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.
Prevalence of Serious Mental Illness and Substance Use Disorders Adults with any mental illness are classified as having serious mental illness (SMI) if they have a mental, behavioral, or emotional disorder that substantially interferes with or limits one or more major life activities. SMI includes disorders such as bipolar disorder, major depressive disorder, schizophrenia, and schizoaffective disorder. In 2020, the percentage of adults in the U.S. with SMI grew to 5.6%, or 14.2 million people (up from 3.7%, or 8.3 million people, in 2008). Substance use disorders (SUDs) are characterized by impairment caused by the recurrent use of alcohol, other drugs, or both and include health problems, disability, and failure to meet major responsibilities at work, school, or home. In 2020, 40.3 million people aged 12 or older (14.5% of this population) had an SUD in the past year.
Task Force Recommendations Implementation - Resources and News
Mindful Judging: Strategies for Wellness Mental Health Awareness Month in May served as a reminder to prioritize self-care. The challenges judges face, such as high caseloads, emotional intensity, stress, and the weight of decision-making, can have significant impacts on their mental health and overall wellbeing. Investing in the physical wellbeing of judges and court staff is an investment in the strength and longevity of the justice system.
Pennsylvania Courts Announce Behavioral Health Office In an effort to fulfill the Supreme Court’s long-standing commitment to making justice accessible for all Pennsylvanians, an office has been created to focus on behavioral health. The Administrative Office of Pennsylvania Courts created the office as a way to improve court responses to behavioral health challenges within the judicial system. The office will work to identify gaps in the system, address key issues including access to services and support as well as pinpoint intersections between at-risk populations and the courts in a wide range of matters. “Pennsylvanians with mental illness need access to early intervention, crisis stabilization, behavioral health treatments, and other supports to reach fair and appropriate outcomes,” said Chief Justice of Pennsylvania Debra Todd. “It is often said that instituting lasting change takes a village, and this effort is no different. We look forward to developing shared goals with our government partners and expanding solutions in the courts to better respond to court users with behavioral health needs.”
Research and Resources
Vicarious Trauma in the Judicial Workplace: State Liability for Judicial Psychiatric Injury in Australia There is developing, yet strong, evidence that judicial officers are seriously affected by exposure to traumatic material. The risk and prevalence of psychiatric injury to judges is now increasingly recognized. In light of growing recognition by the High Court of Australia of the likelihood of psychiatric harm arising in people whose work exposes them to traumatic material in Kozarov v Victoria (‘Kozarov’), the possibility that judicial officers may be entitled to compensation for such harm is being investigated through legal analysis.
States Should Make Data on Opioid Use Disorder Treatment Easy to Access Most states collect and report at least one core opioid use disorder (OUD) treatment measure that can be used to improve state treatment systems and save lives. It is crucial that states publicly report such health data—doing so has been linked to improved clinical outcomes. However, finding and interacting with data on OUD treatment measures can be challenging, because very few states share data in a format that is easily accessible such as via interactive dashboards.
Centering Lived Expertise: How to Meaningfully Elevate the Voices of People Directly Impacted by the Criminal Justice and Behavioral Health Systems The behavioral health field has long understood the impact and importance of engaging people with lived experience to support treatment and recovery and improve access to services. Despite increased involvement and hiring of people with lived experience by criminal justice and behavioral health organizations, especially as peers and peer specialists, the full potential and impact of elevating the voices of lived experience in the criminal justice has not been realized. This Stepping Up brief summarizes guidance developed by a panel of people with direct experience in both the criminal justice and behavioral health systems about how to meaningfully engage and partner with people with lived experience to advance policies and practices at this intersection.
First Responder Deflection Mentoring Initiative Now Accepting Applications for Mentor Sites The First Responder Deflection Mentoring Initiative is looking to add new mentors to the program. This program is focused on first-responder or community responder-led deflection and pre-arrest diversion initiatives that serve individuals with opioid, stimulant, and other substance use disorders, mental health disorders, and co-occurring disorders. The program also provides peer-to-peer hybrid learning for deflection and pre-arrest diversion initiatives, including funding for in-person site visits for up to three members of a mentee team.
FY24 Smart Reentry: Housing Demonstration Program With this solicitation, the Bureau of Justice Assistance (BJA) seeks to fund state, local, and tribal governments to enhance or implement evidence-based activities or services to improve reentry and reduce recidivism by expanding and/or increasing access to housing for people who are currently or formerly involved in the criminal justice system. Prior to the release from incarceration, individuals will be screened, assessed, and identified for program participation. The program will help jurisdictions assess their reentry systems, identify strengths and gaps, and then build capacity for improved housing options for adults released from prison or jail.
FY24 Comprehensive Opioid, Stimulant, and Substance Use Site-Based Program With this solicitation, the Bureau of Justice Assistance (BJA) seeks to develop, implement, or expand comprehensive programs in response to the overdose crisis and the impacts of illicit opioids, stimulants, or other substances. The program provides resources to support state, local, tribal, and territorial efforts to respond to illicit substance use and misuse, reduce overdose deaths, promote public safety, and support access to prevention, harm reduction, treatment, and recovery services in the community and justice system.
Advancing Crisis Communications: Highlighting Models of 911/988 Collaboration Counties are leading the development, modernization, and infrastructure of local crisis response systems as communities’ mental and behavioral health needs continue to grow. One critical strategy is implementing the 988 National Suicide Prevention Lifeline in coordination with existing 911 emergency response systems. This April 11th webinar video highlights models of 988/911 collaboration, including recommendations for planning and implementation. Panelists discussed progress, challenges, and lessons learned from advancing their communities’ crisis response systems.
How Can States Better Serve Dually Eligible Populations? Better serving people who are dually eligible for both Medicare and Medicaid is complex but a key priority for many Medicaid agencies. This episode of the Medicaid Leadership Exchange podcast explores the importance of integrating benefits for this population to create more person-centered care and services for members. It also highlights the power of designing integrated programs in partnership with members and their caregivers. The conversation features perspectives from Medicaid directors in New Jersey and Texas.
Olmstead Decision & Importance of Behavioral Health Workforce Innovation The Substance Abuse and Mental Health Services Administration (SAMHSA) is holding a webinar focusing on how states can help people with mental illness live successfully in the community through behavioral health workforce initiatives. This webinar is part of a series of activities honoring the 25th Anniversary of the historic Olmstead v. L.C. decision in which the U.S. Supreme Court affirmed that the Americans with Disabilities Act ensures the right to receive services in the most integrated setting appropriate to a person’s needs.
Lessons Learned: Harm Reduction-Public Safety Partnerships In 2023, the National Council for Mental Wellbeing, with support from the Centers for Disease Control and Prevention (CDC), awarded funding to eight grantees across the country to implement harm reduction-public safety collaborations aimed at reducing the risk of overdose and other drug-related harms for people who use drugs and people with substance use disorders who are, or may become, justice-involved. The power of these collaborations and lessons learned from the partnerships have the potential to change the way communities view and address substance use nationally. This brief offers a quick summary of the historical tensions between harm reduction and public safety, lessons learned from real-world pilots with case studies, and further resources to learn more about harm reduction and public safety partnerships.
CSG Justice Briefing Elevating the voices of those with lived experience inside the justice system; Health care after incarceration; Justice Counts public feedback; and more.
Mental Wellbeing Weekly Recommendations for a sustainable workforce, the proposed Ensuring Excellence in Mental Health Act, upcoming webinars, other resources, and more.
In the News
Medicaid Enrollment Soars in North Carolina After Expansion We're nearing the six-month mark since North Carolina opened up enrollment to its expanded Medicaid program. Since December, 448,242 North Carolinians have been added to the rolls for full coverage, the state Department of Health and Human Services tells Axios. The expansion meant that another 600,000 residents — nearly 6% of the state's population — became eligible for coverage they previously might not have been able to afford, from maternity care to prescription drugs.
Wait Times Decrease for WA Mental Health Patients, but Gains Are ‘Fragile’ Nearly a year after Washington was fined $100 million for failing to quickly evaluate and treat certain mental health patients at its state psychiatric hospitals, the state is nearing compliance with the federal lawsuit that prompted the censure. Average wait times to get into Western State Hospital have decreased and are now hovering near the time limits mandated by a 2014 court order known as the “Trueblood” settlement, which aims to prevent people from languishing in jail without mental health treatment. Kim Mosolf, the class counsel for Trueblood patients, said the decrease in wait times could be attributed to the state’s management of civil conversion patients — patients who were charged with crimes but are found unable to aid in their own defense and are transferred to the state’s civil system. The state has also increased its investment in diversion services, Mosolf said, attempting to prevent patients from re-entering the criminal justice system. The fines the state had to pay have gone toward various programs for patients, including permanent supportive housing.
Courts, Community Leading Efforts to Address Public Health, Safety Commonly cited research estimates 70% of individuals involved in the criminal justice system have a mental health disorder, with 17% of adults (31% women, 15% men) living with a serious mental illness (SMI). Furthermore, 72% of incarcerated adults with SMI also have a co-occurring substance use disorder. This unfortunate reality requires courts to serve as a significant referral source to community mental health treatment systems and often places jails in a tenuous position as de facto mental health institutions. The Illinois Supreme Court’s Mental Health Action Plan is built on the premise that no one agency or institution can address the overrepresentation of justice-involved individuals with mental health needs, so all must work together.
Ohio's Jails Have Long Been De Facto Mental Health Hospitals. Now They Look Like Them Franklin County Sheriff Dallas Baldwin strolls through the wide, brightly lit hallways of the new $350 million jail and opens the door to a medical wing that looks strikingly like an urgent care clinic. Corrections staff across Ohio and the nation are struggling to handle complex medical conditions, addictions, and serious mental illnesses. Between 2020 and 2023 in Ohio, at least 220 people died while in jail custody. About one third of the deaths were drug related and another 29% were suicides. Baldwin and Geoff Stobart, his chief deputy, said the county designed and built the new jail with these challenges in mind.
Pew - Mental Health Awareness Month This week, we're looking beyond the numbers, sharing stories from people who are affected by mental health issues. You'll also meet some of the experts and advocates who are working to make a difference for those affected.
Law Aims to Prevent Mental Health Patients From Sitting in a Jail Cell While Awaiting Treatment To curb instances of being held in jail when no crime was committed, the new law mandates that prescreening takes place before the affidavit is filed. Mississippi Department of Mental Health Executive Director Wendy Bailey told Magnolia Tribune this will enhance the diversion process. “It connects the person and/or family to the Community Mental Health Center for a pre-affidavit screening in order to enhance the diversion process and allow for other options for treatment such as a crisis stabilization unit or follow-up appointment or medication adjustment,” Bailey explained, adding, “before the courts and law enforcement become involved.” The bill also mandates the creation of a daily updated bed registry to assist with finding available out-of-county services. “The state now has 196 Crisis Stabilization Beds throughout the state. Many times, if a bed is not available in one region, there is a vacant bed in another region,” Bailey noted.
Wellbeing
Vicarious Trauma in the Judicial Workplace: State Liability for Judicial Psychiatric Injury in Australia There is developing, yet strong, evidence that judicial officers are seriously affected by exposure to traumatic material. The risk and prevalence of psychiatric injury to judges is now increasingly recognized. In light of growing recognition by the High Court of Australia of the likelihood of psychiatric harm arising in people whose work exposes them to traumatic material in Kozarov v Victoria (‘Kozarov’), the possibility that judicial officers may be entitled to compensation for such harm is being investigated through legal analysis.
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