatment (AOT) is a court-ordered, community-based treatment approach for individuals with serious mental illness who meet specific legal criteria. AOT allows courts to require treatment and support in the community rather than relying on jail or inpatient hospitalization when community-based treatment can safely meet legal and public safety needs.

Leadership can convene stakeholders, sponsor training, standardize orders/templates, improve data collection, and coordinate legislative reform efforts.