Jail-Based Competency Restoration: What's Out There and What's Missing

Forensic systems have seen an increase in the number of defendants in need of competency restoration services. Traditionally, competency restoration services have occurred at state psychiatric hospitals. Unfortunately, the waitlists for hospital competency restoration are extensive and result in many defendants waiting in jail for more than 4 months for an inpatient bed. These waitlists have led to lawsuits forcing states to provide adequate treatment and evaluation services to mentally ill adults languishing in jails. To reduce waitlists for competency restoration and to combat the extensive delays in restoration, some states have implemented jail-based restoration to reduce hospital waitlists, restoration time, and costs to complete restoration. This review article discusses pros and cons of jail-based services and provides a framework for future services and research.