In this study, we investigated the potential benefits of using an alternative approach for completing court ordered fitness to stand trial assessments in a Canadian forensic mental health service. Using file information, court databases, and an economic analysis, we compared a hospital-based model of evaluation to a court clinic model in a sample of 96 accused persons from 2013 to 2017. Results revealed a significantly shorter time period for forensic report completion in the court clinic group, but no difference in criminal case processing time between groups. There was a higher rate of accused persons opined to be unfit to stand trial in the court clinic group (25.9%) compared to the hospital-based model (7.7%). Report quality varied somewhat between groups, with forensic assessment reports citing mental disorder and relevant case law more often in the court clinic model. Economic analyses indicated there was a marked cost savings associated with completing assessments at court instead of hospital. Our findings suggest there are several benefits for forensic mental health systems in utilizing community-based models of forensic evaluation.
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