Building a Better Mental Health Court: New Hampshire Judicial Branch Establishes State Guidelines

Unlike drug courts, which have been informed by national standards for 10 years, mental health courts (MHCs) have developed without national guidance. This January, after receiving support from The Council of State Governments (CSG) Justice Center, New Hampshire became one of a growing number of states to establish statewide governing documents for MHCs, such as guidelines, principles, and best practice standards. Released by the New Hampshire Judicial Branch, the Guidelines for New Hampshire Mental Health Court Teams provides a framework of best practices to guide program development and operation. These guidelines are now being used to help state officials begin to implement a range of programmatic strategies that support MHCs to improve outcomes for MHC participants.

While the guidelines were released in 2023, the work to develop them began years before. With 14 MHCs in its 10 counties, the New Hampshire legislature initially sought to understand how these programs operate to be able to support their success in reducing recidivism and increasing connections to care. Following a statewide commission recommendation in 2019, the New Hampshire Judicial Branch created a committee and requested technical assistance from the Center for Justice and Mental Health Partnerships—a training and support center administered by the CSG Justice Center with support from the U.S. Department of Justice’s Office of Justice Programs’ Bureau of Justice Assistance as part of the Justice and Mental Health Collaboration Program.

Their request was for a thoughtful analysis of current MHC operations in the state and assistance in developing statewide guidelines grounded in national best practices. To support this request, CSG Justice Center staff:

  • Collaborated with the National Center for State Courts, which is coordinating conversations among various states on MHC standards;
  • Developed an inventory of key elements for statewide MHC standards based on existing research and analysis of recently developed standards from Georgia, Michigan, and Nebraska; and
  • Completed a line-by-line comparison with New Hampshire’s draft standards to suggest additional items for consideration, such as a new section bringing together various standards protecting defendant rights and another on due process and confidentiality.

“The technical assistance provided by the CSG Justice Center, including the survey of practices and procedures in our existing MHCs, provided important data to New Hampshire’s committee studying MHC standards,” said Hon. Susan Ashley, deputy administrative judge of the New Hampshire Circuit Court.

To assess current practices of existing MHCs in New Hampshire, CSG Justice Center staff analyzed the results of a 100-plus-question state MHC policy survey that New Hampshire mental health coordinators received in October 2021. By comparing the newly developed state guidelines with the survey results, CSG Justice Center staff were able to identify strengths as well as gaps and potential areas for assistance across the state. Some identified areas for assistance included:

  • Educating MHCs on the role of a stakeholder/interagency workgroup
  • Educating MHCs on the role of staffing meetings and the importance of collaboration from the judge in those meetings
  • Discussing requirements that would be necessary for people to graduate from MHCs
  • Developing a statewide reporting system to hold certain MHC-related data

“The survey results reflected several consistencies among our MHCs while also highlighting divergent practices,” added Judge Ashley. “This information was key to formulating statewide guidelines for existing and future mental health courts in New Hampshire.”

Shelly Golden, one of the state’s mental health court coordinators, agreed. “CSG Justice Center staff provided us with professional, effective, and supportive guidance,” she said. “We now have what we need to understand and support our existing MHCs to be the best based on a review of national data and best practices, taking into account the varied strengths and resources available to us in different regions of New Hampshire.”


States or other jurisdictions looking for support to help improve their mental health court practices can request assistance through the Center for Justice and Mental Health Partnerships.



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Project Manager, Behavioral Health
Rachel Lee provides technical assistance to Justice and Mental Health Collaboration Program grantees and offers support on other projects that focus on the intersection of behavioral health and criminal justice. Prior to joining the CSG Justice Center, Rachel worked for
C4 Innovations, where she provided project assistance to several recovery-focused Substance Abuse and Mental Health Services Administration initiatives. Rachel has also served as a therapist for people with behavioral health disorders in both inpatient and outpatient health care settings. Rachel earned her BA in psychology from Bates College and her MSW and MPA from Columbia University.
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    Interim Director, Behavioral Health
    Hallie Fader-Towe works with local and state policymakers to craft policies, processes, and programs that bring research-informed approaches to their jurisdictions. In her positions with the CSG Justice Center, she has worked with jurisdictions around the country on collaborative, data-driven
    planning and implementation efforts to address criminal justice functions from initial detention through reentry, including a focus on people with mental illnesses. She has also managed the development of training materials on mental health courts and on judicial responses to the prevalence of individuals with mental illnesses involved with the criminal justice system. She has written on court case processing, competency to stand trial, dispute systems design for state trial courts, pretrial responses to people with mental illnesses, information sharing between criminal justice and mental health systems, and mental health court design and implementation. Before joining the CSG Justice Center, she was a management consultant with McKinsey & Company in New York. Hallie received a BA from Brown University and a JD from Harvard Law School. 
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    Statewide Treatment Court Coordinator, New Hampshire Judicial Branch
    Alex Casale oversees all drug courts, mental health courts, and veterans courts in New Hampshire as the state’s first statewide treatment court coordinator. He has worked in treatment courts since 2005 and has provided his expertise as a consultant with
    American University, National Drug Court Institute, and the U.S. Department of Justice’s Office of Justice Programs’ Bureau of Justice Assistance and the Office of Juvenile Justice and Delinquency Prevention. He received his BA in psychology with dual minors in justice studies and philosophy from the University of New Hampshire.
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