Defendants with mental health problems will differ, sometimes greatly, with respect to the severity of their symptoms, as well as their need for treatment. They also differ as to their potential response to treatment, level of dangerousness, etc. The definition of competence, however, does not include any of this. An evaluation of competency does not examine such factors as general treatment needs, violence risk assessment, adjustment to incarceration, rehabilitation recommendations, or any other ancillary issues. The competency standard only exists to ensure that the defendant is able to get a fair trial because they were able to assist in their defense, and to understand the proceedings against him.
This does not mean, of course, that an individual who requires treatment will not receive it. It means, though, that the evaluator does not concern him or herself with those issues. The only treatment the evaluator is concerned with is treatment regarding restoring the defendant to a level of competence necessary to stand trial. More broadly speaking, evaluators and treatment providers should never be the same person - these are different roles, with different agendas and different types of professional conduct. Where I work, I inform the defendant during the initial evaluation session that if they desire some form of mental health services during the course of the evaluation period, I will be happy to accommodate their desire, via a referral to a clinician who is not involved in their evaluation process. Once a clinician has evaluated an individual, they ought not provide treatment to that individual, and vice versa. One or the other, never both.
In terms of the evaluation for competency, there is an expectation that the evaluator, should the defendant be found incompetent, provide recommendations regarding the restoration process. Again, however, these recommendations will only concern themselves with issues related to competency, and no more.