IV. Courts and the Mentally Ill
After initial contact with law enforcement, mentally ill offenders who are arrested are booked into jail and receive an initial hearing in a court, where they often lack the proper resources, both mental and financial, to ensure proper outcomes. A 2002 study conducted by the Council of State and Local Governments: Criminal Justice/Mental Health Consensus Project determined that “People with mental illness are falling through the cracks of this country’s social safety net and are landing in the criminal justice system at an alarming rate” (p. 2). The report also focused on the fact that many individuals with mental illness are turned away or intimidated by the mental health system; thus, “Officials in the criminal justice system have encountered people with mental illness with increasing frequency” (p. 3).
Part of the reason why mentally ill individuals are falling through the cracks is funding. Mental health agencies are mandated to provide care to persons designated as mentally ill by state governments. These agencies are given funding to supplement the expense of treatment and care for those individuals, often referred to as clients. A gap in the funding system exists when the client enters the criminal justice system. The funding stream for a client who enters the criminal justice system changes from the mental health agency to the criminal justice agency. This change often interrupts the continuity of care for the client and results in a reevaluation of the client’s needs by criminal justice agency personnel without the benefit of medical and mental health records from the mental health agency. To combat this recurring issue, mental health courts were created. A report by the Council of State Governments (2008) provided the following definition of mental health courts:
A mental health court is a specialized court docket for certain defendants with mental illnesses that substitutes a problem-solving model for traditional criminal court processing. Participants are identified through mental health screening and assessments and voluntarily participate in a judicially supervised treatment plan developed jointly by a team of court staff and mental health professionals. Incentives reward adherence to the treatment plan or other court conditions, non-adherence may be sanctioned, and success or graduation is defined according to predetermined criteria. (p. 30)
Only a handful of mental health courts were implemented in the late 1990s, but today more than 175 are now functioning nationwide. It is interesting to note that mental health courts are not cookie-cutter projects; they vary in size, scope, programs, and partnerships, making them unique to the communities and populations they serve. The framework and utility of the mental health courts provide offenders with an opportunity to participate in court-supervised treatment. This treatment involves a team composed of a judge, court personnel, and treatment and community providers, all of whom define the terms of participation. Throughout the case, continuous assessments are provided to the treatment team, along with individualized sanctions and incentives for the offender. The final key element is the resolution of the case upon successful completion of the mandated treatment plan (Council of State Governments, 2008).
Among other goals, such as increased public safety, mental health courts seek to provide improved quality of life for participants by ensuring that program participants are connected to needed community-based treatments, housing, and other services that encourage recovery. On a broader scale, they seek to find a more effective use of resources for sponsoring jurisdictions by reducing repeated contacts between mentally ill people and the criminal justice system and by providing, when appropriate, treatment in the community, where it is more effective and less costly than in correctional institutions (Council of State Governments, 2008).
Several studies have evaluated the effectiveness of mental health courts. Moore and Hiday (2006) found that participants were significantly less likely to incur new charges than a comparison group of offenders with mental illness who did not utilize the mental health court. In addition to fewer new charges, participants in the Broward County Mental Health Court spent less time in jail than offenders going through traditional criminal court (Boothroyd, Poythress, McGaha, & Petrila, 2003). This is significant, because mentally ill inmates are typically incarcerated for up to three times longer than typical inmates. By minimizing mentally ill inmates’ jail time, the criminal justice system may experience significant cost savings in the long term. The cost of implementing a mental health court is not a significant burden for government. This was verified in a case study completed by the RAND Corporation in 2007 that assessed the Allegheny County Mental Health Court in Pennsylvania (Ridgely et al., 2007). The study found that the program did not result in substantial added costs, at least in the short term, over traditional court processing for individuals with serious mental illnesses. In addition, it suggested that the mental health court may result in a net savings for government over the long term because of decreased recidivism and use of the criminal justice system’s resources.