The Sell effect: Involuntary medication treatment is a “clear and convincing” success.

Abstract

The Supreme Court ruling Sell v. United States in 2003 (539 U.S. 166) set a new precedent by mandating federal judges function as decision makers on the issue of whether "nondangerous" incompetent defendants charged with federal crimes can be involuntarily medicated to restore their competency to stand trial. To provide data to inform future opinions by mental health professionals and decisions for judges involved in these matters, a retrospective record review of all incompetent defendants in the entire U.S. federal court system (N = 132) involuntarily treated under Sell over a 6-year period was conducted. Results indicated the majority (79%) of treated defendants suffering from a psychotic related illness were sufficiently improved to be rendered competent to stand trial, surpassing the "clear and convincing" standard established by federal appellate courts. High rates of treatment responsiveness were found across all diagnoses.