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.
- 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
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.
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.
Policy and Practice Guides
Callahan, Lisa, 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.
Carmichael, Dottie, 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.
Chavers, Mikel, and Hallie Fader-Towe. “Judges Find Hope In Different Approach For People With Mental Illness.” Capitol Ideas. n.d. This article explores the prevalence of mental illness in the court system and the potential benefits of mental health courts.
Clark, John. Non-Specialty First Appearance Court Models for Diverting Persons with Mental Illness: Alternatives to Mental Health Courts. Delmar, NY: the National GAINS Center for People with Co-occurring Disorders in the Justice System, Technical Assistance and Policy Analysis Center for Jail Diversion, 2004. This guide provides program examples to illustrate the pretrial decision making process across jurisdictions for individuals with mental illnesses.
CMHS National GAINS Center. Practical Advice on Jail Diversion: Ten Years of Learnings on Jail Diversion from The CMHS National GAINS Center. Delmar, NY: CMHS National GAINS Center, 2007. This publication offers guidance to communities interested in developing jail diversion programs, including recommendations for design and implementation.
The Council of State Governments Justice Center. A Guide to Mental Health Court Design and Implementation. New York, NY: Council of State Governments 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.
The Council of State Governments Justice Center, Behavioral Health Diversion Interventions: Moving from Individual Programs to a Systems-Wide Strategy (New York, The 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.
The Council of State Governments Justice Center, FAQ: A Look into Jail-Based Behavioral Health Diversion Interventions (New York, The 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?
The Council of State Governments Justice Center, FAQ: A Look into Court-Based Behavioral Health Diversion Interventions (New York, The 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?
The Council of State Governments Justice Center. Mental Health Courts: A Primer for Policymakers and Practitioners. New York, NY: Council of State Governments 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.
Fader-Towe, Hallie and Fred C. Osher, Improving Responses to People with Mental Illnesses at the Pretrial Stage: Essential Elements. New York: The Council of State Governments 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.
Goodale, Gregg, Lisa Callahan, and Henry J. Steadman. “What Can We Say About Mental Health Courts Today?” Psychiatric Services 64: 298-300, 2013. 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.
Munetz, Mark R., and Patricia A. Griffin. “Sequential Intercepts for Developing CJ–MH Partnerships.” 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.
National Drug Court Resource Center (NDCRC): The NDCRC is the drug court resource center of the National Drug Court Institute (NDCI).
Osher, Fred, David A. D’Amora, Martha Plotkin, Nicole Jarrett, and Alexa Eggleston. Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery. New York, NY: Council of State Governments 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.
Prins, Seth J., and Fred C. Osher. Improving Responses to People with Mental Illnesses: The Essential Elements of Specialized Probation Initiatives. New York, NY: Council of State Governments Justice Center, 2009. This publication identifies ten key components found in successful initiatives to improve outcomes for people with mental illnesses under probation supervision.
Prins, Seth J., and Laura Draper. Improving Outcomes for People with Mental Illnesses under Community Corrections Supervision: A Guide to Research-Informed Policy and Practice. New York, NY: Council of State Governments 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.
Reuland, Melissa, Laura Draper, and Blake Norton. Improving Responses to People with Mental Illnesses: Tailoring Law Enforcement Initiatives to Individual Jurisdictions. New York, NY: Council of State Governments 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.
Schwarzfeld, Matt, Melissa Reuland, and Martha Plotkin. Improving Responses to People with Mental Illnesses: The Essential Elements of a Specialized Law Enforcement-Based Program. New York, NY: Council of State Governments 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.
Thompson, Michael, Fred C. Osher, and Denise Tomasini-Joshi. Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court. New York, NY: Council of State Governments 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.
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.
National Center for State Courts, Mental Health Courts State Links. This online database contains a listing of mental health courts from across the country. Users can look for programs by state.