To determine whether fitness-to-stand-trial assessments “in detention” offer cost benefits over inpatient assessments.
Method:
The development of a pilot “fitness clinic” in a detention centre is described, and the results of 1 year of assessments are presented. The cost benefit of fitness assessments conducted in detention centres is outlined.
Results:
Significant cost savings were realized by operating fitness clinics in detention centres.
Conclusion:
Fitness clinics in detention centres offer important benefits and are recommended as an adjunct to forensic programs.
BonnieRSHopeSKMonahanJPoythressNErsenbergMFeucht-HaviarT. The MacArthur Adjudicative Competence Study: A campaign of criteria for assessing the competence of criminal defendant. J Am Acad Psychiatry Law1997;25:249–59.
4.
ZapfPARoeschR. Assessing fitness to stand trial: A companion of institution based evaluations and a brief screening interview. Canadian Journal of Community Health. 1997;16:53–66.
5.
McDonaldDANossbaumDSBagbyRM. Reliability, validity and utility of the Fitness Interview Test. Can J Psychiatry1991;36:480–4.
6.
GothardSViglioneDJMeloyJRShermanM. Detection of malingering in competency to stand trial evaluations. Law Hum Behav1995;19:493–505.
7.
RogersRGillisJRMcNairSDicksonSE. Fitness evaluations: A retrospective study of clinical, criminal, and sociodemographic characters. Canadian Journal of Behavioural Sciences1988;20:194–200.
8.
R v Taylor, 77 C.C.C. (3d) 551 (OntCA) 1992.
9.
BloomHBayM. A practical guide to mental health capacity and consent law of Ontario. City: Carswell; 1996.
10.
GreenbergDM. Capacity to stand trial: Pitfalls of legal interpretation. Can J Psychiatry1994;39:113–5.
11.
RoeschROglottJRPHartSDDempsterRJZapfPAWhittemoreKE. The impact of Canadian Criminal Code changes as remands and assessments of fitness to stand trial and criminal responsibility in British Columbia. Can J Psychiatry1997;42:509–14.
12.
ZapfPARoeschR. Fitness to stand trial: Characteristics of remands since the 1992 Criminal Code Amendment. Can J Psychiatry1998;43:287–93.
13.
SchutteNSMalouffJMLucorePShernD. Incompetency and insanity: Feasibility of community evaluation and treatment. Community Ment Health J1988;24:143–50.
14.
FitchWLWarrenJI. Community-based forensic evaluation. Int J Law Psychiatry1988;11:359–70.
15.
MenziesRJDebsterCDButlerBTTurnerRE. The outcome of forensic assessments: A study of remands in six Canadian cities. Criminal Justice and Behaviour1980;7:471–80.
16.
Hochsteder StevryEChoinskiMStevrySR. Incompetency to stand trial and mental health treatment: A case study testing the subversion hypothesis. Bull Am Acad Psychiatry Law1996;24:319–31.
17.
LambHR. Incompetency to stand trial. Arch Gen Psychiatry1987;44:754–8.
