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 resources for courts and our partner stakeholders. Each Behavioral Health Alerts revisits an original Task Force resource or a new resource that supports a Task Force recommendation.
Behavioral Health Data Elements Guide for the State Courts Data are a critical tool in the state courts’ fight to address behavioral health needs in the legal system. At the level of individual cases, high-quality data are crucial for ensuring people’s cases move through the system as efficiently and justly as possible and that their behavioral health needs are being fully addressed. At the system level, data can also be used to support evidence-based decision-making in a variety of ways.
First, courts can use data to describe the state of court programs and outcomes and the experiences of people with behavioral health needs as they move through the system. Second, courts can use data to establish baselines in performance and monitor for changes over time. Third, courts can use data to examine the effectiveness of new policies or programs. This guide provides a framework for data collection and data analysis by state courts looking to better meet the needs of court users who are living with behavioral health conditions.
Task Force Recommendations Implementation - Resources and News
New Dates Set for Decriminalizing Mental Illness: The Miami Model These two-day workshops in Miami provide an opportunity to hear directly from Judge Steve Leifman and his colleagues about Miami’s innovations in crisis response, diversion, civil off-ramps, competence to stand trial alternatives, and the effective use of peers. Attendees also visit the new model wraparound services facility the Miami Center for Mental Health and Recovery. Most importantly, attendees learn how to engage in meaningful system change and leave with a plan to implement new strategies in their jurisdictions. The new dates: February 6-7 and May 8-9. Contact Rick Schwermer to hold a spot for you or your team at rschwermer@ncsc.org.
Research and Resources
Study Identifies 59 Recommendations for Mental Health Care for Justice-Involved Populations The study identified 59 essential practices that counties can use to improve mental health outcomes for justice-involved populations. These practices include 27 general mental health approaches (such as jail diversion programs and permanent supportive housing) and 32 diagnosis-specific interventions (including medication and psychotherapy for common conditions). Key practices recommended by the study include supportive housing and Medicaid reactivation in local jails. mental health treatment diversion, problem-solving courts, crisis intervention teams, education on mental illness for families and caregivers, standardized mental health screenings, and counseling for physical pain. The results also revealed that these recommended practices are inconsistently available, estimating that each practice was accessible to justice-involved individuals in only 22-43% of U.S. counties.
Just Released: Journal for Advancing Justice Vol. V, “Sustaining Long-Term Recovery as Part of Justice Reform” Our understanding of recovery, particularly from substance use and mental health disorders, is continuously evolving as research offers new insights into the risks and protective factors that impact the recovery process. This volume of the Journal for Advancing Justice presents articles that add to the knowledge base on how a collaborative relationship among justice, treatment, and social service professionals can help justice-involved individuals sustain their recovery. As we continue to seek improvement and innovation in the justice system and to help individuals impacted by substance use and mental health disorders, these articles demonstrate that we must provide a safe environment for people to heal, promote empowerment through education, and identify the inherent strengths of all the people we serve.
Breaking the Cycle: Effectively Addressing Homelessness and Safety This paper responds to municipalities’ concerns about the increase in visible homelessness and its perceived impact on community safety. The overlap between the criminal justice system and homelessness is well-documented, but debates on how to best address these issues remain divisive. Many stakeholders entrenched in their viewpoints, often overlooking the complexity of homelessness and the need for a multifaceted approach. Arrest and jail should always be a last resort for addressing homelessness, as criminalizing survival behaviors only perpetuates the cycle of homelessness and incarceration. This approach is costly, can be harmful, and fails to address the underlying causes of homelessness. To break this cycle, it is crucial to find better solutions, some of which we explore in this piece.
CMS Announces Funding to Improve the Continuity of Care for Justice-Involved Individuals This funding opportunity represents a critical resource for counties, enhancing healthcare access for individuals re-entering the community after incarceration. By streamlining Medicaid and CHIP enrollment, counties can reduce gaps in care especially for those with mental health or substance use issues. This will lower emergency room visits and reduce recidivism, easing the strain on county services. Additionally, the funding will help automate processes, reducing administrative burdens for county health departments and jails.
A Statutory Proposal for the Expedited Development of Iowa’s Treatment Courts Iowa’s treatment court system has developed through the grassroots efforts of individual judges and their teams utilizing federal grant money. However, the state has failed to provide adequate funding to allow treatment courts to evolve and come into compliance with evidence-based best practice standards. This Note argues that Iowa must adopt treatment court legislation that encourages the proliferation of treatment courts, creates a judicial branch committee to ensure that treatment courts are compliant with best practice standards, and funds treatment courts directly through the Judicial Branch, rather than through each district’s department of corrections.
Accommodating Incompetency in Immigration Court In criminal law, an individual must be deemed competent to stand trial, yet our immigration courts routinely order the deportation of incompetent noncitizens. A removal proceeding against a noncitizen—where an outcome of deportation often risks life-threatening harm—continues apace even if the noncitizen has been deemed incompetent by the immigration judge. By unifying a small but rich body of literature from immigration, disability, and criminal competency scholarship and cases, this Article closes a gap in understanding how the machinations of the immigration legal system result in the removal of noncitizens whose disabilities render them incompetent.
National Council for Mental Wellbeing Youth Hub The Youth Hub features an extensive collection of national resources supporting youth mental health and wellbeing developed in collaboration between the National Council for Mental Wellbeing and multidisciplinary stakeholders including the American Academy of Pediatrics (AAP). The Hub is organized by audience, and has a page devoted to information and tools for youth-serving providers and trusted adults.
Creating Community-Based, Trauma-Informed Behavioral Health Services for Underserved Populations As we recognize Native American Heritage Month, Homelessness Awareness Month, and Veterans Day, it is essential to acknowledge the significant impact that trauma can have on individuals and communities. Many people, especially populations disproportionately affected by trauma—such as Native Americans, individuals experiencing homelessness, and military veterans—face unique behavioral health challenges that require targeted, culturally competent, and trauma-informed approaches. The Evidence Based Practices Resource Center (EBPRC) plays an integral role in promoting behavioral health awareness, trauma-informed behavioral health services, access to prevention and treatment services, and equity through high-quality, evidence-based resources and support for all individuals. This Newsletter focuses on building community-based, trauma-informed systems to address the impact of trauma and promote healing and resilience in communities across the nation.
Texas Criminal Procedure and the Offender with Mental Illness: An Analysis and Guide This book is not intended to be a primer on mental health treatment issues concerning defendants with serious mental illness. Instead, the primary purpose of the book is to set forth and analyze the relevant criminal procedure statutes that apply to persons with mental illness who get caught up in the criminal justice system. It is hoped that the analysis set forth in the chapters regarding the relevant Texas statutes will prove beneficial to judges, prosecutors, defense attorneys, law enforcement officials, parole and probation officers, persons with mental illness, family members, and all others interested in criminal justice issues involving persons with mental illness.
Improving Behavioral Health Care for Older Adults in the Criminal Justice System In response to an aging population that is quickly expanding within the criminal justice system, tailored care strategies that address both the physical and behavioral health complexities of older adults are needed. This webinar will explore the current need for improved behavioral health strategies for aging adults and critical partnerships between correctional facilities and state- or community-based agencies. Emerging best practices for addressing the behavioral health needs of aging populations in the criminal justice system will also be presented, building on SAMHSA GAINS Center’s 2024 presentation "Responding to a Growing Demographic: Supporting Older Adult Populations within the Criminal Justice System."
NAMI Virtual Town Hall: Pathways to Healing: Insights from a Cop, a Client and a Counselor Substance use and mental health conditions are a major challenge at the intersection of public health and criminal justice. The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that 44% of people in jail and 37% of people in prison have a mental illness, while 63% in jail and 58% in prisons report having substance use disorders. The treatment court model consists of many opportunities to improve outcomes for people who come into contact with the criminal justice system. It incorporates tools and skills along the continuum of the Sequential Intercept Model and harm reduction that can help connect people to care and reduce risk of re-incarceration. During this webinar, participants will hear from the perspective of a police officer, a person in recovery and a psychiatrist to improve how we address the underlying public health concerns and causes of crime, reduce offending and re-arrests, and strengthen communities.
Identifying and Addressing Behavioral Health Needs in Encampments - Webinar Recording People experiencing homelessness experience higher rates of behavioral health conditions, and many symptoms can be caused or exacerbated by their living situations. As communities across the country change how they respond to and interact with encampments, outreach workers, community health workers, and peers continue to be essential team members who foster relationships and trust with encampment residents. These front-line professionals are often first to notice the onset or changes in behavioral health symptoms and serve as trusted individuals who can help support a person across a spectrum of behavioral health needs. This webinar discussed core principles and engagement techniques for providers to serve as a bridge to care for mental health, substance use, and medical needs.
CSG Justice Briefing Expanding reentry housing; Inside the CSG Justice Center; Reducing the prison population in Iowa; and more.
In the News
DEA and HHS Extend Telemedicine Flexibilities Through 2025 The Drug Enforcement Administration (DEA) in concert with the Department of Health and Human Services (HHS) issued a third extension of telemedicine flexibilities for the prescribing of controlled medications, through December 31, 2025. In 2023, in response to a set of proposed telemedicine rules, DEA received more than 38,000 comments and held two days of public listening sessions. In light of that feedback and discussion and to give DEA time to consider a new path forward for telemedicine, DEA and HHS extended current telemedicine flexibilities through the end of 2024.
California Falling Short of Enrollment Goal as Mental Health Courts Roll Out California’s new initiative to compel treatment for some of the state’s most severely mentally ill residents — many of whom are living on the streets — is falling short of its initial objectives. But with the program expanding from 11 counties to all 58 on Dec. 1, state officials are projecting confidence that they can reach their goal to help 2,000 adults by the end of the year. In the first nine months of CARE Court, 557 petitions were filed by first responders, families, or local health officials, all of whom can now request help for individuals who are ill. As of the end of June, 100 people had been placed in court-approved treatment plans, according to the latest data available.
Maine Settles with U.S. DOJ over Children’s Behavioral Health Services Concerns As part of the agreement, the state will invest $260 million to increase the availability of community-based behavioral health services for children while allowing families to make informed choices about accessing services outside of their homes. It also includes commitments to provide timely assessments, reduce wait lists, and lessen the need for short-term stays in hospitals and other institutional settings. The Maine Department of Health and Human Services is also making improvements such as spending $15.4 million annually to expand accessibility of the Maine Crisis Line as well as the Mobile Crisis and the Cumberland County Crisis Receiving Center. This includes doubling the staff at the Maine Crisis Line.
Oregon Group Wants to Make It Easier to Commit Those in Mental Health Crisis A bill that the group is helping to author would change current law in several ways. One is allowing a judge to consider a person’s past suicide attempts and potential to harm themselves or others within 30 days, rather than immediately, when assessing that person’s risk. Another is clarifying the definition of danger to self. Chris Bouneff, executive director of Oregon NAMI, said the state’s existing criteria are so narrow that they exclude people who are vulnerable to self-harm or are unable to care for themselves.
U.S. District Judge Says Oregon State Hospital Must Remedy Violation of a Court Order U.S. District Judge Adrienne Nelson wants the Oregon State Hospital, in violation of a court order to admit jailed criminal defendants for mental health treatment within seven days, to remedy the situation in less than two months. At a court hearing on Monday, Nelson heard that the hospital had pushed the wait period to an average of 26 days. Oregon State Hospital lawyer Carla Scott could not give Judge Nelson a timeline of when the psychiatric hospital would be able to meet the court order, adding that there were no projections of when compliance could be met. The judge dismissed the explanation, saying ‘…this has been going on for years…something needs to happen…like less than 60 days.’ Scott said the Oregon Health Authority will ask for $55 million for improvements to the mental health system at the next session of the Legislature. She said the proposal appears to have the support of Governor Tina Kotek.
TTUHSC Working to Provide Mental Health Services to Lubbock Criminal Justice System The program will allow students who graduated from their psychiatry residency to specialize in providing mental health services to those in the criminal justice system. The program, part of the Texas Tech Health Sciences Center, trains newly-graduated psychiatrists to address these problems in hopes of promoting rehabilitation rather than punishment. “They can participate with mental health courts, be a subject-matter expert, participate on the treatment team,” Nancy Trevino, Ph.D., director of the Texas Tech mental health initiative said, “but then also if someone is needing that competency restoration, the forensic fellow can help participate in that service line during their training.”
Should Judges Keep the Mentally Ill Out of Rikers? Not My Problem, One Says An attempt to keep a schizophrenic man out of Rikers Island — where deplorable conditions for the mentally ill have been well documented — ran into a brick wall recently when a Manhattan Criminal Court judge said: “I don’t pick the jails that people go to when crimes are committed.” Public defender Casey Anis was able to get Judge Goldsmith’s ruling setting bail overturned by going to another judge in a higher court to keep his client in the mental health diversion program, but the encounter raises the question of what responsibility judges have in assessing the conditions defendants will face when they are locking people up. Stan German, executive director of the defender group suggested there is a disconnect between the message from the state’s chief judge Rowan Wilson, who has advocated for more use of so-called “diversion” courts, and day-to-day decisions made in court.
Local Organization Gets Nearly $1.5M to Expand Mobile Court Services The organization’s mobile court launched in October 2023 to offer people a different option from the brick-and-mortar office at the One Texas Center. Operations Manager Robert Kingham said they help populations experiencing homelessness, substance abuse problems, or mental health issues. He added that coming into an unfamiliar building with security may discourage people from seeking help. Instead, the organization takes its services on the road, where staff physically meet clients who may have had run-ins with the law where they are. $500,000 of the money would go toward training case managers on how to check online court cases and deepen partnerships with mental health organizations over the next three years. Another $900,000 will expand the mobile court services and strengthen connecting people to substance use services over the next four years.
Comments or feedback about Behavioral Health Alerts?
Related news or resources from your state or jurisdiction?
Please contact Rick Schwermer.
