Effects of State Organizational Structure and Forensic Examiner Training on Pre-Trial Competence Assessments

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Delivery System, Health Promotion, Health Psychology, Disease Prevention, Service Delivery

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States differ widely in their delivery of pretrial forensic evaluation services, in terms of organizational structure and training requirements of forensic examiners. It was hypothesized that defendants adjudicated incompetent to proceed in states using community-based, private-practitioner systems would show less impairment on a competence assessment measure, the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), than defendants adjudicated incompetent in states using traditional, inpatient systems. It also was hypothesized that mean MacCAT-CA scores for incompetent defendants from states requiring forensic training/certification would be lower than for defendants from states lacking such requirements. Results indicated significant differences across the four types of service delivery systems examined. However, planned comparisons revealed no differences between a state using a traditional, inpatient model and a state employing a community-based, private-practitioner model. Analyses examining the effects of mandatory forensic training failed to support the hypothesis that training requirements result in the adoption of higher thresholds for determining incompetence.

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Citation / Publisher Attribution

The Journal of Behavioral Health Services and Research, v. 26, issue 2, p. 140-150