Title:
Factors effecting length of hospitalization for forensic inpatients: a descriptive and predictive analysis
Author:
Amy L. Taylor
Thesis Advisor:
Jenny L. Lowry
Committee Member:
Lawrence J. Raifman
Committee Member:
Matthew W. Kirkhart
Degree Granting Institution:
Loyola University Maryland--College of Arts and Sciences
Place:
Baltimore (Md.)
Publisher:
Loyola University Maryland
Date Created:
2004
Type of Resource:
text
Genre:
thesis
Language:
eng
Format:
application/pdf
Physical Form:
electronic
Digital Source:
reformatted digital
Abstract:
Competency to stand trial evaluations are the most frequently made referral to forensic mental health professionals in this country. The determination of a patient's competence to proceed with trial is essential to protect society's interest in a fair and "just" criminal process, as well as the defendant's Constitutional rights. This study assessed whether patient characteristics, such as diagnoses, offense severity, medication usage, and demographic variables affected the length of hospitalization experienced during the competency evaluation phase, as well as during the restoration of competency phase. This information was important to obtain because unnecessarily prolonged hospitalization is, without question, a serious deprivation of liberty and a substantial financial burden to society. The total sample was comprised of 420 patients/defendants in an inpatient state psychiatric hospital who were evaluated regarding their competence to stand trial. In the first phase, 394 patients were evaluated regarding their competence to stand trial. Of this sample, 326 were found competent, while 68 were found incompetent to stand trial. Results demonstrated that no variables within the 394 pretrial patients were predictive of length of stay, yet they yielded interesting clinical findings. Further, in the first phase, the sub-sample of 68 patients who were found to have been incompetent to stand trial by the forensic evaluator were examined independently. Results revealed that ethnicity, medication usage, and offense severity accounted for 32% of the variance in predicting length of hospitalization. Specifically, African American patients that were deemed NCST experienced longer pretrial hospitalizations. Patients who refused medication were discharged to court faster during the competency evaluation phase. Misdemeanor defendants experienced a shorter length of stay than those patients charged with felony offenses. The second phase was comprised of 94 patients who were referred to the hospital for the restoration of their competency following adjudication as not competent to stand trial. No variables were found to have been predictive of post-trial length of stay. Each sample group in the two phases was examined using stepwise multiple regressions to assess whether patient characteristics predicted their length of stay. Overall, the results suggest that as a majority, patients were not hospitalized for a prolonged period of time in either phase and that current policies and procedures governing court ordered patients and involuntary medication have been effective. Suggestions for an even more efficient competency process were addressed.
Subject:
Forensic psychiatry
Subject:
Competency to stand trial
Subject:
Insanity (Law)
Subject:
Psychiatric hospital patients
Degree:
Doctor of Psychology
Level:
Doctoral
Discipline:
Psychology
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Identifier:
TaylorAL-04
