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.
Co-Occurring Mental Illness and Substance Use Disorders Individuals with both mental illness and substance use disorders (“co-occurring disorders” or “CODs”) are commonly before the courts. Within the broad categories of mental illness and substance use disorders, a COD might involve bipolar disorder and methamphetamine use disorder, posttraumatic stress disorder and opioid use disorder, or any combination of two or more conditions or disorders. Non-psychiatric conditions also co-occur (e.g., heart disease and asthma). Co-occurring conditions complicate clinical treatment and recovery (e.g., by impacting medication management) and also have implications for justice involvement. For example, criminal recidivism and risks to parental rights or housing stability can increase when substance use co-occurs with mental illness.
This Mental Health Facts in Brief reviews the history and issues presented by co-occurring mental illness and substance use disorders and the strategies courts can use to address them.
Task Force Recommendations Implementation - Resources and News
Protecting Vulnerable People in the Judicial System: Judge Leifman Advocates for Change Through JPLI TrainingAlthough he is retiring from the bench this month, Judge Steven Leifman has no plans to slow down his involvement with mental health and the law. As one of the founders of JPLI, he is stepping down as the associate administrative judge of the Miami-Dade County Court Criminal Division this month where he has served for almost 30 years. He will continue to be involved with a new behavioral health center in Miami and work with courts and states to improve their responses to people with mental illnesses. Additionally, he plans to intensify his involvement in training with JPLI to create structural change in how court systems respond to people with behavioral health needs.
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
Interdepartmental Serious Mental Illness Coordinating Committee 2024 Report to Congress The ISMICC is responsible for submitting comprehensive reports to Congress and relevant federal agencies on its activities and accomplishments. These reports, including this 2024 report, provide a summary of research advances in SMI and SED, an evaluation of federal programs related to SMI and SED, and recommendations for the coordination of federal activities related to SMI and SED.
Report: County’s Diversion Programs, Home Monitoring, Court System Grants Save $20 Million+ a Year Lancaster County courts’ diversion programs and home detention in lieu of incarceration save more than $13 million a year, according to figures presented this week by incoming President Judge Leonard Brown III. In many cases, the savings accrue to the county, and thus lower the burden on taxpayers. Some accrue to defendants: For example, mortgage diversion allows mortgage holders to avoid thousands of dollars in foreclosure fees. There are other examples of savings to residents that are not included because they are too difficult to quantify, Brown noted on a one-sheet summary of the savings made available at Tuesday’s meeting.
New NRI State Profiles Report: Behavioral Health Crisis Technology and Outcomes Tracking the impact of a comprehensive crisis system requires states to implement new data and outcome systems to monitor the effectiveness of these services. Twenty-eight states have established data reporting requirements for Crisis Contact Centers to report on their operations and outcomes. This report focuses on what IT systems states are using to track crisis services, the use of data dashboards and visualizations, and outcomes being monitored by states across components of their crisis system.
Scaling Coordinated Specialty Care for First-Episode Psychosis: Insights from a National Impact Model This whitepaper explores the potential societal and economic impact of scaling Coordinated Specialty Care (CSC) for first episode psychosis (FEP). Expanding access to CSC programs for individuals in need could not only improve lives but also generate an economic return. The economic impact of CSC could result in potential cost savings across healthcare, employment, housing, criminal justice, and caregiving. In this paper, readers will find insights from a national model on the economic implications of reaching 90% access and become part of a conversation on what it might take to get there.
National Center on Substance Abuse and Child Welfare (NCSACW): Family Treatment Courts: An Evidence-Based Approach to Family-Centered Care — Webinar Learn more about FTCs and discover how a family-centered approach helps achieve better outcomes. Presenters and panelists explore how FTCs implement a collaborative approach to resolve barriers in service access and engagement. Join this free event to discover the benefits of a family-centered approach and learn how to help families get the services they need.
The CARE of Substance Use and Mental Health Disorders in Primary and Integrated Care Services for Hispanic Communities — Webinar This webinar explores the intersection of mental health, substance use, and integrated healthcare within Hispanic communities. Participants will gain insights into current mental health and substance use trends affecting this population, providing a foundation for understanding their unique needs. The session will define integrated healthcare, highlighting the evidence supporting its implementation and necessity for improved outcomes.
"Standards of Justice" New Episodes: Standards V and VI This special two-episode installment of the Standards of Justice podcast tackles Standards V and VI with Impaired Driving Solutions project director and national expert on substance use and mental health treatment, Julie Seitz, L.A.D.C., L.G.S.W.
2025 Treatment Court Practitioner Training Research confirms that individualized training improves treatment court outcomes. Practitioner training includes opportunities to network with your colleagues, share ideas, ask questions, participate in breakout discussions by court type, and join moderated discussions on burning issues. In 2025, All Rise will offer practitioner training for court coordinators, judges, and defense attorneys. All Rise will apply for CLE/CJE hours for all judicial and defense attorney attendees.
Cannabis and Adolescents: An Overview of the Science and Concerns from Leading Experts Join us for an engaging webinar on January 15, 2025, on the complex relationship between cannabis use and adolescent development with Dr. Mark Gold, M.D., and Dr. Sarah Vinson, M.D. The presentations will explore the effects of cannabis on adolescent brain development, its potential long-term consequences, and emerging trends in use among younger populations.
Pretrial, Prosecution, Defense Counsel, and Courts Mentoring Initiative The purpose of the Pretrial, Prosecution, Defense Counsel, and Courts Mentoring Initiative is to support the adoption and growth of strategies that focus on diverting justice-involved persons with substance use disorders to community-based treatment or connecting these individuals to treatment and support services during the pretrial and court adjudication phases of justice processing. The mentor sites will serve as models for individuals and teams interested in starting a program or for established programs, providing the opportunity to learn from experienced practitioners in a structured way.
Embracing Equity and Cultural Humility to Improve Care for Youth with Trauma Data from the 2019 National Survey of Children’s Health shows 21% of children in the United States have experienced at least one adverse childhood experience (ACE); it has also shown that certain racial and ethnic groups have an increased prevalence of ACEs. For example, 27% of Black children and 23% of Hispanic children have experienced at least one ACE. Additionally, LGBTQ+ and neurodivergent youth are at higher risk of experiencing ACEs. Clinicians and school-based health providers can address ACEs during care by incorporating cultural and racial equity into trauma-informed care, and considering how broader cultural, political and societal factors affect trauma in youth. This resource provides considerations, practical recommendations, case studies and self-care approaches for youth-serving primary care and mental health professionals to ensure providers are well equipped to enhance quality of care, improve patient outcomes and reduce clinician burnout.
Veterans Courts Help 15,000 a Year, Many Still Lack Treatment Veterans treatment courts have helped thousands of former service members get much needed help for addiction and mental health problems rather than being incarcerated. Strict eligibility criteria, difficulty identifying veterans in the justice system, and a limited number of courts combine to turn away many veterans who most need their services, according to veterans’ advocates, reports Law360. Those advocates are trying to change how the courts operate to ensure that no veteran in need falls through the cracks. “This is not radical. This is about giving a veteran who raised their right hand to serve the United States a hand up, not a handout,” said retired U.S. Army Colonel D.J. Reyes, who mentors veteran defendants in Florida. “They made a mistake. Does that mean we just throw them in prison with no rehab or treatment?”
SAMHSA Issue Brief: Co-Occurring Mental Health and Substance Use This Issue Brief offers valuable information to State Mental Health Authorities (SMHA) about co-occurring mental health and substance use disorders (COD). The document highlights the commonality of CODs and negative outcomes in the absence of evidence-based integrated care. It also provides an overview of treatment barriers and potential solutions, and the effectiveness of integrated care.
The Often-Invisible Defendants Who Move Directly to Sentencing After ‘Noncompliance’ in Court Diversion Stitt found that 70% of diversion participants assessed as having the highest need for treatment were removed from the program she followed, compared to 57% of those in the middle tier and only 40% of those assessed as “lowest need.” More than two thirds of Black participants returned, compared with 45% of white participants. Because the highest-diversion track requires a guilty plea prior to program entry, the “noncompliant” defendants receive automatic felony convictions and proceed directly to sentencing. Stitt describes the practical-financial barriers of courts-involved people who are often unemployed or on disability, coupled with lack of trust, trauma, and mental-health struggles that can make treatment through the courts an insurmountable challenge for the most vulnerable defendants who enter the legal system.
The Fentanyl Crisis: How Synthetic Opioids Are Driving Addiction, Overdose, and Deaths Drug overdose, specifically as it pertains to the opioid crisis, has long been one of the leading public health crises facing the United States. Overall drug overdose deaths continue to rise year after and reached a record 108,000 in 2021. From 2019 to 2020, the nation saw a 30 percent increase in overdose fatalities. There was a smaller, but no less alarming, increase of 15 percent from this year to last. While there are many secondary factors that may be leading to this crisis, including but not limited to COVID-related mental health challenges, lack of access to resources and support systems, and persistent problems with black-market prescription medications, the primary driver has, for years now, been synthetic opioids, specifically fentanyl.
CSG Justice Briefing Equity in action; Improving campus safety; Upcoming webinars; and more.
In the News
‘Absolute Scandal’: MD Fails to Promptly Hospitalize Mentally Ill Defendants Maryland has repeatedly failed to quickly transfer mentally ill defendants who need treatment from local jails to state psychiatric hospitals, a violation of state law that has prompted judges across the state to level $1.5 million in fines against the state Health Department over the past year. The judges were acting on a Maryland state law that requires the Health Department to admit detainees to state hospitals within 10 business days of a ruling that they’re too mentally unfit to understand the charges against them. Instead, according to recent state data, people wait in jail an average of two-and-a-half months. Some stays, corrections officials say, exceed six months. “It’s a civil rights violation,” Judge Trunnell said. “We are reliving past times here with mental health.”
Mental Health Advocates Suggest Upgrading State Crisis Response On Monday, the Mental Health Association in New York State (MHANYS) released 10 recommendations to improve New York’s mental health crisis response. They said the state misses too many opportunities to intervene on behalf of people with mental health needs, leading to scapegoating, stigmatizing, and discriminating against them. MHANYS wants better support for those getting out of hospitals, prisons, or jails. To achieve safer “hand-offs,” they proposed monitoring people with mental health or substance use disorders for 30 days after release when they’re at their most vulnerable. Also, expanding mental health courts would offer all New Yorkers alternatives to incarceration, supporting recovery in an effort to limit recidivism. Today, they operate in 40 counties. That’s why MHANYS recommended installing them statewide.
As Community Services Collapse, Experts Say the Mentally Ill Are Being Left Behind Bars “When we talk about mentally ill people languishing in custody, what’s important to keep in view is that you’ve got a delay in getting the evaluation to begin with and then after you get the evaluation and everybody agrees they should go to the state hospital for restoration, you’re looking at maybe a year wait,” Kalispell OPD Manager Nick Aemisegger said. According to Flathead County District Court Judge Amy Eddy, the volume of civil involuntary commitments, which are categorized as people who are suicidal, homicidal or unable to take care of daily activities, has dramatically dropped in recent years. This year, there were only eight involuntary commitments in Flathead County. But while the civil commitments have dropped, the waitlist for criminal commitments continues to rise. The women’s waitlist is even longer because there are only eight beds at Galen, the forensic unit of the state hospital where evaluations are conducted. Women are also typically more complex to treat because they are often victims of pervasive violence. One Flathead County woman has been waiting in jail since August 2023. “The waitlist for the state hospital is a crisis,” Eddy said.
California Fights $130 Million Fine in 30-year Inmate Mental Health Case How long does it take to fix California's prison mental health system? Apparently, almost 30 years and counting. The Ninth Circuit held two hearings Friday in Coleman v. Newsom, a decades-long class action focused on mental health care for California inmates who claim the state isn’t doing enough to address serious mental disorders in the corrections system. In its appeal of two court orders from the Eastern District of California, the state argued the lower court overstepped its authority by levying a $6.7 million fine for every month the state is out of compliance with previous court orders. The bill has topped $130 million.
Recent Homicides Renew Debate Over How to Tackle the Intersection of Crime and Mental Health Law enforcement officials say these unusually violent incidents highlight a long-standing gap between the criminal justice and mental health systems. And they are calling for renewed attention on a concern that has plagued Vermont for many years — whether the mental health system is doing enough to prevent cases like this from happening.
Criminal Justice, Health Officials Use This Exercise to Find Gaps in Milwaukee's Mental Health System Supported by the federal Substance Abuse and Mental Health Services Administration, Sequential Intercept Model mapping is widely used throughout the U.S. to better equip government entities to divert individuals away from the criminal justice system. The model identifies six points where people with severe mental illnesses might come into contact with the criminal justice system and could be provided with resources. They include community-based mental health services, jail, courts and supervision programs like probation and parole. Milwaukee County held two such mappings in 2015 and 2018. Those exercises have led to many positive changes, including increased use of Crisis Assessment Response Teams, where law enforcement officers respond to people in crisis with a trained clinician, according to Milwaukee County Behavioral Health Services administrator Mike Lappen.
Tarrant County Agrees to Fund Jail Diversion Center Through September as Pandemic Funding Dwindles The diversion center is a place where people with mental health issues — suspected of low-level, nonviolent crimes — can get treatment instead of jail time. Most people who go to the center are experiencing homelessness and have been picked up for trespassing. The diversion center opened in response to a mental health crisis in the local jail. Sheriff Bill Waybourn, who’s in charge of the jail, has said two thirds of the population inside has a mental health issue. People in jail who are too mentally ill to participate in their own defense must go through a treatment process called competency restoration, with the goal of stabilizing them enough to understand their charges. Often, competency restoration has to happen in a state psychiatric hospital, but there aren’t enough beds to go around. The waitlist for a bed stretches months or even years, and while people wait, they’re stuck in jail.
Wellbeing
Cultivating Gratitude in the Workplace — Turning Challenges into Triumphs And, as highlighted in our “Turning Challenges Into Triumphs” webinar, practicing gratitude has measurable impacts on mental health, team dynamics and organizational success. Research has shown that consciously practicing gratitude can reduce feelings of stress and anxiety. In fact, studies have found that a single act of thoughtful gratitude produces an immediate 10% increase in happiness and a 35% reduction in depressive symptoms. These effects disappeared within three to six months, which reminds us to practice gratitude over and over.
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