A long time coming: API launches new program for mentally ill defendants

Officials at the Alaska Psychiatric Institute, the state’s only psychiatric hospital, say they plan to double the facility’s capacity to treat felony-level criminal defendants deemed incompetent to stand trial.

A separate program will offer treatment for people facing less serious misdemeanors, changing the current practice of largely dismissing such charges.

New programs help solve Officials at the facility say there is a large backlog within the state’s criminal justice system when it comes to what is known as competency restoration for people with mental health problems. People accused of crimes in Alaska must be able to understand court procedures to stand trial or meaningfully assist in their defense; otherwise, Charges against him should be dropped.

API is the only facility in Alaska for defendants suffering from serious mental illnesses to receive competency restoration to meet that threshold set by a judge.

The facility has come under controversy in recent years as a lack of beds has led people to remain behind bars for months waiting for admission, leaving their criminal charges in limbo. The hospital has only 10 so-called competency restoration beds, and for years, waiting lists for the program have been months or years long, a situation that the court and hospital officials have agreed is unacceptable.

At a recent open house, forensic psychologist Dr. Christine Collins and other top API officials announced a new program that will allow defendants who commit more felonies to receive competency restoration treatment while in custody. He said a jail-based program would open 10 new beds for people accused of felony-level crimes and another 10 spots in an outpatient clinic for people facing misdemeanor charges.

Before the new programs, there were only 10 eligibility restorations. Dr. Christy Baker, chief of clinical services, said the number of beds at API is the lowest per capita in the entire state.

Baker said defendants facing misdemeanor charges will now have the opportunity to undergo an outpatient restoration program aimed at connecting them with the state’s mental health court, where they will have access to additional resources and services.

Instead of punishment for misdemeanor crimes, the new outpatient program is intended to provide community monitoring, legal restitution and access to additional support, he said.

It kind of acts as a bridge to get them out of custody and into a community setting, where they would have more monitoring than if their charges were dismissed, Baker said, which is now the case for these misdemeanor cases. Inevitably it is happening. ,

Dismissed allegations come at a cost

Competency restoration is more like training than treatment. Such programs use a variety of techniques, including therapy or medication, to stabilize a patient, then teach them the basics of the trial process so their cases can move forward.

This practice has raised questions nationally about the money spent simply to ensure that defendants can go through the trial process, while some say they should not be in the criminal justice system in the first place.

Researchers say people suffering from serious mental illnesses are generally not violent and are more likely to be victims of crime than to commit crimes themselves. Still, programs can prevent potentially violent criminals from dropping charges, returning them to the community.

Two random violent attacks in Anchorage involving people who had been found incompetent to stand trial highlighted challenges within Alaska’s competency restoration system.

A man found incompetent to stand trial has been freed from prison after he attacked two women in separate incidents last year and then stabbed another woman in Lussac Library. During 2018, a man found incompetent to face charges stemming from violent, unprovoked attacks was released from custody after his charges were dismissed, and then fatally stabbed an employee at the Alaska Zoo .

Misdemeanor charges involving disability have generally been dismissed because long waiting lists for services often mean the accused person spends more time in jail waiting to get into a program than if they were convicted of a crime. When convicted, they spend time in custody, which judges consider a violation of the defendant’s rights. ,

Currently, few defendants found incompetent to stand trial ever join API for restitution services. But even among those who are admitted to the facility, success is not assured: more than half are never restored to the competency threshold. This means their charges are dismissed or they are placed under civil commitment.

Statewide, an average of 216 defendants were found incompetent to stand trial per year over the past three years, according to API data. Of that number, just under 20% received qualified restoration services.

In Anchorage, about two-thirds of the more than 200 cases per year involved defendants who received competency evaluations, according to three years of average fiscal year data provided by the Alaska Court System. As a result they were unable to prosecute. According to state data, an average of 53, or about a quarter, were sent for restitution.

Of that number, an average of only 12 actually accessed the API for the restoration program each year. Some cases were still on the waiting list, and in some the defendant was found competent before API entry, but the data showed that an average of 32 of those cases were dismissed by the court or prosecutors.

In total, 37 Anchorage defendants made restitution during the past three fiscal years. The data shows that of that number, 14 were competent after the program, but 21 still did not meet the required threshold and had their charges dismissed. In some cases the defendants are still involved in the program.

[Statewide data tells mixed story about crime in Alaska]

deal with a long wait

Backlogs and long waiting lists are a problem nationwide, as the need for eligibility restoration services has increased significantly over the past few decades.

In Alaska, a A 2019 study identified outpatient and prison-based competency restoration programs as potential solutions. Collins said the programs being started now have taken a long time.

There are now 50 people on the API eligibility restoration waiting list, said Melissa Luce, a paralegal for the facility. Each person will spend about five months in jail, he said, waiting to get a bed and start the program.

If a person is not restored to competency after going through the program, the criminal charges against him or her must be legally dismissed. There may also be some defendants who are not suitable for restitution, such as those with severe intellectual disabilities, whose charges will be dismissed, Baker said.

The 10 additional beds made available for eligibility restoration through the new program will be located inside the Anchorage Correctional Complex, Baker said. He said they would house felony-level defendants who do not require hospitalization, who can take their medications, go to group therapy and follow instructions in jail.

The outpatient program is located in a small office on Gambell Street and is staffed by Collins and two psychiatric nursing assistants. it Offer competency restoration treatment only to people facing misdemeanor charges and out on bail for non-violent crimes, Collins said.

Ideally, this would restore eligibility to people whose charges would otherwise be dismissed so they can enter mental health court and be connected to services there, Baker said. Mental Health Court is a voluntary program that serves defendants with mental health disorders or disabilities by offering treatment plans and monitoring progress in hopes of managing underlying factors that may lead a person to commit crimes. .

The new programs, named Journey to Resilience, were funded by $850,000 from the Alaska Mental Health Trust Authority spread over three fiscal years to establish and oversee the program, as well as $800,000 from the Alaska Legislature, added to each API’s base budget . year, according to Brian Studstill, communications director for the Alaska Department of Family and Community Services.

API plans to track data about patient outcomes and analyze the impact of new programs on waiting lists and backlogs, Baker said.

Collins said the programs officially started several weeks ago, but officials plan to begin intake sessions with the first few clients in the coming weeks and begin group therapy sessions early next month. Baker said the programs will initially serve only a few patients, but the plan is to have each program serve 10 people within the next three to six months.

They hope the new programs will shorten Alaska’s waiting list, but it’s not yet clear how significant any changes might be.

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