Developing a forensic service delivery system for juveniles adjudicated incompetent to stand trial

Our study examines the experiences of 563 youth ordered into restoration services after a judicial finding of adjudicative incompetence. Among this group, 72% were determined to be restored to competence usually within 90 to 120 days of services provided in the least restrictive environment allowed by the courts. These outcomes were achieved using an individualized psycho-educational intervention that combined intensive case management, developmentally informed interactive educational tools, and case integration and mentoring by specially trained restoration counselors. These individualized services were provided to each youth on average three times a week by the restoration counselor contracted to provide services in the location where the youth was residing. No juveniles were admitted for inpatient hospitalization for the purpose of restoration only. Five percent were hospitalized based upon civil commitment criteria or for further psychiatric evaluation or stabilization. Chi-square Automated Interaction Detector (CHAID) analyses were used to create decision trees of the restoration pathways demonstrated by four subgroups of youth: Mental IllnessOnly (MIO), Mental Retardation Only (MRO), Mental Illness and Mental Retardation (MI-MR), and No Mental Illness and No Mental Retardation (NMI-NMR). The interaction of individual characteristics and interventions varied across the four groups with the highest rates of restoration being achieved by youth in the NMINMR group (91%) and the lowest rate among youth in the MRO group (47%). These rates of restoration are comparable to those achieved using residential treatment for youth and inpatient hospitalization for adults.