How One Local Judge is Working to Improve Responses to People with Mental Health Needs

The Council of State Governments Justice Center and the American Psychiatric Association Foundation have partnered to highlight leaders working to address mental health needs among people in the criminal justice system through innovative practices and programs. This feature is the second in a series under the Judges and Psychiatrists Leadership Initiative.

Judge Waller smiles

Judge Nan Waller has served in the Multnomah County, Oregon, circuit court system for 30 years. But when she became the presiding judge of the mental health court and competency dockets in 2018, she quickly realized the need to expand her understanding of the mental health care opportunities and challenges for people in the criminal justice system.

“People are often scared, understandably, and if they don’t have an idea of what to expect, I think it’s harder for them,” she said. “I wanted to be able to explain to somebody who is being sent to the hospital for restoration, for example, what that’s going to look like.”

That’s when she set out to visit each of the mental health programs available to the people who come before her in court, totaling eight locations. These visits gave Judge Waller detailed insight into what treatment was being offered—as well as what was lacking—and helped her more clearly envision what an ideal local system might look like. “I realized that we needed to build up our menu of what is available for people in the community and use the right level of support,” she said.

I wanted to be able to explain to somebody who is being sent to the hospital for restoration, for example, what that’s going to look like.

Honorable Nan Waller

judge for the Multnomah County circuit court in Portland, OR

Judge Waller has since taken her increased awareness of the challenges that people with mental health needs face in the criminal justice system and used it to help inform decisions intended to improve people’s outcomes. She’s done this in her role as a sitting judge, but also in her participation in committees and task forces at the state and national level. For example, in 2018, she joined the behavioral health steering committee for The Council of State Governments Justice Center’s Justice Reinvestment Initiative in Oregon. Her work with this committee led to the recommendation of a grant program for counties focused on people with complex health needs who frequently utilize the criminal justice and health systems. The Improving People’s Access to Community-Based Treatment, Supports, and Services grant program is expected to address a shortage of supports and services in local communities, from supportive housing to crisis stabilization units to medication and care coordination.

She is also co-chair of the Oregon Chief Justice’s Behavioral Health Advisory Council and is a member of the National Judicial Task Force to Examine State Courts’ Response to Mental Illness. In both of these capacities, Judge Waller advises on solution-oriented ideas related to improving competency to stand trial—a process designed to protect the rights of people who are unable to assist in their own defense that has become increasingly overburdened nationwide.

I’m hoping that as a country we begin to look at ‘how do we create community?’ and good solutions for people who are struggling and vulnerable.

Honorable Nan Waller

Judge Waller’s participation in these broader efforts has reinforced her belief that changes can be made to improve outcomes for people with mental health needs in the criminal justice system. But also, that this change requires a cross-systems approach that involves housing services, community organizations, and others.

“I’m so hopeful that we are in a moment in time where people are beginning to recognize the importance of mental health initiatives,” she said. “We’re moving in the right direction. Maybe slower than I’d like, but we’re moving. And I’m hoping that as a country we begin to look at ‘how do we create community?’ and good solutions for people who are struggling and vulnerable.”

Profile photo caption: Courtesy of Honorable Nan Waller, judge for the Multnomah County circuit court in Portland, OR

Hero image: Photo by Toa Heftiba on Unsplash

ABOUT THE AUTHOR

Elizabeth Fleming

Senior Operations Specialist, Behavioral Health

Elizabeth Fleming provides writing, research, and project management support to the Behavioral Health Division. Prior to joining the CSG Justice Center, she was a fine art photographer for over a decade and served as a chapter leader for the International

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