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Evaluations of competency to stand trial are the most common source of referrals to forensic mental health practitioners. While the clear majority of those examined are viewed as competent to proceed, those found incompetent to stand trial (IST) may be subjected to treatment and training to enable them to proceed to trial, typically referred to as competency restoration. These individuals constitute the largest group referred for mental health treatment under the auspices of the criminal justice system, with several thousand persons hospitalized in the United States at any given time. Despite the significant variability in treatment and education efforts, as many as 9 in 10 persons originally found unfit are eventually adjudicated competent and proceed to disposition of the charges against them. There is a ...

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