The Wilson Center for Science and Justice at Duke Law hosts a roundtable discussion about people with mental illnesses who are criminally accused and found incompetent to proceed in the criminal legal system. Topics include how competency restoration poses a challenge and costly management problem for state mental health and criminal legal systems; alternative pathways to community reentry for this population; the ethical-legal aspects; how mental health authorities and policymakers in different states are (or aren’t) dealing with it, and what should be done. Panelists are Dr. Reena Kapoor, from Yale School of Medicine; Dr. Debra Pinals, from University of Michigan Law and Medicine; W. Lawrence Fitch, from University of Maryland Francis King Cary School of Law; and Dr. William Fisher, who works with the National Association of State Mental Health Program Directors. Dr. Jeffrey Swanson from Duke School of Medicine moderated.