Implementation of the National Judicial Task Force to Examine State Courts' Response to Mental Illness Report and Recommendations

The Task Force made a number of important findings, with corresponding recommendations, supported by over 100 new resources for courts and our partner stakeholders. Going forward each Behavioral Health Alerts will revisit a Task Force recommendation and accompanying resources.

Finding: On state and local levels, behavioral health and justice system stakeholders and community leaders must come together to examine their systems and community resources to determine the best path forward to provide the best care and responses to individuals with mental illness. Judges are in a unique position to lead this change.

Recommendation: CCJ and COSCA members should utilize the Leading Change Guide for State Court Leaders that outlines the steps that each state court should take, community by community, to develop the systemic changes necessary to improve justice system responses to children, youth, and adults with behavioral health disorders. Also developed was a companion Leading Change Guide for Trial Court Leaders.

Research and Resources

For Decades, Los Angeles Jailed People with Mental Health Needs. Now, It’s Finally Prioritizing Treatment The Los Angeles jail system is the largest mental health institution in the United States, and it’s locking up more people with mental illness than ever before. But this fall, a coalition local organizer, service providers, impacted families, and advocates like Vera secured two major victories that will divert hundreds of people with mental health needs away from Los Angeles County’s inhumane and dangerous Men’s Central Jail (MCJ) and into supportive housing.

Not So Civil Commitment: A Proposal for Statutory Reform Grounded in Procedural Justice Current state laws subject individuals facing commitment to extended periods of confinement with little to no judicial intervention. Indeed, individuals facing commitment may wait weeks or more for a judicial hearing. And when hearings do occur, they start and end in a matter of minutes. Within those few minutes, little advocacy occurs: lawyers are often passive, judges are often impatient, and respondents rarely have the chance to speak. Worse, some states fail to provide hearings at all. In sum, civil commitment occurs in “pitch darkness.”

Research Weekly: 2022 Top 5 List of Severe Mental Illness Research Reflecting on 2022, the Office of Research and Public Affairs has put together our list of the top 5 research articles and reports published this year about severe mental illness. The list includes: Experiences of women with severe mental illness; Psychiatric bed target numbers; 988 and suicide prevention; Serious mental illness and violence; and Serious mental illness policy.

Action Points: Four Steps to Expand Access to Housing for People in the Justice System with Behavioral Health Needs State and local leaders are beginning to understand that providing affordable, permanent housing is fundamental to reducing justice involvement, particularly for people with behavioral health needs. However, affordable housing is scarce nationwide, and people who have been involved in the justice system face a number of barriers to accessing available housing, including stigma and prohibitions based on criminal records. In light of these challenges, this brief presents four steps state leaders should take to increase housing opportunities and improve justice and health outcomes for this population.

Mental Health in America: The Intersection of Mental Health and Justice Personnel from America’s emergency response systems are on the front lines answering calls from individuals experiencing mental health crises. In this episode of “Mental Health in America,” Julie Wertheimer, project director for Pew’s work on mental health and justice partnerships, discusses the current state of these response systems and their impact on our criminal justice system.

When People Face a Mental Health Crisis, What’s the Best Response? Failure to recognize mental illness can take fatal turns. In 2017, 1 in 4 people shot by police suffered from mental distress at the time of their encounter with law enforcement. Similarly, a 2015 study also found that at least 25%—and as many as half—of all fatal shootings by police involved people with untreated severe mental illness. New efforts in Texas diffuse potentially volatile situations and provide care to those in need.

Cleveland Courts’ Revolving Door in One Chart This Marshall Project analysis of 70,000 cases makes a number of findings about those who comprise those cases, including that most of the crimes are linked to untreated drug addiction or mental illness, and that Black people make up less than a third of all people from Cuyahoga County, while about three-quarters of the people who were convicted in Cuyahoga County and are in state prisons are Black.

CSG Justice Briefing Congress approves the Justice and Mental Health Collaboration Reauthorization Act; an Ohio county joins the national Justice Counts initiative; improving supervision and expanding diversion in Kansas through the Justice Reinvestment Initiative; and more.

JPLI Newsletter JPLI Co-Chairs Join National Experts to Examine Mental Health and the Courts, Q&A with three of Idaho’s State Supreme Court Justices; William H. Rehnquist Award names this year’s recipient, and The Judges’ Guide to Mental Health Diversion.

In the News

Community MH Must Include Care for Incarcerated Individuals, Released Prisoners “People in our jails and prisons are part of the community, and if we are going to call ourselves community mental health professionals, we have to understand the trauma and disruption in people’s lives [that come with] being in the criminal justice system.” Stephanie Lemelle, M.D., M.S., director of public psychiatry education at Columbia University and the New York State Psychiatric Institute said mental health professionals have responsibilities for helping individuals in their care avoid criminal justice involvement, advocating for individuals who are in the criminal justice system, and helping those who are re-entering the community from jails and prisons.

Waitlist grows for psychiatric beds at state hospitals in Texas 842 in-patient psychiatric beds at Texas state hospitals are offline, according to data from the Health and Human Services Commission. These are beds that the hospitals are set up to operate, but a continued staffing shortage has left these many of these beds empty for months. The waitlist of people waiting for a bed has grown to over 2,500. Most of these people are waiting for "forensic" beds, where Texans deemed incompetent to stand trial go to receive mental health care and get their competency restored.

Dallas County officials try to ease jail pressure with more mental health funding Elected officials in Dallas County approved spending over $4.3 million on a problem that has plagued its jail: the lack of beds in state mental hospitals for defendants deemed incompetent to stand trial. The money is meant to reserve a modest number of spaces in North Texas behavioral health facilities for people to regain competence and return to the criminal court system. The state of Texas is typically responsible for treating people who are deemed incompetent to stand trial, but there are hundreds of people in the Dallas County Jail awaiting transfer to a state mental hospital. The Dallas Morning News reported over the summer that some people have waited years for competency restoration services, sometimes longer than any potential sentence.

Unlike most jails in Kansas, Douglas County has found a way to lock up fewer mentally ill inmates The number of people booked into the Douglas County jail with serious mental illness dropped from 18% in 2014 to 10% in 2022 — and hit a low of 5.5% in 2018. “The easy answer is that there was this real shift in culture within the criminal justice system through education, through identifying who we are trying to serve,” said Mike Brouwer, who served as Douglas County’s criminal justice coordinator from 2019 to 2021. “That really is what made the difference … and lowered the number.”

Still Dying with Their Rights On, 50 Years Later While it is true that there have historically been abuses of the civil commitment process, particularly in the late 19th and early-to-mid 20th centuries, the current reality is that it is too hard for the severely mentally ill to receive the care they need. State hospital beds have been reduced from over half a million in 1955 to a mere 35,000 presently. In the current non-system of care, homelessness and incarceration function like treatment options.

Mental Health and The Future of Diversity and Inclusion: A Discussion with Generation Z Your future students and employees are telling you exactly what they need from you. They need to be able to be themselves and they need to not have to hide themselves. But so many of our institutions were formed during a very different time and under much more narrow definitions of what success looked like.

HHS Awards More Than $130 Million in 988 Lifeline Grants From the BSCA to Address Nation’s Ongoing Mental Health and Substance Use Crises This month, the U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), will award more than $130 million in 988 Suicide & Crisis Lifeline grants – part of the $800 million provided to SAMHSA under the Bipartisan Safer Communities Act to address the nation’s ongoing mental health and substance use crises.

Congress passes bill to fund police de-escalation training The bill that passed the House will amend a 1968 federal crime law to authorize $70 million in annual grant funding for law enforcement training on alternatives to the use of force that include scenario-based exercises for officers. It will also require the Justice Department to develop a series of curriculum and training topics in partnership with stakeholders like law enforcement and civil liberties groups and mental health professionals.

Illinois Courts Connect Illinois Mental Health Task Force Action Plan to serve as guide for meeting behavioral health needs; and Illinois courts awarded $50,000 State Justice Institute grant for competency to stand trial processes.

Congress Ends Discrimination Against Public Employees’ Mental Health Coverage Prior to the passage of this provision in the year-end omnibus legislation, estimates suggest over one million public workers and their family members were enrolled in 229 plans nationwide that had chosen to "opt-out" of the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). MHPAEA requires insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than illnesses of the body, such as diabetes or cancer.

Manhattan DA unveils intervention plan for mentally ill Manhattan District Attorney Alvin Bragg seeks to break the cycle of severely mentally ill New Yorkers entering and leaving the criminal justice system without the treatment they need. “These individuals need help. As do our neighborhoods and our small businesses,” he said Wednesday, announcing a $9 million initiative independent of court-mandated services. The funding would be used to help people directly in neighborhoods as well as at their criminal court arraignments.

How the mentally disabled can languish in CA jails For almost nine years, Lorenzo Mays disappeared inside Sacramento County jail, charged with a murder he insists he didn’t commit. During that time, Mays was never brought to trial. He wasn’t allowed to leave. Instead, he remained in a kind of legal limbo, with most of his years spent in solitary confinement. The reason? Judges and psychologists determined that his cognitive issues and mental illness meant he couldn’t understand court proceedings well enough to be considered competent to stand trial. But they didn’t know what else to do with him.

Travis County Judge will prioritize Mental Health Diversion Facility in 2023 Judge Brown says the biggest problem facing Travis County as we turn the calendar and start the new year is the fact that not only is the jail population continuing to surge, but also that the percentage of people in jail with unmet mental health needs has more than doubled since pre-COVID. “It was 21% by our measure and now it’s 45%.  And I think we’re seeing the repercussions of that everywhere.” Travis County is looking to build a Mental Health Diversion Center and Judge Brown and other county leaders are traveling the country for ideas. Judge Brown tells us he’s particularly interested in the models being used in Nashville, TN and Miami, FL.

Wellbeing

Judicial work and traumatic stress: Vilification, threats, and secondary trauma on the bench This article reports the results of a survey of judicial officers’ exposure to potentially traumatic stressors in a single state in Australia. The survey focused on the prevalence and impact of three kinds of traumatic stress: threats to the person, vicarious trauma, and vilification. It sought to measure prevalence and to identify how different events in the workplace impacted psychological wellbeing and traumatic stress. The results indicated that 61% of respondents had experienced threats of violence to themselves or someone close to them. Three quarters (75.1%) of respondents reported being exposed to events associated with vicarious trauma, and 61 (29.7%) reported symptoms consistent with trauma-related effects. Just over half (52.7%) reported instances of harsh public criticism amounting to vilification.

Losing Our [Best] Minds:  Addressing the Attrition Crisis of Women Lawyers in a Post-Pandemic World In 2021, a new study was published that shed light on the disturbing trend of women leaving the legal profession at alarming rates. Aptly titled, “Stress, drink, leave: An examination of gender-specific risk factors for mental health problems and attrition among licensed lawyers,” this study of 2,863 employed California and D.C. lawyers found “the prevalence and severity of depression, anxiety, stress, and risky/hazardous drinking were significantly higher among women lawyers.” Alarmingly, researchers found that 24.2% of women were considering leaving the legal profession due to mental health problems, burnout, or stress, compared to only 17.4% of men surveyed.