The ROC program: accelerated restoration of competency in a jail setting

Area of Science:

• Forensic Psychiatry
• Correctional Mental Health Services

Background:

• Defendants found incompetent to stand trial often face lengthy delays in receiving treatment.
• Traditional state hospital restoration processes are resource-intensive and slow, leading to system inefficiencies.

Purpose of the Study:

• To evaluate the effectiveness and cost-efficiency of an in-jail Restoration of Competency (ROC) program.
• To assess the impact of the ROC program on forensic system wait times and resource allocation.

Main Methods:

• The ROC program provided treatment services to 192 incompetent to stand trial patients within a jail setting over 29 months.
• Outcomes measured included competency restoration rates, time to restoration, and cost per patient compared to state hospital benchmarks.

Main Results:

• The ROC program restored competency in 55% of patients, averaging 57 days per patient, compared to 180 days in state hospitals.
• The average cost per admission was $15,568 for ROC, versus $81,000 for state hospitals, representing substantial cost savings.
• The program reduced state hospital waiting lists and improved access to psychiatric services.

Conclusions:

• The jail-based ROC model is a highly effective and cost-efficient approach for restoring competency in defendants.
• Implementing ROC programs can significantly improve the management of mentally ill inmates, reduce forensic system burdens, and enhance overall patient care and stakeholder satisfaction.