Mental health court: friend or foe?
Written by Tara Wasik
Mental health courts have rapidly become a staple in the judicial system, mirroring the growing consciousness of mental health awareness throughout the country. Traditional courts and prisons were unable to address underlying mental illnesses in situations where prior diversion attempts proved ineffective. In instances where the nature of a charge is not serious enough to require prosecutors to maintain control, these courts failed.
A few mental health courts began sprouting in the late 1990’s, and as of 2022, over 650 were active. The Bureau of Justice Assistance (BJA) explains how almost all mental health courts share the following elements: a specialized court docket, community-based treatment plans, regular status hearings, and a set of expectations detailing program completion.
The BJA finds that successful mental health courts have ten key features:
Planning and administration: a broad-based stakeholders group guides the administration of a court.
Target population: eligibility criteria addresses public safety and the community’s treatment capacity.
Timely participant identification and linkage to services: participants are identified, referred, and accepted in a streamlined process.
Terms of participation: participation is clear, facilitates an engaging treatment plan, and promotes public safety.
Informed choice: program requirements are fully understood before participation.
Treatment support and services: comprehensive and individualized community services are provided.
Confidentiality: constitutional rights of defendants are protected.
Court team: criminal justice and mental health staff have ongoing collaborations.
Monitoring adherence to court requirements: graduated incentives, sanctions and modified plans are administered
Sustainability: data is collected and analyzed to promote future improvements.
In the state of Michigan, mental health courts have continued to have a growing, profound impact. From 2013-2016, the number of mental health courts have more than tripled in the state, with most operating as single jurisdiction programs with the exception of a few regional programs. The different types of mental health courts include adult and juvenile courts, district court programs for misdemeanor offenders, circuit court programs for felony offenders, and programs that accept both misdemeanor and felony offenders.
Michigan’s target population for mental health courts include individuals who have been diagnosed by a mental health professional with a serious mental illness, serious emotional disturbance, developmental disability, or a co-occurring disorder, as a standard requirement for their involvement. Jurisdictions that are interested in starting a mental health court are encouraged to work with the local jail, the Community Mental Health service provider (CMHSP), and probation department to first determine how many people would benefit from the establishment of such a court.
Training-wise, there is no standardized national training specifically for mental health courts. However, the National Association of Drug Courts Professionals and the Michigan Association of Treatment Court Professionals conferences have added processes for mental health courts.
As of May 2024, Michigan has forty-two mental health courts.
In Washtenaw County, where the University of Michigan resides, the participant handbook for the local mental health court follows guidelines that are very similar to the rest of the nation. The normal judicial approach that someone would pursue is replaced with a treatment based system under a team approach to undertake relevant issues and needs. Probation officers, defense counsels, case managers, and more, play a crucial part in an individual’s plan. Local jurisdictions are the backbone of mental health courts, as the very first mental health court and a majority that followed after began in local jurisdictions. Washtenaw County follows the BJA’s guidelines.
Individuals opt in for participation mainly to avoid incarceration and obtain treatment, but little is known about the factors that influence referrals and the actual decision-making process for admitting a participant into a mental health court. This point of uncertainty is critical because determining which populations are benefitting from referrals and which are not can address potential biases. In fact, an earlier study from 2005 revealed that individuals referred to mental health courts tended to be older, white, and female. If left to continue in this manner, the implicit racial bias that already occurs in the judicial system could be expanded as people of color, men, and younger people have a harder time seeking alternatives from the traditional court system.
As the amount of mental health courts have expanded, so have relevant research efforts that were formerly neglected. A 2017 meta-analysis evaluating the effectiveness of mental health courts on recidivism, or a relapse into criminal behavior, found a small but significant effect on recidivism compared to conventional criminal courts. Mental health courts were most effective with respect to jail time and charge outcomes.
The Council of State Governments (CSG) Justice Center clarifies that there is strong evidence to suggest that mental health court participants have lower recidivism rates while under court supervision than their mentally ill counterparts undergoing the traditional criminal court process. However, there is only a small amount of empirical evidence to suggest that this trend could continue after program graduation. More in-depth research is needed to ascertain the effects of mental health court.
Positive feedback, although limited, has prompted many organizations to support mental health courts and any related legislation. Human Rights Watch, an organization that investigates and advocates for human rights globally, has recommended that Congress and other public officials establish more diversion programs such as mental health courts.
However, there are controversies regarding mental health courts. First, there is one major issue that is not directly the fault of these courts. In “A Court of Refuge: Stories from the Bench of America’s First Mental Health Court,” Judge Ginger Lerner-Wren, one of the first judges to run a mental health court, wrote: “These court strategies, which look to respond to root causes and the vexing social problems that land on the courthouse steps, are not and were never intended to be a substitute for a comprehensive public health model of mental-health and behavioral-health care in the United States.” Although mental health court systems attempt to respond to the mental health crisis as best as they can given that they are not the single, definitive solution, many are afraid that these courts could be seen as such.
Lisa M. Wayne, executive director of the National Association of Criminal Defense Lawyers, explains that limited resources can exacerbate the pressure to apply for mental health courts. There does not seem to be many alternatives for participants, in both seeking help and navigating court complexities.
Mental Health America, a nonprofit dedicated to advancing the mental well-being of everyone in the U.S., uses Judge Lerner-Wren’s ideas as a basis for their recommended strategies. Basically, mental health courts are being treated as a superset for most issues under the intersection of mental health and crime. They fail to address certain issues simply because they were never meant to take on every concern. The government should still make other meaningful pursuits aimed at mental health issues due to its sheer complex nature. Some further steps away from the judicial system could include expanding the insurance coverage of crisis services and holding public insurance plans accountable for the care that they provide across treatment settings.
Additionally, within the structure of mental health courts, there are problems. National Public Radio followed Donald Brown’s story, in which the 55-year-old was charged with a felony of firearm possession after he threatened to take his own life with a gun. Brown was faced with the option of pleading guilty and being connected with mental health services to avoid incarceration or refusing a plea bargain and risking further punishment. Additionally, if he had not fully completed the mental health court program, jail time would have been a possibility. These binding conditions can commonly make mental health court more stressful, especially if these programs are not the most suitable pathway for an offender.
Furthermore, the elusive criteria on who gets into mental health courts has grown into a larger point of contention. Since some courts don’t allow admission to participants with violent or sexual crimes, people who could benefit the most from these programs are excluded. Also, the outcomes of high-profile offenders are often linked to public pressure instead of what is most helpful for both the participant and the community at large.
All in all, mental health courts have proven to show small yet impactful results as they have progressed in popularity. They tend to follow the structure of other non-traditional courts, like drug court and veterans court, even if there is no nationally mandated system. However, major drawbacks are invoked from the improper use of mental health courts as a single, broad solution for the lack of mental health resources as well as the conditions under which participants are admitted. The public health issues that do not have a relation to crime still need to be focused on. As a national awareness of mental health continues to gain momentum, tackling these problems while thinking about the most favorable outcome for all parties is something to be cognizant of.
