Kent S. Miller

The processing and disposition of incompetent mentally ill offenders

Pretrial hospitalization of mentally ill offenders has been increasing in recent years and a number of abuses have been noted with respect to competency to stand trial. This is a report on 431 male felony defendants who were found incompetent to stand trial, hospitalized, and returned to court for a final disposition. Approximately one-half of those brought back to the court gained release to the community, with one-half continuing to be held in a hospital or a prison, and with 70% continuing in treatment in one setting or another. Disposition was significantly related to race, criminal history, severity of charges, and the recommendations of mental health professionals. Offenders were found to have spent unnecessarily long periods of time in jail and in the hospital awaiting court processing, raising questions about the fairness and efficiency of current procedures.

The effects of statutory change on the civil commitment of the mentally ill

Several states have revised their civil commitment statutes in recent years. A majority of the recent revisions reflect judicial directives to provide more explicit commitment criteria, but in some instances, criteria have been broadened in reaction to the difficulty of getting some individuals hospitalized under strict criteria. Such statutory changes have impacted considerably on both process and outcome of the civil commitment system. Adoption of explicit commitment criteria has resulted most visibly in substantial reduction of hospital admissions and census. The present study examines the impact of explicit changes in commitment criteria in Florida following the 1982 enactment of amendments to the Baker Act. A total of 80 commitment hearings are reviewed before and after the law took effect to determine procedural effects of the law on degree of defense counsel advocacy, client dispositions, and on the courts adherence to more explicit criteria. State hospital admissions, discharge, and census information is examined in order to identify the larger impact of 1982 statutory changes on the commitment system. Evidence from hearings and state data suggests that changes in the Florida law impacted significantly on both process and outcome of the civil commitment system. Clients referred to commitment hearings are more dangerous, and may represent a new “hard-core” group remaining after more explicit eligibility criteria are applied by local intake, and emergency detention facilities. State hospital admissions and census in Florida declined significantly following enactment of the 1982 law, consistent with findings from other states enacting similar statutory reforms. Implications for deinstitutionalization policy and administration are discussed.

Executing the mentally ill : the criminal justice system and the case of Alvin Ford

Drawing the Lines Who Lives and Who Dies? An Introduction to Alvin Ford Family Background, the Crime, and Trial 1953-1974 Anticipating and Enduring the First Death Warrant 1975-1981 Psychological Deterioration and the Road to the Supreme Court 1982-1986 Physicians, Mental Health Professionals, and the Death Penalty Alvin Ford and the Courts Additional Issues Competence for Execution The Supreme Court Speaks Back to Federal Court The 1988 Hearing and Beyond The Cure That Kills

Planning for mental health

This report is based on a study of comprehensive mental health state plans submitted to the National Institute of Mental Health in 1965, interviews with mental health planners in selected states, discussions with professionals and citizens involved in the planning, and a review of the pertinent literature. This study was made to bring together observations about the outcome of this massive planning effort, to comment on the current status of mental health planning, and to develop some directions for facilitating planning at the state level.

Legal Processes and Adjudication in Mental Incompetency Proceedings

Court records of mental incompetency proceedings for a five-year period from a single county were analyzed to determine (1) the extent of actual involvement of the legal system in the cases, and (2) whether the adjudication was correlated with the legal variables and with two characteristics of the examining physicians. It was concluded that the legal system is only peripherally involved in incompetency cases and that the decisions, rather than being objective medical decisions, were correlated with a number of non-medical factors, including the legal variables and the amount of experience of the examining physicians in these types of cases.