The ROC program: accelerated restoration of competency in a jail setting

J Correct Health Care. 2014 Jan;20(1):59-69. doi: 10.1177/1078345813505067. Epub 2013 Nov 13.


In 29 months of operation, the restoration of competency (ROC) program provided treatment services to 192 incompetent to stand trial patients in a jail setting. The ROC restored competency for 55% of the patients in an average of 57 days compared to the state hospital average of 180 days. The average cost of treatment/restoration per admission was $15,568 compared to the state hospital average of $81,000. The ROC model accelerates needed treatment for mentally ill defendants, cuts demand for costly state hospital forensic beds, and assists jails in better managing inmates with severe psychiatric disorders--yielding major cost savings and improved care. In addition to preventing readmissions and negative behavioral episodes, the ROC improved the broader forensic system by eliminating the state hospital waiting list, accelerating access to psychiatric services, promoting local access for lawyers and family, and gaining stakeholder satisfaction.

Keywords: forensic patients; jails; mental illness; psychiatric treatment; restoration of competency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Forensic Psychiatry / organization & administration
  • Humans
  • Insanity Defense
  • Length of Stay
  • Male
  • Medication Adherence
  • Mental Competency*
  • Mental Disorders / economics*
  • Mental Disorders / therapy*
  • Middle Aged
  • Patient Care Team / organization & administration
  • Prisons / organization & administration*
  • Referral and Consultation / organization & administration
  • Socioeconomic Factors
  • Time Factors