A study of criminal defendants referred for competency to stand trial in New York City.

The Court Clinic of the Bronx-Lebanon Hospital was established in 1967 to deal with a combination of certain needs related to the overburdening of the city hospitals designated to furnish psychiatric competency examinations to the Bronx Supreme Court and the Criminal Court. At that time all such examinations were conducted on an inpatient basis in either the Bellevue or Elmhurst hospital forensic psychiatry units, because there was no appropriate facility in the Bronx. This procedure presented many serious drawbacks. Hospitalizations tended to be long, usually thirty to sixty days. The forensic units were overburdened, and overcrowded. Delays in submitting competency reports to the Court were commonplace and caused unnecessary delays in court proceedings. The costs of this system both financially and in tenns of human suffering had to be corrected. When court officials expressed the need for a clinic to be organized in the Bronx, we enthusiastically welcomed the suggestion. The clinic was opened in 1967 with the specific purpose of completing as many competency examinations as could be prepared on an outpatient basis. The first year's history of this enterprise was one of struggle and frustration, of maneuvering within the labyrinth of government agencies to acquire the small amount of money, space and staff to start this program. In 1968 for the first time we had the opportunity to receive our cases systematically. At the present time we operate an adequately staffed outpatient psychiatric clinic located within the Bronx Criminal Court Building. It is administered by the hospital and supported by New York City and State Mental Health Departments. In addition to conducting competency examinations, the program has expanded and now conducts "pre-sentencing" examinations after conviction, and also provides outpatient treatment for convicts who are mentally ill. In this study, however, we will confine ourselves to the competency issue. In New York State, competency to stand trial is a right guaranteed under article 730 of the criminal procedure law. Simply stated, it means that a defendant in a criminal proceeding, who is suspected of being incapacitated