The Psychiatric Security Review Board supervises individuals who successfully asserted the insanity defense (Guilty Except for Insanity or GEI) to a criminal charge. The board also supervises youth who successfully assert the insanity defense (Responsible Except for Insanity or REI) and certain civil commitments. It has been designated by the Legislature as the “relief” authority for two different populations: GEI sex offenders who request relief from sex offender registration and those who are barred from possessing a firearm due to a mental health determination (e.g. civil commitment, competency, GEI) who request restoration of firearm rights.

The board includes adult and juvenile panels. Each consists of five members, appointed by the governor and confirmed by the Senate for four-year terms. The adult panel is made up of of a psychiatrist and a psychologist experienced in the criminal justice system, an experienced parole and probation officer, an attorney experienced in criminal trial practice and a member of the general public. The juvenile panel has a child psychiatrist, child psychologist, parole and probation officer experienced in juvenile criminal justice, an attorney experienced in juvenile criminal trial practice and a member of the general public. The agency employs 12 staff.​