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Competency Restoration – ORS 161.370
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Competency Restoration – ORS 161.370

       Oregon State Hospital – ORS 161.370

When a person is accused of a crime, sometimes they are not able to participate in their trial because of a mental illness. In these cases, the court may issue an order under ORS 161.370 for the defendant to be sent for mental health treatment, most often at the Oregon State Hospital, so he or she can become well enough to “aid and assist” in their own defense.

 

Services provided for patients under a .370 order
The primary treatment goals for patients under a .370 order are stabilization and achieving a level of legal competency so that they can cooperate with attorneys and participate in their own defense.

  • Treatment teams – At admission, patients are assigned a “treatment team” which includes a psychiatrist, a psychologist, a social worker, a treatment care plan specialist, a case monitor, a primary registered nurse and other clinicians who work with the patient to design a customized treatment plan to meet their individual treatment needs.
  • Treatment malls – Each weekday, patients attend four hours of treatment groups at a central location in the hospital called a “treatment mall,” which is similar to a school or community college. Groups are designed to help patients meet the treatment needs identified in the treatment plans. All patients under a .370 order are enrolled in a legal skills group, where they learn basic legal terminology and ideas that will help most of the patients become able to “aid and assist”. Other treatment groups and resources include: law library, legal assistance, symptoms management, anger management, tai chi, physical fitness, medication management, relapse prevention, drug and alcohol education, music and art therapy, sensory, skill building, and hobbies and other activities.

Evaluations to determine ability to “aid and assist”
Oregon State Hospital has a team of certified examiners (psychologists and psychiatrists) who conduct periodic evaluations of patients who are sent to Oregon State Hospital under the “.370” statute. They interview the patients to determine whether they are able “aid and assist” in their defense and ready to return to court. By statute, the first evaluations are due within 30 days of admission, 90 days of admission and then every 180 days after that. However, treatment teams may request an evaluation as soon as they believe the patient is ready.

Possible evaluation outcomes - The evaluator may determine:

  • The patient is able, meaning he or she is competent to stand trial. In this case, the patient is sent back to her or his respective county jail to await trial.
  • The patient is never able, or that the patient is unlikely to regain competency in the foreseeable future. If the determination is never able, the hospital notifies the court, and the judge may decide to discontinue the order. In both cases, the court dismisses the charges and either:
    • Orders that the patient be discharged; or
    • Initiates civil commitment proceedings.
  • This patient is not yet able, which means the patient does not have the capacity to participate in a trial but may regain competency in the foreseeable future.

Length of stay
The hospital may keep patients who are under an “aid and assist” order for:

  • up to three years; or
  • the period of time equal to the maximum sentence the court could have imposed if the defendant had been convicted, whichever is shorter.

The average length of stay for a patient at OSH in 2012 under the .370 statute was 107 days (mean) or 72 days (median). It’s important to note, however, that each patient is different depending on the nature of their illness and treatment needs. Some patients under the .370 statute return to Oregon State Hospital after pleading “guilty except for insanity” (GEI).
Roughly 20 percent of the patients at OSH are under a .370 order. Below is an overview of the outcomes for patients admitted under a .370 order from January 2008 to December 2010. Seventy-seven percent of patients passed their evaluation.

Admitted

Unique Patients

Episodes of Care*

Able

Never Able

Other**

2013

410

425

311

57

57

* Episodes of Care (some patients had more than one admission under ORS 165.370)
** Patients who were discharged before receiving either “able” or “never able”