Evaluating an Expedited Process to Assess Fitness to Stand Trial in Canada

Abstract In this study, we investigated the potential benefits of using an alternative approach for completing court ordered fitness to stand trial assessments in a Canadian forensic mental health service. Using file information, court databases, and an economic analysis, we compared a hospital-based model of evaluation to a court clinic model in a sample of 96 accused persons from 2013 to 2017. Results revealed a significantly shorter time period for forensic report completion in the court clinic group, but no difference in criminal case processing time between groups. There was a higher rate of accused persons opined to be unfit to stand trial in the court clinic group (25.9%) compared to the hospital-based model (7.7%). Report quality varied somewhat between groups, with forensic assessment reports citing mental disorder and relevant case law more often in the court clinic model. Economic analyses indicated there was a marked cost savings associated with completing assessments at court instead of hospital. Our findings suggest there are several benefits for forensic mental health systems in utilizing community-based models of forensic evaluation.