Abstract
The purpose of this study was to examine the rate of agreement between clinicians and judges in civil incompetency adjudications in incompetency and restoration cases and to determine predictors of court adjudications with clinician recommendation as a predictor. Court files were obtained for court-ordered requests (N = 345) for incompetency evaluations from one urban county. Court files containing the legal opinion were linked with clinical files containing demographic variables such as age, education, sex, race, residency status, relationship status, and cognitive and functional testing. The latter were the Mini-Mental State Examination and Managing Money and Health and Safety subtests of the Independent Living Scales. In each case, we documented the clinician’s opinion about whether the examinee was competent or incompetent. Overall, the court agreed with the clinician 87.1% of the time. However, the rate of agreement was higher for incompetency adjudication (94.4%) versus competency restoration (55.9%). The only difference between cases of agreement versus disagreement was that the former were significantly older. In terms of predicting judicial decision-making, the clinician recommendation was significant even after controlling for demographic and functional variables. We address how these findings compare with clinician-court agreement for criminal cases and the implications of our findings.