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Assessing Racial Effects on Adjudicative Competence.

Kelsey S Hobart1, Shilpa Krishnan1, Sean D Cleary1

  • 1At the time of this work, Dr. Hobart was Physician Resident (PGY-IV), Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC; she is currently a fellow in forensic psychiatry at the University of Rochester Medical Center, Rochester, NY. Dr. Krishnan is Deputy Director, Forensic Services Division, DC Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC. Dr. Cleary is Associate Professor, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC. Dr. Candilis is Director of Medical Affairs, Saint Elizabeths Hospital, Washington, DC, and Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC.

The Journal of the American Academy of Psychiatry and the Law
|October 3, 2023
PubMed
Summary
This summary is machine-generated.

This study examined racial disparities in forensic outcomes among pretrial defendants. Researchers found only differences in psychological testing referrals, suggesting socioeconomic factors heavily influence race in forensic practice.

Keywords:
competency to stand trialforensic hospital psychiatryinstitutional racismracial determinants

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Area of Science:

  • Forensic Psychology
  • Racial Disparities Research
  • Legal Medicine

Background:

  • Racial influences are prevalent across forensic practice, necessitating methods to separate race from its socioeconomic, historical, and attitudinal factors.
  • Variations in jurisdictional influences create inconsistencies in forensic data analysis and policy development.
  • Understanding these complexities is crucial for equitable forensic evaluations.

Purpose of the Study:

  • To compare racial outcomes among pretrial defendants.
  • To investigate socioeconomic, clinical, and forensic factors influencing these outcomes.
  • To determine if racial influences can be isolated from confounding variables.

Main Methods:

  • Retrospective database review of 200 pretrial defendants (160 Black, 40 White).
  • Exploration of socioeconomic, clinical, and forensic data before, during, and after hospitalization.
  • Confirmatory data collection and logistic regression statistical analysis.

Main Results:

  • Investigators hypothesized difficulty in distinguishing racial influences due to the strong link between socioeconomic factors and race.
  • Only differences in referral for psychological testing were statistically identified between racial groups.
  • No other significant differences in forensic outcomes were found when controlling for other variables.

Conclusions:

  • Socioeconomic factors are closely intertwined with race in forensic settings, complicating the isolation of racial influence.
  • Referral for psychological testing may be a key area where racial disparities manifest in forensic evaluations.
  • The proposed methodology, adapted to local demographics, can help institutions assess racial influences on forensic outcomes.