Incompetency and insanity: Feasibility of community evaluation and treatment

In order to examine the feasibility of doing more sanity and competency evaluations and treatment on an outpatient basis rather than at a state hospital, we gave a feasibility questionnaire to 288 CMHC and state hospital administrators and treatment staff members. The respondents indicated that, given enhanced community evaluation and treatment programs for forensic clients, (a) 41 percent of the sanity evaluations and 45 percent of the competency evaluations done at the hospital could be done in local communities, (b) 35 percent to 38 percent of the clients found incompetent could be treated in local communities, and (c) 39 percent to 50 percent of the clients found insane could be released to outpatient treatment six months earlier than presently. Other findings indicated several specific improvements needed in the community mental health system before it can properly handle more forensic clients.