Severe mental illness, especially psychotic disorders that are worsening, acute or complicated, normally require intensive psychiatric care and treatment that is most appropriately provided in a mental hospital. For criminal defendants, transfer to a forensic security hospital has traditionally been the means of achieving hospital care for mentally disordered defendants who have been found incompetent to stand trial or not guilty by reason of insanity. In recent years, with the shortage of intermediate and long‐term hospital beds in the United States, including forensic security hospital beds, jail‐based competency restoration programs are being established, seemingly obviating hospital transfer. Potential advantages of and concerns about jail‐based, as opposed to hospital‐based, competency restoration programs are discussed in the literature. If defendants with severe mental illness traditionally treated in a forensic security hospital for competency restoration are now treated for competency restoration in jail, it is not inconceivable that insanity acquittees could one day be treated in jail for sanity restoration. With the premise that it is better to consider the potential consequences before this becomes a serious proposal and is implemented, this analysis examine the advantages and concerns that have been put forth for jail‐based competence restoration programs as they may or may not apply to jail‐based sanity restoration programs. Substantial commonality is recognized, but also some differences, as well as reason for skepticism of the purported virtues of either alternative to care and treatment in forensic security hospitals.

中文翻译：

---

恢复监狱理智的问题。

严重的精神疾病，尤其是加剧，急性或复杂的精神病，通常需要加强精神病治疗和治疗，这是在精神病院最合适的方法。对于刑事被告，传统上转移到法医医院是为精神错乱的被告提供住院治疗的手段，这些精神错乱的被告因精神错乱而无力接受审判或无罪。近年来，由于美国中长期法医床位（包括法医治安病床）的短缺，正在建立基于监狱的能力恢复计划，这似乎消除了医院的转移。与基于医院的能力恢复计划相比，基于监狱的能力的潜在优势和担忧在文献中进行了讨论。如果传统上在法医安全医院接受治疗以恢复能力的患有严重精神疾病的被告现在在监狱中接受恢复能力的治疗，那么不可思议的是，有精神错乱的被告有一天可以在监狱中接受治疗以恢复理智。在此前提下，最好先考虑潜在的后果，然后再将其作为一项严肃的建议并付诸实施，此分析检查了针对基于监狱的能力恢复计划提出的优点和关注点，因为它们可能适用于监狱，也可能不适用于监狱。基于的健全性恢复计划。人们认识到了实质性的共性，但也存在一些差异，以及对法医安全医院替代护理和治疗的所谓美德的怀疑的理由。