After the Webinar: Competency Restoration in Jails. Q&A with Dr. Amber Simpler

Webinar presenter Dr. Amber Simpler answered a number of your questions after her presentation, Competency Restoration in Jails: A Versatile Response to the Competency Crisis. Here are just a few of her responses.

Audience Question: What provisions are made for pretrial detainees in a jail-based restoration program to meet with their attornies?

Dr. Amber Simpler: You wouldn’t want to restrict access to the attorney. In some jurisdictions, it’s required that an attorney be afforded an opportunity to be present during evaluations. Again, a point of contention – some examiners will have a hard no, but that is something I’ve always welcomed. Because part of what we’re doing is assessing for that ability to assist counsel and watching how the defendant takes instruction or is responsive to the attorney, is very informative to an evaluator. I’ve had examples where a defendant would ask me in the middle of evaluation, “What does that mean?” I responded, “Well, your attorney is right there.” This gives the attorney an opportunity to explain a legal term, and I get to watch that play out. So again, in terms of having confidential meetings, absolutely. You shouldn’t have any restrictions on being able to meet with defendants. In terms of participating in the evaluation process, it will vary by jurisdiction. But you’ve heard my opinion on the matter.

Audience Question: Will there be another national survey to evaluate the need for more competency services?

Dr. Amber Simpler: I certainly hope so. I think early on in the 2000s, we were very much focused – as a collective body of forensic evaluators and researchers – on, what’s the enormity of the problem. And so, what you’ll see at that time was an emphasis on research of what is competency? How do we measure it? What are we looking at? Now the pendulum has shifted, where a lot of research efforts are now looking at this concept of restoration. I’d love to know what those current numbers are. I think that it’s worthwhile because it does help us better understand what resources are needed and how we dedicate our resources to not only the evaluation but also the services required.

Audience Question: What obligation do correctional facilities bear in terms of identifying mentally impaired people within their population?

Dr. Amber Simpler: So, I certainly appreciate that. In terms of identifying individuals for the purposes of raising competency, no responsibility to my knowledge. In terms of identifying those with mental illness for the purposes of providing treatment, sans competency issue, it is imperative. We adhere to NCCHC Guidelines, and the assessment for and treatment of mental conditions is imperative. It also peripherally leads to a conversation that we were having just prior to the start of our webinar today, about who can raise the issue of competency. And certainly, some jurisdictions allow for corrections staff to informally broach the issue with the court saying, “Hey, we’ve got this person we’re really concerned about. They’re not doing well. Don’t know if the attorneys made contact or has awareness of what’s going on, but we really think that this person is suffering from a mental illness.” Other jurisdictions allow for a formal inquiry based on the jail personnel, disclosures that something’s going on with that person. Raising the doubt.

Audience Question: It seems like mentally ill people are left to languish in jail while working their way through the system. How does this not meet the requirements for a speedy trial?

Dr. Amber Simpler: It’s an excellent question, and I don’t have enough time to soapbox for you, but I’m happy to another day. I will say, by and large, our jails are becoming de facto mental health institutions. But if you look at the history of how we’ve treated our mentally ill population, it’s really not new that we leave them in places. If we think about couple hundred years ago we were chaining people to walls because they were aberrant, because they were not “normal” – whatever that means. We’ve seen changes in where we house people, but the idea of putting them in an institution where we don’t have to encounter them – that is not new. It’s not right, and I will certainly be the first to advocate against indefinite detention or isolation. My goal is to bring awareness of how we treat our mentally ill individuals and how we criminalize mental illness by placing these individuals in jail because our state hospitals are no longer an alternative place for housing..it is fundamentally unfair and unjust. We have recovery models that can help individuals with severe mental illness live functional, optimal lives. I think we need to dispel the stigma and the myths surrounding mental illness so that people don’t feel fearful of what they don’t understand and what they don’t know. Treating mental illness is certainly the first course to really preventing a lot of these issues, by and large, some of the charges. I mean, ——– Jackson, petty theft, who stays in jail for years because of a minimal charge? I think what we have to do is identify where our system is broken and how we treat these individuals and really make for a better outcome. Because how we treat our mentally ill, how we treat our elderly, it’s how our society is judged, and I think that we can do a much, much better job.