{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:47:01Z","timestamp":1792248421423,"version":"4.4.0"},"reference-count":74,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T00:00:00Z","timestamp":1569974400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec id=\"S1092852919001342_sec1\"><jats:title>Objective.<\/jats:title><jats:p>Evidence is clear that the nation is experiencing an increasing number of incompetent to stand trial (IST) admissions to state hospitals. As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852919001342_sec2\"><jats:title>Methods.<\/jats:title><jats:p>The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1\/1\/2009 and 12\/31\/2016 were eligible for inclusion in the study.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852919001342_sec3\"><jats:title>Results.<\/jats:title><jats:p>There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852919001342_sec4\"><jats:title>Conclusion.<\/jats:title><jats:p>Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation\u2019s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1092852919001342","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T11:16:10Z","timestamp":1570014970000},"page":"223-236","source":"Crossref","is-referenced-by-count":4,"title":["A longitudinal description of incompetent to stand trial admissions to a state hospital"],"prefix":"10.1017","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6303-1897","authenticated-orcid":false,"given":"Barbara E.","family":"McDermott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7027-2907","authenticated-orcid":false,"given":"Katherine","family":"Warburton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Auletta-Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,10,2]]},"reference":[{"key":"S1092852919001342_r38","first-page":"297","article-title":"Demographic, criminogenic, and psychiatric factors that predict competency restoration","volume":"39","author":"Colwell","year":"2011","journal-title":"J Am Acad Psychiatry Law"},{"key":"S1092852919001342_r57","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200515"},{"key":"S1092852919001342_r63","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001051"},{"key":"S1092852919001342_r66","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13048"},{"key":"S1092852919001342_r36","first-page":"34","article-title":"Predicting restorability of incompetent criminal defendants","volume":"35","author":"Mossman","year":"2007","journal-title":"J Am Acad Psychiatry Law"},{"key":"S1092852919001342_r59","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1602959"},{"key":"S1092852919001342_r45","doi-asserted-by":"publisher","DOI":"10.2466\/pr0.1962.10.3.799"},{"key":"S1092852919001342_r39","doi-asserted-by":"publisher","DOI":"10.1002\/bsl.2040"},{"key":"S1092852919001342_r74","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.01.022"},{"key":"S1092852919001342_r4","volume-title":"Psychological Evaluation for the Courts: A Handbook for Mental Health Professionals","author":"Melton","year":"2007"},{"key":"S1092852919001342_r11","unstructured":"11. 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