Minn. DHS abruptly ends program for mentally incompetent defendants

The Department of Human Services is ending a program designed to restore criminal defendants with mental illness to competency to stand trial. DHS says people in the program are taking up much-needed spots in state facilities and that it is not the state's responsibility to get people ready to go to trial.

The law says that to be put on trial, a person needs to be sane enough to understand the charges against him or her, to understand the consequences of those charges and to be able to provide meaningful help to his or her defense lawyer.

Since 2006, the DHS has offered the Competency Restoration Program, a special service for defendants who were committed to state hospitals. The program made sure the person received mental health care and was also being prepared to go to trial. But now, with a deep shortage of hospital bed space, the state says it needs to stop providing those services to free up beds. It is possible for a person to be too sick to stand trial, but well enough to be discharged from inpatient care.

"At a time when mental health services are in such high demand, it is our primary obligation to focus on the mental health treatment needs of our patients — not on their competency to be tried on criminal charges," wrote Commissioner Emily Piper in a letter to stakeholders, explaining the agency's decision.

The question now, though, is where defendants will get those services. DHS says that about 70 percent of defendants in their care are restored to competency simply by getting the medication — as well as therapy and other mental health care — they need. But it's not clear where the others will get treated. People in jail do have a constitutional right to health care, including mental health care. But the treatment in a jail isn't the same as treatment in a hospital setting.

Public defenders, mental health advocates and others are worried that people who are not sick enough to be in the hospital, but who are still too sick to go on trial, could end up languishing in jail for long periods of time with no obvious way for their cases to proceed. And their condition could worsen.

"In my experience, it is highly unusual that someone is restored to competency within a jail setting," said social worker Katie Benson with the Ramsey County Public Defenders Office. "My greatest concern with this new statement from DHS is that even if folks can get stabilized in a short-term hospitalization ... I'm worried that once they're transferred back to the jail that we will see them decompensate quite quickly. "