Advancing Corrections Journal - Edition #12 - Innovation in Correctional Healthcare (ACJ12-A004)
Abstract
The existing literature offers little in the way of best practices regarding the reintegration of those found not guilty by reason of insanity (NGRI) after violent offenses. Unique to New Hampshire, step-down from an inpatient setting for such patients is largely controlled by the Department of Corrections (DOC) rather than the Department of Health and Human Services (DHHS). Quarantine restrictions in response to the COVID-19 pandemic required a departure from the standard plan involving a stepwise process of decreasing supervision. In its place the hospital initiated an accelerated plan with greater reliance on structured clinical judgment (SCJ). Under the accelerated plan, patients were recommended for discharge in less than 1/3 of the time required for patients advanced under the standard plan. This observational study suggests that SCJ may be non-inferior to a sequential step-down process in determining appropriateness for discharge of NGRI patients from a state psychiatric hospital, in keeping with Foucha.
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