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Oklahoma Appleseed Center 
for Law and Justice

Signed in as:

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  • Home
  • Mission
  • Who We Are
    • Strategic Issue Areas
    • Board of Directors
    • Advisory Board
    • Our Team
    • We're Hiring!
  • Projects
    • Criminal/Juvenile Justice
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    • Election Justice
    • Legal Filings
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  • Media
  • Contact Us
  • Donate
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  • Misdemeanor Justice
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  • Competency Restoration
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NEW REPORT LIVE NOW! Fractured: Oklahoma's System of Competency Leaves Hundreds Languishing in Jail

Read and download now
Something must be done.

Mental illness is destroying Oklahoma families.

OK Appleseed is co-facilitating a working group with the Oklahoma Disability Law Center that includes judges, attorneys, psychologists, experts, and impacted families. This group will study the competency restoration process currently occurring in Oklahoma, and examine policy solutions that have been enacted in other s

What does competency mean?

How long does competency restoration take?

What is competency restoration?

People who have been charged with a crime have to be mentally competent to stand trial or enter a plea. Competency means being able to understand the charges against you and being able to assist in your own defense.

What is competency restoration?

How long does competency restoration take?

What is competency restoration?

When someone is found incompetent to stand trial or enter a plea, they are ordered to competency restoration. This requires transport from the jail to Oklahoma Forensic Center where they are stabilized and given proper medications in hopes they will raise their competency standard to be able to participate in their case. Here is a diagram of the process.

How long does competency restoration take?

How long does competency restoration take?

How long does competency restoration take?

The Oklahoma Statutes allow for two years to attain competency. This means someone could be attempting to attain competency for two years after they are transferred to Oklahoma Forensic Center. 

How long is the competency waitlist?

What happens if someone can't gain competency?

How long does competency restoration take?

Currently the competency waitlist is over 200 people in Oklahoma. All of those people are waiting for services while in jail.

How much does competency restoration cost?

What happens if someone can't gain competency?

What happens if someone can't gain competency?

Studies estimate that in-hospital restoration costs from $401-$834 per defendant per day.

What happens if someone can't gain competency?

What happens if someone can't gain competency?

What happens if someone can't gain competency?

If they are not a danger to society and don't have a history of treatment noncompliance they are discharged. If there is a history of dangerousness and they cannot attain competency, the defendant is civilly committed.

Oklahoma is over 1,500 mental health beds short of what's required.

read the report now

Our report is full of policy recommendations. We've summarized them below.

Whether you're a legislator, a lawyer, a judge, a district attorney, advocacy organization, or state employee who wants to improve the system, you can find ways to collaborate and reduce the waitlist.

Add 1,500 Mental Health Beds

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Address the Mental Health Care Professional Shortage

The Treatment Advocacy Center recommends 50 mental health beds per 100,000 people. Oklahoma is approaching a population of 4 million people, which means we should have around 2,000 mental health beds available. Currently we have a little over 500 beds, some of which are still under construction.

Address the Mental Health Care Professional Shortage

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Address the Mental Health Care Professional Shortage

Oklahoma has a dire shortage of Ph.D.s who provide mental health care. There are 10.3 psychiatrists per 100,000 in the state and 13.4 psychologists in the state to serve the entire population. Data also shows Oklahoma underpays public psychologists by about $10,000 compared to the national average.

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Programs like Florida's     

Eleventh Judicial Circuit Criminal Mental Health Project (CMHP) sort defendants by seriousness and funnel those who are not likely to go  to prison into mental health services. Their low-level charges are dismissed.  General arrests fell from 118,000 to 53,000 in 2021. This reduction has led to a savings of 300 years of jail days and a cost avoidance of over $29 million. 

Implement Outpatient Competency Restoration Services

Mandate Time Period to be Transported to Competency Services to 7 days or less

Improve Mental Health Services and Increase Access to Diversion Programs for Mentally Ill people

Many other states, like Colorado, have developed outpatient competency restoration services for clients who are well indicated to receiving these services in the community.

Mandate Time Period to Receive and Evaluation to 14-days

Mandate Time Period to be Transported to Competency Services to 7 days or less

Mandate Time Period to be Transported to Competency Services to 7 days or less

In states where litigation on this issue has taken place, courts have found a 14-day period to receive a competency assessment after being ordered by the court falls in line with constitutional requirements.

Mandate Time Period to be Transported to Competency Services to 7 days or less

Mandate Time Period to be Transported to Competency Services to 7 days or less

Mandate Time Period to be Transported to Competency Services to 7 days or less

In states where litigation on this issue has taken place, courts have found a 7-day period to be transported to services after a finding of incompetence to stand trial falls in line with constitutional requirements.

Reduce the Time to Restore to One Year

Reduce the Time to Restore to One Year

Reduce the Time to Restore to One Year

Currently, Oklahoma law requires people to continue getting competency restoration services for up to two years, even if the doctors think it's unlikely the patient can regain competency. Research shows if competency cannot be reached within one year, it is unlikely it will be attained.

Fund SQ 781

Reduce the Time to Restore to One Year

Reduce the Time to Restore to One Year

Passed by Oklahoma voters in 2016, a fund for mental health and substance use services at the county level has never been funded by the Oklahoma legislature. Recent reforms have saved between $10 and $20 Million per year since 2017 which could go toward services like out patient restoration and other needed services. 

Hire Forensic Navigators

Reduce the Time to Restore to One Year

Increase mental health training across the system

Washington's settlement agreement on this issue required the state to hire forensic navigators to work in the system to find cases that would benefit from out-patient services, and which would track cases. through the competency process.

Increase mental health training across the system

Implement practices to reduce prescribing poorly tolerated medications

Increase mental health training across the system

Lawyers, judges, police, corrections officers, and counselors need additional training for handling serious mental illness in the context of criminal law.

Maintain medications and protocols upon return to jail

Implement practices to reduce prescribing poorly tolerated medications

Implement practices to reduce prescribing poorly tolerated medications

Sometimes people return from having competency restored and they are not kept on the same regimen that was used to stabilize them. When medications are changed, people can decompensate and have to start the process all over again. The state should require jails to keep medications the same upon return from competency services.

Implement practices to reduce prescribing poorly tolerated medications

Implement practices to reduce prescribing poorly tolerated medications

Implement practices to reduce prescribing poorly tolerated medications

A contributing factor to long wait lists is the trial-and-error practices of prescribing medications. Trying different medications can take months to find the right doses etc. Many governmental bodies have begun genetic mouth swab testing to equip patients with information about which medications are contra-indicated or poorly metabolized.


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