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Mental Health Courts

August 26th, 2014 · No Comments

Lately there have been a disturbing number of news reports about mentally-ill people being shot by police. The need for better training of police to deal with the mentally ill has been amply covered by other blogs. But mentally-ill people who survive their encounter with law enforcement have a chance for better treatment from the court system – and that’s where this blog comes in.

Back in 2008 we touched on two different aspects of court procedure involving people with mental health problems. A court system’s involvement with a mentally ill person may occur when the person is facing involuntary commitment to an institution, and we’ll explore that aspect in more detail next month.

The criteria for involuntary commitment are very specific and limited, and simple commission of a crime by a mentally-ill person is not one of them. If a mentally-ill person commits a crime but does not need to be committed, should the justice system treat that person the same as any other perpetrator? Many court systems have answered “no” and created a special program called a Mental Health Court.

Mental Health Courts are not a separate “court” in any court system; although some courts may have a dedicated judge or docket, they are usually held in the same courtroom with the same judge as other criminal cases. They are a program that falls into the category of “problem-solving courts” or “accountability courts” or “collaborative courts” or similar language, depending on location. But the concept is the same: a procedure to help the individual avoid future encounters with the criminal justice system through supervision and treatment. Simply incarcerating a drug addict or mentally-ill individual doesn’t fix the problem that led to their offense, and they are likely to re-offend when they’re eventually released. Problem solving courts aim to break that cycle.

We’ve already explored several other types of problem-solving or collaborative court programs. Drug Courts are the most common, and we’ve talked about them in 2008 and again in 2014. Note that Drug Courts – started in 1989 - numbered over 200o in 2008 and now number over 2800. Others that we have explored include Veterans Court (which addresses both drug and mental health issues),  Family Dependency Treatment Court, juvenile and non-juvenile diversion programs, and Teen Court. All of these share similar goals and practices:

  • providing offenders with treatment and other services to help them overcome the problems that brought them into the justice system
  • collaboration between the court, other justice system components, and social service providers such as counselors, treatment centers, and schools
  • close supervision by the court to insure compliance with the program
  • reducing costs and jail populations
  • reducing recidivism
  • helping individuals avoid the stigma of a criminal conviction

Mental Health Courts are among the fastest growing problem-solving courts. They are a response to the increasing numbers of mentally-ill inmates in the prison system. Treatment and medication in a jail or prison setting is very expensive and is rarely effective. Mental Health Courts, like other problem-solving courts, are selective: they may only accept individuals charged with misdemeanors or non-violent offenses; they may screen individuals and only accept those they deem likely to benefit or who have specific diagnoses; and they usually only accept individuals who voluntarily apply. Many court systems have separate adult and juvenile Mental Health Courts. They include not only the judge and court staff, but also defense counsel, the prosecutor’s office, the probation department, and community social and mental health service providers.

Mental Health Court programs universally include treatment such as counseling and  psychotherapy (which may include a period of residential treatment), medication management, and regular reporting to the court/probation department/service providers. Many programs include additional elements such as education, job placement help, and parenting skills instruction.

Length of the program depends on the individual participant’s treatment needs and compliance with the program. Incidents of non-compliance can extend the length of the program. Because mental-illness treatment is a long-term process, the treatment program is usually longer than a typical jail sentence for the same offense. Most programs result in dismissal of charges for successful participants, although some may require a guilty plea (with credit for time served in treatment) for more serious offenses.

Mental Health Courts, like Drug Courts and other problem-solving courts, can use sanctions such as temporary incarceration to enforce compliance with the program. But they are more likely to use incentives and positive reinforcement for participants who comply with the program.

Here are just a few examples from around the country: Tucson AZ where City Court has a dedicated Mental Health Division; Orange County, CA with two programs (Opportunity Court and “Whatever It Takes” Court), Delaware’s statewide program, Georgia’s many programs (just scroll down the page and look for “Mental Health Court”), Idaho’s statewide resources and local programs, the Will County IL program from the perspective of the Public Defender’s Office, MD’s Baltimore City District Court program, New York’s many district- and county-based programs, Orange County NC’s Community Resource Court, Pennsylvania’s many county-based programs, Harris County TX with its separate Felony and Juvenile Mental Health Court programs, and the Spokane County WA District Court program (which includes links to its application form and annual reports).

All these and more can be found on CourtReference, in our Self Help and Legal Research category. As with other problem-solving courts, studies have shown that they do reduce recidivism – as well as homelessness and mental-illness hospitalizations. Unfortunately, many mentally-ill people don’t receive the same level of attention, treatment, and incentive. That some people’s best hope for help with their illness is to get arrested is a sad commentary on the state of mental health awareness and treatment in our society.

VanB

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