- Not dangerous due to mental illness AND not in need of continue supervision or history of treatment noncompliance
- Not dangerous due to mental illness BUT needs continued supervision due to symptoms of mental illness or history of treatment noncompliance
- Dangerous to public peace and safety due to mental illness
Treatment and Evaluations
The Oklahoma Forensic Center provides services for Pretrial Defendants as an evaluation of adjudicate competence and ODMHSAS inpatient services for evaluations, treatment, competency restoration, as well as care, treatment and evaluation for those deemed to be NGRI/NGRMI (not guilty by reason of insanity/mental illness).
All consumers admitted to the Oklahoma Forensic Center are additionally provided with consistent and innovative forensic psychiatric service and case management. Service includes comprehensive Psychiatric evaluations, medication management, pharmacological consult and psychoeducation, and comprehensive treatment collaboration.
Insanity/Mental Illness for criminal charges is a legal concept and by law, a defendant must be presently competent in order to plead NGRI/NGRMI.
If found “insane/mentally ill” at the time of a crime then court has determined that the individual could not understand, due to a mental illness, the:
- nature,
- consequences, or
- wrongfulness of their crime(s) at the time of their crime(s)
Finding of insanity/mental illness = not guilty of a crime and cannot be retried. Consumers cannot be discharged without the court's permission, regardless of the opinion of medical staff or the opinion of the forensic mental health administration. The NGRI/NGRMI program goal is to provide a therapeutic environment with specified guidelines to decrease the consumer's level of risk to society.
Nationally, NGRI/NGRMI are likely to spend just as much time confined in a mental health facility as they would have in prison.
- Non-murder cases typically spend longer
- Murder cases typically spend approximately the same amount of time
Oklahoma: NGRI/NGRMI typically results in longer period of confinement.
Processes for Evaluation
Forensic Services
- Pretrial Defendants
- NGRI/NGRMI Acquittees
- For adult defendants found to be incompetent to proceed by a State of Oklahoma District Court, said defendants are subsequently committed to OFC for treatment, therapy, and training to restore them to adjudicative competence.
- After defendants are admitted to OFC, they are assigned to a unit and treatment team, consisting of a psychiatrist, social worker, and nurse.
- Once the individual has been deemed behaviorally stable enough to leave the secure unit by their treatment team, that consumer is then referred to a Standard Competency training group. ----The curriculum for the Competency Restoration group at OFC was developed in-housed by the psychology department, in consultation with other similar forensic institutions across the county. The material is educational in nature, and designed to provide a basic overview of the adversarial nature of the criminal justice system. Consumers are also provided with a written copy of the materials, as well as basic descriptions of the person’s case, potential penalties if convicted, etc.
- The Competency restoration group has three tiers: (1) Standard Group, ran by unit staff which consists of an overview of courtroom roles and procedures, lasting six sessions across two weeks. Consumers are then given a brief quiz of the material to assess mastery of it. If the consumer passes, they proceed to the (2) Advanced Group, ran by a pre-doctoral psychology intern, which focuses on more advanced concepts such as rational application of case information to decision-making about how to proceed in a criminal case (hypothetical). If the consumer is unable to pass the (1) Standard Group quiz, they have the opportunity to take it a second time. If the consumer is still unable to pass it the second time, they are then placed in the (3) Special Needs Group, which consists of the same material as the (1) Standard Group, but presented in a more broken down, simplified form, to assist with information acquisition. If the consumer is able to demonstrate mastery of the material while in the (3) Special Needs Group, they are then able to be moved to the (2) Advanced Group.
- As consumers progress in their treatment, the treatment team will then make a referral to the psychology department to have one of the psychologists evaluate the consumer to see if the competency restoration treatment has been successful and if the consumer now appears to meet statutory criteria for adjudicative competence. If the opinion of the evaluator is that the consumer does appear to meet said criteria, then a letter is drafted to the Court and the consumer is referred to their referring county for further disposition. If the opinion of the evaluator is that the consumer still does not appear to meet criteria, then a detailed progress note addressing the evaluator’s concerns is provided to the consumer’s treatment team, so that any adjustment to treatment can be made in an attempt to address those concerns. As is the case with outpatient adjudicative competence evaluations, inpatient evaluations can also utilize all of the same psychological assessment measures noted above, if and/or as needed.
If an NGRI/NGRMI acquittee is ultimately committed to the DMHSAS/OFC NGRI/NGRMI program, that consumer is then eligible to engaging in psychology department-led individual and group psychotherapy.
- Individual psychotherapy is initiated upon consumer request through a treatment team referral to the psychology department, and is carried out by either psychology staff and/or pre-doctoral interns.
- Group psychotherapy is also voluntary, consistent with the Recovery Model orientation of DMHSAS, and based upon consumers signing up and being screened by psychology department as being appropriate for groups.
- Group psychotherapy consists of two main types of groups: (1) Process Group and (2) Alternative Groups. Process groups are run year-round and are consumer-topic driven. Alternative groups are eight session/eight week groups based upon either empirically-based and/or empirically-supported treatments (i.e., anger management, stress management, social skills, substance use treatment, etc.).
2020 Treatment and Evaluation Data
In 2020, 930 evaluations were completed across all counties in Oklahoma.
Outcome of Evaluation
| Opinion | Number (%) of Total Evaluations |
|---|---|
Competent to stand trial |
600 (65%) |
Incompetent, but can attain competency |
262 (28%) |
Incompetent, but cannot attain competency |
30 (3%) |
Cannot be determined |
38 (4%) |
