International Journal of Emergency Mental Health and Human Resilience
Open Access

Abstract

Competency restoration can be a difficult and seemingly unachievable, legal mandate for many with severe and persistent mental illness. As a result, a large portion of incompetent defendants remain suspended within the psychiatric hospital system for years and are never able to return to the legal processes which rendered them there in the first place. At face value, instilling the knowledge and understanding necessary to establish a patient’s “competence” appears to be a relatively straightforward task. Standard competency restoration methods aim to teach information related to an individual’s specific case and the overarching legal and criminal justice systems. The capacity to learn and comprehend such information relies on frequently used cognitive processes related to attention, memory, reasoning, processing speed and executive functioning. However, studies on the neuropsychological deficits associated with major psychiatric illnesses, such as schizophrenia, bipolar disorders and depression, indicate global dysfunction of these vital mental abilities. Thus, legally incompetent individuals with severe mental illnesses often lack the very cognitive resources that they need for competency restoration, subsequent hospital discharge and the resumption of their court case. Simply stated, typical competency restoration methods, which include individual and group therapy, remain largely inadequate due to discrepancies between many patients’ cognitive abilities and the mental requirements necessary to understand, conceptualize, recall and integrate legally required knowledge. Therefore, treatments used with the severely mentally ill should not rely on intact cognition, and, instead, should seek to mitigate its deficits. Cognitive remediation therapy (CRT) has emerged as a promising treatment approach for this population to improve cognitive skills, social and vocational functioning and motivation. Despite overwhelming promise, CRT therapies have not yet been used to address barriers related to competency restoration. Thus, this proposed poster will outline the underlying theory and overall design of a group-based treatment manual that adapts competency restoration strategies and incorporates cognitive remediation therapy (CRT) as an adjunctive form of treatment to promote better outcomes for legally incompetent defendants who have been court ordered to receive competency restoration treatment at an inpatient psychiatric facility.

Biography

E-mail: acgiord@gmail.com