Encyclopedia of Psychology and Law

“competency to stand trial,” and many of the interview

guides and competency assessment instruments devel-

oped for forensic examiners focused on defendants’

comprehension of trial proceedings. In a sense, this

emphasis was misplaced because in reality, few defen-

dants ever go to trial. Upward of 90% of criminal

cases are resolved by some form of plea bargain or

plea agreement, each of which entails the waiver of

one or more of the constitutional protections dis-

cussed above. Thus, Bonnie’s elaboration of the deci-

sional competence construct has stimulated clinical

thinking about the mental abilities needed to intelli-

gently weigh decisional alternatives (e.g., to be able to

describe the potential risks and benefits of alternative

courses of action) and ways to craft new measures for

the systematic assessment of those abilities. Through

careful consultation with defense attorneys about the

likely case decision points, particularly those that

involve the waiver of rights, psychiatric and psycho-

logical examiners may better tailor their evaluations to

provide information to the courts about defendants’

foundational and decisional competence abilities.

Norman G. Poythress

See also Adjudicative Competence of Youth; Capacity to

Waive Rights; Competency to Stand Trial

Further Readings

Bonnie, R. (1990). The competence of criminal defendants

with mental retardation to participate in their own defense.

Journal of Criminal Law and Criminology, 81,419–446.

Bonnie, R. (1992). The competence of criminal defendants:

A theoretical reformulation. Behavioral Sciences and the

Law, 10, 291–316.

Bonnie, R. (1993). The competence of criminal defendants:

Beyond Duskyand Drope. University of Miami Law

Review, 46,539–601.

Dusky v. United States, 362 U.S. 402 (1960).

Godinez v. Moran, 509 U.S. 389 (1993).

Melton, G. B., Petrila, J., Poythress, N. G., & Slobogin, C.

(in press). Psychological evaluations for the courts: A

handbook for mental health professionals and lawyers

(3rd ed.). New York: Guilford Press.

COMPETENCY, RESTORATION OF

Evaluations of competency to stand trial are the most

common source of referrals to forensic mental health

practitioners. While the clear majority of those exam-

ined are viewed as competent to proceed, those found

incompetent to stand trial (IST) may be subjected to

treatment and training to enable them to proceed to

trial, typically referred to as competency restoration.

These individuals constitute the largest group referred

for mental health treatment under the auspices of the

criminal justice system, with several thousand persons

hospitalized in the United States at any given time.

Despite the significant variability in treatment and

education efforts, as many as 9 in 10 persons origi-

nally found unfit are eventually adjudicated compe-

tent and proceed to disposition of the charges against

them. There is a dearth of systematic research on the

methods used to accomplish this result. Restoration

efforts typically require no more than 4 months, and

an increasing number of jurisdictions allow for outpa-

tient treatment and training to minimize pretrial depri-

vation of liberty. Medication is often a key component

of treatment for defendants with psychiatric illness.

Prognosis is more guarded for restoration of cogni-

tively impaired defendants.

Some commentators have questioned the propriety

of the competency restoration programs provided by

mental health practitioners. An alternative view holds

that enabling impaired defendants to develop or regain

the ability to participate in the resolution of their legal

predicaments is ethically justified. This entry summa-

rizes the legal and ethical context of competency

restoration efforts, the presenting problems that are

typically the focus of treatment, treatment methods

and programs, and the outcomes of restoration efforts.

Legal and Ethical Context

All U.S. jurisdictions provide for treatment of individ-

uals found IST. Traditionally, this was presumed to

involve commitment to a government-run facility for

inpatient care. In Jackson v. Indiana (1972), the

Supreme Court clarified that such commitment must be

reasonably related, in duration and circumstances, to

the purpose of restoring the individual to competency.

Those found not restorable within the reasonably fore-

seeable future may be subjected to civil commitment.

Surveys suggest that nearly half the defendants referred

for restoration are placed in state hospitals and receive

services typical for a civil patient population. Most of

the remainder are confined in high-security facilities. In

view of the significant deprivation of liberty entailed in

inpatient restoration, a small number of jurisdictions

have created provisions for outpatient competency

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