The Connecticut Experience with Sell Legislation

Area of Science:

• Forensic Psychiatry
• Legal Medicine
• Mental Health Law

Background:

• Connecticut utilizes two legal frameworks for involuntary medication of defendants undergoing competency restoration.
• These mechanisms, one in criminal court and one in probate court, evolved following the Supreme Court's ruling in Sell v. United States.
• The study compares the procedural development and outcomes of these distinct legal pathways.

Purpose of the Study:

• To compare the effectiveness and efficiency of two distinct legal mechanisms for involuntary medication in competency restoration.
• To analyze procedural differences between criminal court and probate court pathways for involuntary medication orders.
• To evaluate the impact of each mechanism on the duration of competency restoration.

Main Methods:

• Retrospective analysis of 1,455 admissions to a secure forensic hospital for competency restoration (2005-2011).
• Examination of involuntary medication petitions filed in criminal versus probate courts.
• Comparison of competency restoration rates and resolution times between the two legal mechanisms.

Main Results:

• The probate court mechanism was used significantly more often (12.2%) than the criminal court mechanism (0.3%).
• The probate court pathway led to a significantly shorter resolution time for competency matters.
• Both mechanisms demonstrated effectiveness in restoring competency, with success rates of approximately 66% (criminal) and 74% (probate).

Conclusions:

• The civil probate court mechanism is a more frequently utilized and efficient pathway for involuntary medication orders in competency restoration.
• Both criminal and civil pathways are effective in restoring defendants' competency to stand trial.
• The findings support the use of civil mechanisms as suggested by dicta in Sell v. United States.