Mental health courts link offenders who would ordinarily be prison-bound to long-term community-based treatment. They rely on mental health assessments, individualized treatment plans, and ongoing judicial monitoring to address both the mental health needs of offenders and public safety concerns of communities. Like other problem-solving courts such as drug courts, domestic violence courts, and community courts, mental health courts seek to address the underlying problems that contribute to criminal behavior. [1]
Mental health courts share characteristics with crisis intervention teams, jail diversion programs, specialized probation and parole caseloads, and a host of other collaborative initiatives intended to address the significant overrepresentation of people with mental illness in the criminal justice system. [2]
In the United States in the early 1980s, Judge Evan Dee Goodman helped establish a court exclusively to deal with mental health matters at Wishard Memorial Hospital. The mentally ill were frequently arrested and had charges pending when the treatment providers sought a civil commitment to send their patient for long-term psychiatric treatment. Goodman's court at Wishard Hospital could serve both purposes. The probate part of the mental health court would handle the civil commitment. The criminal docket of the mental health court could handled the arrest charges. The criminal charges could be put on diversion, or hold, allowing the patient's release from jail custody. The civil commitment would then become effective and the patient could be sent to a state hospital for treatment. Goodman would schedule periodic hearings to learn of the patient's progress. If warranted, the criminal charges were dismissed, but the patient still had obligations to the civil commitment.
In addition to arranging inpatient treatment, Goodman often put defendants on diversion, or on an outpatient commitment, and ordered them into outpatient treatment. Goodman would have periodic hearings to determine the patient's compliance with the treatment plan. Patients who did not follow the treatment plan faced sanctions, a modification of the plan, or if they were on diversion their original charge could be set for trial.
Goodman's concept and the original mental health court were dissolved in the early 1990s. In 1995, Goodman was reprimanded for nepotism. [3]
In the mid-1990s, many of the professional mental health workers who had worked with Goodman sought to re-establish a mental health court in Indianapolis. Representatives of the county's mental health service providers and other stake holders began meeting weekly. The group decided to accept the name of the PAIR Program (PAIR stood for Psychiatric Assertive Identification and Referral). After, a couple years of lobbying the local authorities in Marion County, Indiana, the mental health court began as a formal program in 1996. Many consider this to be the nation's first mental health court in this second wave of mental health court initiatives.[ citation needed ] Since the PAIR Program did not operate with any new funds, there was not much scholarly research and therefore the accomplishments of Goodman and the PAIR Program are frequently overlooked. The current PAIR Program is a comprehensive pretrial, post-booking diversion system for mentally ill offenders. [4] A program launched in Broward County, Florida was the first court, to be recognized and published as a specialized mental health court. Overseen by Judge Ginger Lerner-Wren, the Broward County Mental Health Court was launched in 1997, partially in response to a series of suicides of people with mental illness in the county jail. The Broward court and three other early mental health courts, in Anchorage, Alaska, San Bernardino, California, and King County, Washington, were examined in a 2000 Bureau of Justice Assistance monograph, which was the first major study of this emerging judicial strategy. [5]
Shortly after the establishment of the Broward County Mental Health Court, other mental health courts began to open in jurisdictions around the U.S., launched by practitioners who believed that standard punishments were ineffective when applied to the mentally ill. [6] In Alaska, for example, the state's first mental health court (established in Anchorage in 1998) was spearheaded by Judge Stephanie Rhoades, who felt probation alone was inadequate. "I started seeing a lot of people in criminal misdemeanors who were cycling through the system and who simply did not understand their probation conditions or what they were doing in jail. I saw police arresting people in order to get them help. I felt there had to be a better solution," she explained in an interview. [7] Mental health courts were also inspired by the movement to develop other problem-solving courts, such as drug courts, domestic violence courts, community courts and parole reentry courts. The overarching motivation behind the development of these courts was rising caseloads and increasing frustration—both among the public and among system players—with the standard approach to case processing and case outcomes in state courts. [8] In February 2001, the first juvenile mental health court opened in Santa Clara, California.
Since 2000, the number of mental health courts has expanded rapidly. There are an estimated 150 courts in the U.S. and dozens more are being planned. [9] An ongoing survey conducted by several organizations identified more than 120 mental health courts across the country as of 2006. [10] The proliferation of courts was spurred in large part by the federal Mental Health Courts Program [11] administered by the Bureau of Justice Assistance, which provided funding to 37 courts in 2002 and 2003.
In England, UK, two pilot mental health courts was launched in 2009 in response to a review of people with mental health problems in the criminal justice system. They were considered a success which met needs that would have otherwise gone unmet; however they required financial support and wider changes to the system, and it is not clear whether they will be more broadly implemented. [12]
Mental health courts vary from jurisdiction to jurisdiction, but most share a number of characteristics. The Council of State Governments Justice Center has defined the "essential elements" [13] of mental health courts. The CSG Justice Center, in a publication detailing the essential elements, notes that the majority of mental health courts share the following characteristics:
Potential participants in a mental health court are usually screened early on in the criminal process, either at the jail or by court staff such as pretrial services officers or social workers in the public defender's office. Most courts have criteria related to what kind of charges, criminal histories, and diagnoses will be accepted. For example, a court may accept only defendants charged with misdemeanors, who have no history of violent crimes, and who have an Axis I diagnoses as defined by the DSM-IV.
Defendants who fit the criteria based on the initial screening are usually given a more comprehensive assessment to determine their interest in participating and their community treatment needs. Defendants who agree to participate receive a treatment plan and other community supervision conditions. For those who adhere to their treatment plan for the agreed upon time, usually between six months and two years, their cases are either dismissed or the sentence is greatly reduced. If the defendant does not comply with the conditions of the court, or decides to leave the program, their case returns to the original criminal calendar where the prosecution proceeds as normal. As a rule, most mental health courts use a variety of intermediate sanctions in response to noncompliance before ending a defendant's participation. An essential component of mental health court programs for protection of the public is a dynamic risk management process that involves court supervised case management with interactive court review and assessment.
As in other problem-solving courts, the judge in a mental health court plays a larger role than a judge in a conventional court. Problem-solving courts rely upon the active use of judicial authority to solve problems and to change the behavior of litigants. For instance, in a problem-solving court, the same judge presides at every hearing. [8] The rationale behind this is not only to ensure that the presiding judge is trained in pertinent concepts, such as mental illness, drug addiction, or domestic violence, but also to foster an ongoing relationship between the judge and participants. [14] Although the judge has final say over a case, mental health courts also take a team approach in which the defense counsel, prosecutor, case managers, treatment professionals, and community supervision personnel (for example, probation) work collaboratively to, for example, craft systems of sanctions and rewards for offenders in drug treatment. Many mental health courts also employ a full-time coordinator who manages the docket and facilitates communication between the different team members.
Some have criticized mental health courts for deepening, as opposed to lessening, the involvement of people with mental illness in the criminal justice system. They argued that this was particularly true in mental health courts that focus on misdemeanor offenders who would have received short jail sentences or probation if not for the mental health court. These critics urged mental health courts to accept defendants charged with felonies, which many of the more recent courts, such as the Brooklyn Mental Health Court, [15] have started to do. [16]
Critics have also raised concerns about the use of mental health courts to coerce people into treatment, the requirement in some courts that defendants enter a guilty plea prior to entering the court, and about infringement on the privacy of treatment information. Furthermore, many have noted that the rise of mental health courts is, in large part, the result of an underfunded and ineffective community mental health system, and without attention to the deficiencies in community treatment resources, mental health courts can only have a limited impact. [17] Finally, it has been noted that when scarce mental health services are redirected to those who have come in contact with the criminal justice system, it creates a perversion in the system were a person's best bet for obtaining services is to get arrested. [18]
Several studies of the Broward County court were released in 2002 and 2003 and found that participation in the court led to a greater connection to services. A 2004 study of the Santa Barbara County, California, Mental Health Court found that participants had reduced criminal activity during their participation. An evaluation of the Brooklyn Mental Health Court [15] documented improvements in several outcome measures, including substance abuse, psychiatric hospitalizations, homelessness and recidivism. [19] In a 2011 meta-analysis of literature on the effectiveness of mental health courts in the United States, it was found that mental health courts reduced recidivism by an overall effect size of −0.54. [20] In 2012, an Urban Institute evaluation found that participants in two New York City mental health courts were significantly less likely to re-offend than similar offenders whose cases are handled in the traditional court system. [21] A review published in 2019 concerned with drug-using offenders with co-occurring mental health problems found that mental health courts may help people reduce future drug use and criminal activity. [22]
A study conducted in Washington state in 2019 had found that timely mental health services is associated with the risk of incarceration. [23] It was shown in this finding that timely mental health services can be a catalyst for deeper involvement in the criminal justice system since the mental health service can act as a form of monitoring, resulting in higher technical violations in relation to higher supervision. Other studies show that more involvement of mental health services, or more supervision of the individual receiving treatment, is positively correlated with higher levels of recidivism. [24] [25] [26] [27]
The insanity defense, also known as the mental disorder defense, is an affirmative defense by excuse in a criminal case, arguing that the defendant is not responsible for their actions due to a psychiatric disease at the time of the criminal act. This is contrasted with an excuse of provocation, in which the defendant is responsible, but the responsibility is lessened due to a temporary mental state. It is also contrasted with the justification of self defense or with the mitigation of imperfect self-defense. The insanity defense is also contrasted with a finding that a defendant cannot stand trial in a criminal case because a mental disease prevents them from effectively assisting counsel, from a civil finding in trusts and estates where a will is nullified because it was made when a mental disorder prevented a testator from recognizing the natural objects of their bounty, and from involuntary civil commitment to a mental institution, when anyone is found to be gravely disabled or to be a danger to themself or to others.
Probation in criminal law is a period of supervision over an offender, ordered by the court often in lieu of incarceration.
Forensic psychiatry is a subspeciality of psychiatry and is related to criminology. It encompasses the interface between law and psychiatry. According to the American Academy of Psychiatry and the Law, it is defined as "a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.
Drug courts are a type of "specialized court" in the United States that provide a sentencing alternative of treatment combined with supervision for people living with serious substance use. The purpose of this is to aid putting a stop to crime at the source. Drug courts are problem-solving courts that take a public health approach using a specialized model in which the judiciary, prosecution, defense bar, probation, law enforcement, mental health, social service, and treatment communities work together to help addicted offenders into long-term recovery. Drugs courts often aim to do this by utilizing and mandating treatment from addiction specialists and programs such as Narcotic Anonymous, Alcoholics Anonymous, as well as other support groups.
A probation and parole officer is an official appointed or sworn to investigate, report on, and supervise the conduct of convicted offenders on probation or those released from incarceration to community supervision such as parole. Most probation and parole officers are employed by the government of the jurisdiction in which they operate, although some are employed by private companies that provide contracted services to the government.
A presentence investigation report (PSIR) is a legal document that presents the findings of an investigation into the "legal and social background" of a person convicted of a crime before sentencing to determine if there are extenuating circumstances which should influence the severity or leniency of a criminal sentence. The PSIR is a "critical" document prepared by a probation officer via a system of point allocation, so that it may serve as a charging document and exhibit for proving criminal conduct. The PSIR system is widely implemented today.
A diversion program, also known as a pretrial diversion program or pretrial intervention program, in the criminal justice system is a form of pretrial sentencing that helps remedy behavior leading to the arrest. Administered by the judicial or law enforcement systems, they often allow the offender to avoid conviction and include a rehabilitation program to avoid future criminal acts. Availability and the operation of such systems differ in different countries.
Judge Ginger Lerner-Wren is a county court judge in the Criminal Division of the 17th Judicial Circuit, Broward County, Florida. She is an adjunct professor, Nova Southeastern University, Criminal Justice Institute, Doctoral (On-line).
The Boston Municipal Court (BMC), officially the Boston Municipal Court Department of the Trial Court, is a department of the Trial Court of the Commonwealth of Massachusetts, United States. The court hears criminal, civil, mental health, restraining orders, and other types of cases. The court also has an appellate division which reviews questions of law that arise from civil matters filed in the eight divisions of the department.
Sentencing in England and Wales refers to a bench of magistrates or district judge in a magistrate's court or a judge in the Crown Court passing sentence on a person found guilty of a criminal offence. In deciding the sentence, the court will take into account a number of factors: the type of offence and how serious it is, the timing of any plea of guilty, the defendant's character and antecedents, including their criminal record and the defendant's personal circumstances such as their financial circumstances in the case of a fine being imposed.
Problem-solving courts (PSC) address the underlying problems that contribute to criminal behavior and are a current trend in the legal system of the United States. In 1989, a judge in Miami began to take a hands-on approach to drug addicts, ordering them into treatment, rather than perpetuating the revolving door of court and prison. The result was creation of drug court, a diversion program. That same concept began to be applied to difficult situations where legal, social and human problems mesh. There were over 2,800 problem-solving courts in 2008, intended to provide a method of resolving the problem in order to reduce recidivism.
Drug courts are specialized court docket programs that aim to help participants recover from substance use disorder to reduce future criminal activity. Drug courts are used as an alternative to incarceration and aim to reduce the costs of repeatedly processing low‐level, non‐violent offenders through courts, jails, and prisons. Drug courts are usually managed by a nonadversarial and multidisciplinary team including judges, prosecutors, defense attorneys, community corrections, social workers and treatment service professionals. Drug court participants include criminal defendants and offenders, juvenile offenders, and parents with pending child welfare cases.
Incarceration prevention refers to a variety of methods aimed at reducing prison populations and costs while fostering enhanced social structures. Due to the nature of incarceration in the United States today caused by issues leading to increased incarceration rates, there are methods aimed at preventing the incarceration of at-risk populations.
Mentally ill people are overrepresented in United States jail and prison populations relative to the general population. There are three times more seriously mentally ill persons in jails and prisons than in hospitals in the United States. Scholars discuss many different causes of this overrepresentation including the deinstitutionalization of mentally ill individuals in the mid-twentieth century; inadequate community mental health treatment resources; and the criminalization of mental illness itself. The majority of prisons in the United States employ a psychiatrist and a psychologist. There is a general consensus that mentally ill offenders have comparable rates of recidivism to non-mentally ill offenders. Mentally ill people experience solitary confinement at disproportionate rates and are more vulnerable to its adverse psychological effects. Twenty-five states have laws addressing the emergency detention of the mentally ill within jails, and the United States Supreme Court has upheld the right of inmates to mental health treatment.
People in prison are more likely than the general United States population to have received a mental disorder diagnosis, and women in prison have higher rates of mental illness and mental health treatment than do men in prison. Furthermore, women in prisons are three times more likely than the general population to report poor physical and mental health. Women are the fastest growing demographic of the United States prison population. As of 2019, there are about 222,500 women incarcerated in state and federal prisons in the United States. Women comprise roughly 8% of all inmates in the United States.
The Sequential Intercept Model clarifies five points at which standard processing of crimes can be intervened with community-based actions, so that individuals with mental and psychiatric disorders would not have to further penetrate the criminal justice system. By understanding and using the model, communities can develop a series of strategies to increase diversion of individuals with mental disorder from the criminal justice system and to help them receive proper community-based treatments.
Lifetime probation is reserved for relatively serious legal offenders. The ultimate purpose of lifetime probation is to examine whether offenders properly maintain good behavior as well as capability of patience under lifetime probation serving circumstance. An offender is required to abide by particular conditions for rest of their entire life in order to nurture superior social behaviour as a punishment for their criminal offence. Condition of probation orders contain supervision, electronic tagging, reporting to his or her probation or parole officer, as well as attending counselling. The essential component of lifetime probation carries the sense of being examined for well-being character and behaviour for life term period. Legislative framework regarding probation may vary depending on the country or the state within a certain country as well as the duration and condition of probational sentencing.
Decarceration in the United States involves government policies and community campaigns aimed at reducing the number of people held in custody or custodial supervision. Decarceration, the opposite of incarceration, also entails reducing the rate of imprisonment at the federal, state and municipal level. As of 2019, the US was home to 5% of the global population but 25% of its prisoners, until the COVID-19 pandemic, the U.S. possessed the world's highest incarceration rate: 655 inmates for every 100,000 people, enough inmates to equal the populations of Philadelphia or Houston. The COVID-19 pandemic has reinvigorated the discussion surrounding decarceration as the spread of the virus poses a threat to the health of those incarcerated in prisons and detention centers where the ability to properly socially distance is limited. As a result of the push for decarceration in the wake of the pandemic, as of 2022, the incarceration rate in the United States declined to 505 per 100,000; meaning that the United States no longer has the highest incarceration rate in the world.
The Honorable Stephanie Rhoades served as a District Court Judge in Anchorage, Alaska, from 1992 to 2017. Judge Stephanie Rhoades founded the Anchorage Coordinated Resources Project (ACRP), better known as the Anchorage Mental Health Court (AMHC). AMHC was the first mental health court established in Alaska and the fourth mental health court established in the United States. Legal scholars suggest in the Alaska Law Review that mental health courts are to be considered therapeutic jurisprudence and define crime that deserves therapeutic justice as “a manifestation of illness of the offender’s body or character.” They follow that crime that falls under this definition “should be addressed through treatment by professionals.”
There are about 220,000 women currently incarcerated in America. Over 30% of these women are convicted prostitutes. Much of the research on the sex industry in prisons focuses on the experiences of women because the number of jailed female sex workers greatly outnumbers men. Prominent issues that the criminal justice system and women who are incarcerated on prostitution charges currently face include the sexually transmitted infections and diseases epidemic, the sex-work-prison cycle, and the prison-to-sex-trafficking pipeline. Intervention and diversion programs, both within prisons and in traditional and specialty courts aim to address these issues, decrease recidivism, and provide these women with resources to assist them in exiting the sex trade. There are a variety of community-based organizations which seek to help resolve these concerns.