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Supreme Court decisions have implications far beyond the legal principles they articulate, and it is essential that individuals working in the forensic mental health and correctional systems understand the extent to which such decisions can affect their practice and the facilities in which they work. The seemingly-unrelated cases of Godinez v. Moran (1993) (establishing a unitary standard for the determinations of competency to plead guilty, competency to waive counsel, and competency to stand trial), Kansas v. Hendricks (1997) (upholding the constitutionality of one state's “Sexually Violent Predator Act”), Pennsylvania Department of Corrections v. Yeskey (1998) (ruling that the Americans with Disabilities Act (ADA) applies to state prisons), and Olmstead v. L.C. (1999) (finding a qualified right to community treatment for certain persons institutionalized because of mental disability) may have profound impacts on forensic mental health and correctional practices. These potential impacts, however, have been the subject of virtually no academic, practitioner, or clinical attention, and there has been no consideration at all of the “ripple effects” of these four cases as a grouping. It is critical that forensic mental health and correctional professionals understand these cases—not simply their holdings, but how they may profoundly affect day-to-day practices.

Godinez makes it inevitable that more seriously mentally ill criminal defendants will be imprisoned; Hendricks makes it inevitable that more violent sexual offenders will be housed in forensic mental hospitals; Yeskey makes it inevitable that all aspects of institutionalization (whether in a facility labeled “criminal” or one labeled “mental health”) will be subject to far more probing external scrutiny. Olmstead makes it inevitable that institutional decisionmaking as to retention and release of certain patients will be examined more critically.

This article discusses these cases, explains their holdings, demonstrates the likely “ripple effects” of these holdings, and discusses their implications for forensic mental health professionals.