Dispositions after the Competence to Stand Trial Hearing

At the close of the CST hearing, the defendant will be found to be either CST or IST. Chapter 6 addresses what occurs next. If the defendant is found to be CST, the trial proceedings usually resume where they left off, although scrutiny of the defendant’s CST should continue. If the defendant is found to be IST, the trial proceedings will generally remain suspended while custodial treatment is typically ordered for the defendant as the State is given an opportunity to try and restore the defendant’s CST. This chapter provides an overview of the continuing evolution of these placements, as well as a pair of rulings by the USSC that set a ceiling on how long IST defendants can be held by the State in an attempt to restore their CST, established these defendants have a right to refuse medication prescribed to facilitate this restoration, and specified the criteria that must be met if the State wants to administer this medication over a defendant’s objection. Although, as discussed, the increased use of correctional facilities for these placements may be questionable, the systematic resolution of the issues arising following a CST hearing that has emerged provides greater assurance that these determinations are made in a relatively fair and just manner.