Assessing Racial Effects on Adjudicative Competence
Authors
Kelsey S. Hobart, At the time of this work, Dr. Hobart was Physician Resident (PGY-IV), Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC; she is currently a fellow in forensic psychiatry at the University of Rochester Medical Center, Rochester, NY. Dr. Krishnan is Deputy Director, Forensic Services Division, DC Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC. Dr. Cleary is Associate Professor, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC. Dr. Candilis is Director of Medical Affairs, Saint Elizabeths Hospital, Washington, DC, and Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC.
Shilpa Krishnan, At the time of this work, Dr. Hobart was Physician Resident (PGY-IV), Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC; she is currently a fellow in forensic psychiatry at the University of Rochester Medical Center, Rochester, NY. Dr. Krishnan is Deputy Director, Forensic Services Division, DC Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC. Dr. Cleary is Associate Professor, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC. Dr. Candilis is Director of Medical Affairs, Saint Elizabeths Hospital, Washington, DC, and Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC.
Sean D. Cleary, At the time of this work, Dr. Hobart was Physician Resident (PGY-IV), Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC; she is currently a fellow in forensic psychiatry at the University of Rochester Medical Center, Rochester, NY. Dr. Krishnan is Deputy Director, Forensic Services Division, DC Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC. Dr. Cleary is Associate Professor, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC. Dr. Candilis is Director of Medical Affairs, Saint Elizabeths Hospital, Washington, DC, and Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC.
Philip J. Candilis, At the time of this work, Dr. Hobart was Physician Resident (PGY-IV), Department of Psychiatry, Saint Elizabeths Hospital, Washington, DC; she is currently a fellow in forensic psychiatry at the University of Rochester Medical Center, Rochester, NY. Dr. Krishnan is Deputy Director, Forensic Services Division, DC Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC. Dr. Cleary is Associate Professor, Department of Epidemiology & Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC. Dr. Candilis is Director of Medical Affairs, Saint Elizabeths Hospital, Washington, DC, and Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC. philip.candilis@dc.gov.
Document Type
Journal Article
Publication Date
12-8-2023
Journal
The journal of the American Academy of Psychiatry and the Law
DOI
10.29158/JAAPL.230074-23
Keywords
competency to stand trial; forensic hospital psychiatry; institutional racism; racial determinants
Abstract
As racial influences on forensic outcomes are identified in every aspect of practice, scholars are exploring methods to disentangle race from its historical, economic, and attitudinal antecedents. Because jurisdictions vary in these influences, definitions and data may differ among them, creating inconsistencies in analysis and policy. This retrospective database review compared differences in racial outcomes among 200 pretrial defendants, 160 Black and 40 White, exploring a wide range of socioeconomic, clinical, and forensic influences before, during, and after hospitalization. Because of the tight relationship of socioeconomic factors and race, investigators hypothesized that it would be difficult to distinguish racial influences alone. Using a confirmatory approach to data collection and a statistical analysis based in logistic regression, only differences in referral for psychological testing were identified. Application of this method based on local demographics and culture may prove useful for institutions interested in evaluating racial influences on forensic outcomes.
APA Citation
Hobart, Kelsey S.; Krishnan, Shilpa; Cleary, Sean D.; and Candilis, Philip J., "Assessing Racial Effects on Adjudicative Competence" (2023). GW Authored Works. Paper 3994.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3994
