New programs aim to help more mentally ill Alaskans become competent to stand trial

A triangular glass entrance is framed by a beige and ruddy building.
Main entrance of Alaska Psychiatric Institution, or API, in Anchorage. (Photo courtesy of API)

Alaska’s only state-run psychiatric hospital plans to launch two new programs this month for people without the mental capacity to stand trial. The programs are one-year pilots and will triple the Alaska Psychiatric Institute’s capacity to provide “restoration services” for people facing criminal charges. 

Alaska Psychiatric Institute’s, or API’s, initiative would expand a 10-bed inpatient program to also serve outpatients and people in jail. The program aims to help people found “not competent” for trial better manage their condition and educate them about the legal process. Ultimately, the goal is to help people become mentally competent enough to stand trial. Dr. Kristy Becker, an API psychologist and the program lead, said care for patients in the program can take a lot of different forms, depending on their needs.  

“We use medication for individuals who have psychosis to help ameliorate their worst symptoms that interfere with their ability to understand what’s happening to them,” Becker said. “And then for individuals who have cognitive deficits or intellectual disabilities, we do a lot of teaching: ‘This is what your attorney’s job is. This is what a judge does. This is how a plea bargain works.’ Concepts like that.”

The plan will expand API’s program to 30 people, tripling capacity. Becker said Alaska has lagged behind other states in providing restoration services – API’s 10 beds are the only program in the state. 

“That is the lowest per capita bed count for competency restoration in any state in the nation,” Becker said. 

In the past, API’s program has had a long waitlist, and people have had to wait for up to five months for services, according to Becker. But she said the new programs will help cut that waitlist without adding physical beds to the facility. 

One program is for up to ten people who are currently in jail who will work with clinicians from API while they remain incarcerated. 

The second is an Anchorage out-patient program for non-violent offenders who have been released on bail. Becker said it will also serve up to ten people. 

Even with the pilot programs, Alaska will still have the fewest in-patient beds per capita for this type of program. But Becker said it would move Alaska closer to average for how many people can be served through all branches of the program. 

The pilot programs will likely save the state money, Becker said, because inpatient treatment is so costly. The outpatient program could allow non-violent offenders to avoid inpatient treatment altogether, letting them stay in their community, connected to existing support. 

The criminal justice system sometimes catches people who may need mental health care but aren’t getting it. And accessing care, Becker said, even if it’s through the criminal justice system, can be transformative. 

“Mentally ill individuals, based on data, based on research, are not more likely to be violent than other individuals,” Becker said. “And I think that’s a misnomer because often the only time these sorts of cases find their way into the news is when something has gone wrong. Many of these folks do tend to do well. Many of them do only come through the process one time.”

API plans to start the pilot programs by the end of January. Becker said the goal is reduced wait times and reduced recidivism and if successful, they hope to continue and expand the programs.

RELATED: Alaska’s Public Guardians are overloaded with cases, but a new court order mandates they must take on more

Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her at Read more about Rachel here.

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