Competency to stand trial

National Crisis Regarding Competency to Stand Trial: Impact on Public Sector Mental Health Services

UW Department of Psychiatry & Behavioral Sciences Grand Rounds

Speaker: Ira Packer, PhD

Sponsor: Center for Mental Health, Policy, and the Law

June 3, 2022

There is a national crisis regarding individuals with mental illness who are charged with crimes, deemed not competent to stand trial and in need of psychiatric hospitalization, but who languish in jails due to lack of hospital capacity. In addition to the harm suffered by these individuals, the crisis impacts the entire mental health system. Furthermore, many states (including Washington) have been successfully sued in Federal Courts for violation of these individuals’ constitutional rights.

This lecture will address:

  • Some of the possible reasons fueling this competency crisis, including issues of quality of forensic evaluations, and lack of adequate community resources for this population.
  • Suggestions for addressing the competency crisis.

Ira K. Packer, PhD, is professor emeritus of psychiatry at the University of Massachusetts Medical School. He has authored or co-authored over 50 articles and chapters, as well as two books. Dr. Packer has over 40 years experience providing and supervising forensic evaluations, with an emphasis on competence to stand trial, criminal responsibility, and violence risk assessment. In addition to his clinical forensic work, Dr. Packer has extensive experience managing forensic mental health programs, and providing consultation on forensic systems nationally. Dr. Packer served nationally as the president of the American Board of Forensic Psychology, president of the American Academy of Forensic Psychology, and president of the Council of Specialties in Professional Psychology.

Competence to Stand Trial and Civil Commitment: Are They Related?

UW Department of Psychiatry & Behavioral Sciences Grand Rounds Series

Speaker: Debra Pinals, MD

Sponsor: The Center for Mental Health, Policy, and the Law

April 23, 2021

The issues related to competence to stand trial are increasingly receiving national attention. Many states are grappling with waitlists to assist individuals in the competence to stand trial system who are awaiting hospital bed placement. Some states are examining a variety of diversion strategies from the criminal competency system, including the role of civil commitment. This talk will review current trends in addressing challenges in the criminal competency system and explore use of civil commitment as one strategy to address complex issues that has its own benefits and limitations. 

Learning objectives:

  • Describe basic elements of the competence to stand trial system and pathway.
  • Describe how the sequential intercept model can be adapted to divert individuals from the competency system.
  • Discuss the pros and cons of civil commitment as an alternative strategy for individuals at risk of being subsumed in or returning to the criminal competency system.

Debra A. Pinals, MD, is the director of the Program in Psychiatry, Law, & Ethics and clinical professor of psychiatry at the University of Michigan Medical School, and medical director of behavioral health and forensic programs at the Michigan Department of Health and Human Services. She is past president of the American Academy of Psychiatry and the Law, and holds several leadership roles including current chair of the Council on Psychiatry and the Law for the American Psychiatric Association. She has consulted widely on matters related to mental health and forensic services. She’s the author of numerous academic and policy-level publications, some of her more recent work has focused on competence to stand trial and related services.