Psychiatric hospitalization of criminal defendants: new horizons.

The Richard H. Hutchings Psychiatric Center (HPC), located in Syracuse, is a New York State Mental Hygiene Facility providing mental health services to the Central New York Region. At this time the Center primarily serves the 473,000 residents of Onondaga County; however, when fully operational, it will also provide services to the 287,000 residents of surrounding Madison, Oswego, Cayuga, and Cortland Counties. In consonance with current social policy, HPC functions as a Community Mental Health Center, and, as such, is committed to the treatment and rehabilitation of moderately to severely, and acutely disturbed and chronically handicapped, mentally ill adults and adolescents in its catchment area. Consequently HPC provides many levels of care and treatment in a variety of settings, utilizing and involving all available community resources and the social networks of the catchment area residents. Most of the catchment area residents requiring direct intervention by HPC are treated by geographical treatment teams. Specialized teams, however, have been developed for individuals who require more directed treatment settings. Examples of this are the Rehabilitation Unit for chronically handicapped individuals, the Skills for Living Program for mentally ill, mentally retarded individuals, the Geriatric Day Care Program for the ambulatory elderly, and the Center for Youth Services for adolescents between the ages of thirteen and eighteen. Another group of individuals in the Central New York Region who require a specialized treatment setting are individuals who are denied free access to the community by the criminal justice system, have not been adjudicated guilty of any crime, and require inpatient psychiatric care. Specifically these individuals fall into three distinct classes as defined by New York State Law: (I) individuals held in pre-trial detention who require involuntary hospitalization (per the Mental Hygiene Law) but must remain in the custody of the Sheriff's Department;l (2) felony defendants adjudged to be incompetent to stand trial;2 and (3) individuals committed under criminal law following an acquittal by reason of mental disease or defect. 3 The HPC Forensic Unit is mandated to provide mental health services to these three classes of individuals. The Forensic Unit's programs are designed to cope with the complex