Module 1: Understanding Mental Health Courts
Module 1: Understanding Mental Health Courts introduces the mental health court program model and the existing research on the impact of mental health courts, and describes other programmatic and policy changes that are similarly designed to improve outcomes for justice-involved individuals with mental illnesses.
Learning Objectives
- Articulate why a community may decide to start a mental health court
- Describe the mental health court model and the state of research on program outcomes
- Identify program models other than mental health courts that have been shown to improve outcomes for individuals with mental illnesses involved in the criminal justice system
- Item 1: Council of State Governments Justice Center, Mental Health Courts: A Primer for Policymakers and Practitioners, 2008.
- Item 2: Council of State Governments Justice Center, Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court, 2008.
- Item 3: SAMHSA, Sequential Intercept Model Trifold Brochure, September 2019
Presentation
Quiz
Questions
1.1 True or False: Participants always go through the mental health court program in tandem with traditional court proceedings and may be removed from treatment before the program’s completion if found guilty of a serious crime.
1.2 Which are reasons that support starting a mental health court program? Check all that apply.
1.3 Which of the following are among the possible goals of a mental health court? Check all that apply.
1.4 Which of the following is NOT one of the essential elements of a mental health court?
1.5 True or False: Research shows that mental health courts inevitably result in net-widening by creating incentives for people to be arrested in order to receive treatment and services.
Answers
1.1 Correct answer: False. Although there are a variety of mental health court models, most mental health court programs modify traditional court processes in that a participant’s criminal case is “paused” while s/he receives behavioral health treatment and is supervised according to court-ordered conditions. If unsuccessful in the mental health court program, the participant returns to the normal processing of his/her case.
1.2 Correct answer: a, b, and d. A mental health court is one option for addressing a number of realities surrounding justice-involved people with mental illnesses—which include their overrepresentation in the system, the fact that correctional supervision has been less effective, and that people with mental illnesses and co-occurring substance abuse disorders have more criminogenic risk factors. While the mental health court process has many potential benefits, it is not necessarily shorter than a traditional court process (c). Finally, one of the hallmarks of mental health courts is that all participants make an informed choice to enter the program; no one should be coerced into participating in the program or receiving treatment (e).
1.3 Correct answer: a, b, c, d, and e.
1.4 Correct answer: a. Confidentiality is an essential element of a mental health court—information about individual participants and their case plans is shared only among members of the court team. Court teams may include judicial officers, treatment providers, case managers, defense attorneys, supervision officers, and court coordinators, among others (the composition of a mental health court team will be discussed further in Module 3: The Mental Health Court Team).
1.5 Correct answer: False. Stakeholders may be concerned that mental health courts “net-widen” in a number of ways. Some may worry that the existence of a mental health court makes it more likely that law enforcement officers will arrest individuals with the hope of connecting them to treatment through the program. Others may be concerned that the mental health court will mean that individuals are involved in the criminal justice system for longer than they would have been had their cases simply proceeded as normal. However, by being thoughtful about the target population for your program and the terms of participation—particularly the length of program involvement—you can design your program so that it does not lead to net-widening.
Activities Guide
Additional Resources
Policy and Practice Guides
Lisa Callahan and Heathcote W. Wales, “Mental Health Courts Research Roundup: Applying Research to Practice.” This March 2013 webinar provides an overview of emerging research on mental health courts and its implications for selecting target populations, collecting data, sustaining programs, and more.
Available here
Dottie Carmichael et al., Representing the Mentally Ill Offender: An Evaluation of Advocacy Alternatives (Austin, TX: Texas Task Force on Indigent Defense Office of Court Administration, 2010). In 2008, The Texas Task Force on Indigent Defense began a two-year evaluation of mental health public defenders and mental health courts in Texas. This publication gives an overview of the evaluation, including research findings and recommendations for policy.
Available here
Mikel Chavers and Hallie Fader-Towe, “Judges Find Hope in Different Approach For People With Mental Illness,” Capitol Ideas, 2010. n.d. This article explores the prevalence of mental illness in the court system and the potential benefits of mental health courts.
Available here
The Council of State Governments Justice Center, A Guide to Mental Health Court Design and Implementation (New York: CSG Justice Center, 2008). This guide explains critical issues such as determining whether to establish a mental health court, defining the target population, ensuring confidentiality, sustaining the program, and other key considerations.
Available here
The Council of State Governments Justice Center, Behavioral Health Diversion Interventions: Moving from Individual Programs to a Systems-Wide Strategy (New York: CSG Justice Center, 2019). This policy brief describes key components to developing a systems-wide diversion strategy and focuses on the fundamental agencies within the criminal justice system that can lead the implementation of diversion interventions, with the goal of diverting people with mental illness from the justice system and into community-based treatment and support services.
Available here
The Council of State Governments Justice Center, FAQ: A Look into Jail-Based Behavioral Health Diversion Interventions (New York: CSG Justice Center, 2020). This fact sheet answers some common questions from people who may want to invest in jail-based diversion, such as why set up this type of intervention, who can implement it, what are some common best practices, and where and what can people be diverted to?
Available here
The Council of State Governments Justice Center, FAQ: A Look into Court-Based Behavioral Health Diversion Interventions (New York: CSG Justice Center, 2020). This fact sheet answers some common questions from people who may want to invest in court-based diversion, such as why set up this type of intervention, who can implement it, what are some common best practices, and where and what can people be diverted to?
Available here
The Council of State Governments Justice Center, Mental Health Courts: A Primer for Policymakers and Practitioners (New York: CSG Justice Center, 2008). This primer provides a general overview of this program model and discusses the emergence of mental health courts, their objectives and procedures, how they differ from drug courts, and a number of other key issues.
Available here
Hallie Fader-Towe and Fred C. Osher, Improving Responses to People with Mental Illnesses at the Pretrial Stage: Essential Elements (New York: CSG Justice Center, 2015). This report introduces essential elements for responding to people with mental illnesses at the pretrial stage, including decisions about pretrial release and diversion. These elements encourage data collection not only to help individual communities, but also for future researchers who are dedicated to these important questions.
Available here
Gregg Goodale, Lisa Callahan, and Henry J. Steadman, “What Can We Say About Mental Health Courts Today?” Psychiatric Services 64 (2013): 298-300. This article summarizes evidence of the effectiveness of mental health courts, presenting findings from a recent study of 346 adult and 51 juvenile mental health courts operating around the country.
Available here
Mark R. Munetz and Patricia A. Griffin, “The Sequential Intercept Model” (Troy, NY: Policy Research Associates). The CMHS National GAINS Center. n.d. The Sequential Intercept Model provides criminal justice and behavioral health professionals with a framework to aid in the organization of treatment strategies for people with mental illnesses involved in the criminal justice system.
Available here
National Drug Court Resource Center (NDCRC): The NDCRC is the drug court resource center of the National Drug Court Institute (NDCI).
Available here
Fred Osher et al., Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery (New York: CSG Justice Center, 2012). This publication introduces criminal justice and behavioral health practitioners to an evidence-based framework for prioritizing scarce resources based on assessments of individuals’ risk of committing a future crime and their treatment and support needs.
Available here
Policy Research Associates, Inc. Practical Advice on Jail Diversion (Delmar, NY: 2020). This publication offers guidance to communities interested in developing jail diversion programs, including recommendations for design and implementation.
Available here
Seth J. Prins and Fred C. Osher, Improving Responses to People with Mental Illnesses: The Essential Elements of Specialized Probation Initiatives (New York: CSG Justice Center, 2009). This publication identifies ten key components found in successful initiatives to improve outcomes for people with mental illnesses under probation supervision.
Available here
Seth J. Prins and Laura Draper, Improving Outcomes for People with Mental Illnesses under Community Corrections Supervision: A Guide to Research-Informed Policy and Practice (New York: CSG Justice Center, 2009). This guide reviews research on community corrections supervision for people with mental illnesses and translates the findings to help officials develop effective interventions. It also helps program planners and policymakers apply research on promising practices to improve outcomes for people with mental illnesses under community corrections supervision.
Available here
Melissa Reuland, Laura Draper, and Blake Norton, Improving Responses to People with Mental Illnesses: Tailoring Law Enforcement Initiatives to Individual Jurisdictions (New York: CSG Justice Center, 2010). This publication explores the program design process, including detailed examples from several communities across the country. It is meant to assist leaders of initiatives and agents of change who want to select or adapt program features from models that will be most effective in their communities.
Available here
Matt Schwarzfeld, Melissa Reuland, and Martha Plotkin, Improving Responses to People with Mental Illnesses: The Essential Elements of a Specialized Law Enforcement-Based Program (New York: CSG Justice Center, 2008). This publication articulates ten essential elements for specialized law enforcement-based response programs in interacting with people with mental illnesses and provides a common framework for program design and implementation that will promote positive outcomes while being sensitive to jurisdictions’ distinct needs and resources.
Available here
Michael Thompson, Fred C. Osher, and Denise Tomasini-Joshi, Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court (New York: CSG Justice Center, 2008). This publication outlines ten elements essential to mental health court design and implementation and provides guidance on how courts can incorporate these elements.
Available here
Program Examples
Council of State Governments Justice Center, “Criminal Justice/Mental Health Learning Sites.” Criminal Justice/Mental Health Consensus Project. The Council of State Governments Justice Center and the Bureau of Justice Assistance identified successful mental health court programs (“learning sites”) that provide peer-to-peer guidance and learning for other criminal justice/mental health agencies.
Available here