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.
Statewide Behavioral Health Leadership Positions Are Recommended Chief Justices and State Court Administrators require behavioral health personnel in the Administrative Office to provide the necessary leadership to examine and improve state courts’ response to mental illness. State court leaders have taken several approaches and this Court Leadership Brief describes how states have increased their capacity to lead change in this important area.
Task Force Recommendations Implementation - Resources and News
Pennsylvania Courts Hold First Statewide Behavioral Health Summit More than 500 judges, industry leaders and stakeholders gathered this week for the first annual Pennsylvania Courts statewide summit focused on improving court responses to behavioral health challenges within the judicial system. “Communities across the country continue to fight a battle against what is sometimes a silent and invisible opponent – the mental and behavioral health crisis,” Justice Dougherty said. “Over the course of the last decade, courts have seen the behavioral health crisis grow in severity, frequency, and intensity; and the Pennsylvania judicial system is not immune. Hosted in partnership with the Pennsylvania Commission on Crime and Delinquency (PCCD) and spearheaded by Pennsylvania Supreme Court Justice Kevin Dougherty, the summit gives county treatment teams, judges, government partners, and advocates the opportunity to collaborate while creating a roadmap to address the worsening national behavioral health crisis which impacts all aspects of the judiciary.
Research and Resources
Cultivating Healing and Health in the Judiciary While attention to judicial health and wellbeing is of urgent importance, the onus remains largely on judges to heal themselves. Judges are variously encouraged to develop an individual gratitude practice, meditate, seek peer support, exercise, have better sleep habits, and do more “self-care.” These are all valuable tools for managing stress and improving health, and yet the prevailing emphasis on personal responsibility fails to honor judges’ already-depleted emotional resources or their diverse values and priorities. This five-part virtual series recognizes this impossible context and the unique vulnerabilities that many judges carry, however privately. Premised on a model of mutual accompaniment, it honors judges’ wounds and weariness not as a liability but as a shared reference point from which to come together as judges, to learn, and to heal.
Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness Findings from the implementation evaluation identified many sources of heterogeneity in and across AOT programs, resulting from differing statutory characteristics and site-level determinations. Overall, the outcome evaluation showed significant improvements across a range of client outcomes, including appointment and medication adherence, symptomology, perceived mental health, life satisfaction, and therapeutic alliance during AOT and following the order. AOT clients also demonstrate reductions in violent behaviors, suicidal thinking, arrests, drug use, homelessness, the number of inpatient hospitalizations, and days in the hospital. While judicial status hearings are not required to achieve positive client outcomes, our findings suggest this may be an effective practice at sites with the ability to coordinate and fund the additional judicial contacts during the order.
Changing the Route: Seeking Compassionate Alternatives to Police Transport in Involuntary Civil Commitment IVC is a civil legal process that determines whether a person meets the legal criteria to be involuntarily ordered to an inpatient psychiatric treatment, or a supervised outpatient treatment, program. Often, law enforcement is called upon to transport the patient throughout this process. Not only does law enforcement involvement blur the lines between treatment and criminalization of mental illness, people with serious mental illness are also overrepresented in law enforcement use-of-force encounters and law enforcement-related injuries. This brief examines statutory requirements for law enforcement custody and transportation under IVC, when alternative transport is permitted, and opportunities to reduce the role of law enforcement in involuntary commitment when possible.
New SAMHSA Guidance Advances Recovery SAMHSA released six documents to advance recovery across the nation. These resources offer support across the four major dimensions of recovery: health, home, purpose, and community. The guidance focuses on funding recovery support services through the Substance Use Prevention, Treatment, and Recovery Services (SUPTRS Block Grant); the role of diversity, equity, inclusion, accessibility; the expansion of peer support specialists; and the impact of physical activity in recovery.
SAMHSA’s Center for Financing Reform & Innovation (CFRI) Releases Information on New Projects Underway Learn about SAMHSA’s Center for Financing Reform & Innovation (CFRI) new projects underway, which cover financing mechanisms of behavioral health care that help identify opportunities, innovations, and challenges to service delivery and access. These products aim to provide guidance on the most effective and efficient use of resources in the prevention/promotion, early intervention, treatment, and recovery support needs of the American public. Through CFRI, SAMHSA is publishing new reports, one-pagers, journal articles, and hosting webinars on a variety of topics providing information and analysis of various topics to address changes in organization and the financing of behavioral health services.
4 Strategies to Increase Access to Behavioral Health Care Persistent challenges prevent people from accessing behavioral health care in the United States today, despite an overwhelming need for these services. But significant opportunities for improvement exist through the expansion of evidence-based practices, according to The Brookings Institution. With support from The Pew Charitable Trusts, researchers interviewed behavioral health practitioners, experts, and stakeholders and conducted environmental scans of existing literature to identify these evidence-based practices and how they’re being used.
Judges and Psychiatrists Leadership Initiative Newsletter CSG Justice Center Expert Hallie Fader-Towe Weighs in on Mental Health Courts; DOJ/HHS Guidance on Emergency Response to People with Disabilities; Update on Recent JPLI Trainings; and more.
Homeless and Housing Resource Center Newsletter Understanding and Supporting Residents with Serious Mental Illness; Identifying and Addressing Behavioral Health Needs in Encampments, and more.
OJJDP Announces Upcoming Webinars and Events Snapchat for Law Enforcement and Prosecutors; Rural Youth and Adverse Childhood Experiences (ACEs); and Sustained Recovery: Don’t Make Aftercare an Afterthought.
Standards of Justice PodcastDefining the right population. Former New Hampshire Superior Court Chief Justice Tina Nadeau walks through the key takeaways from Standard I: Target Population and addresses some of the common barriers treatment courts face during its implementation. The conversation touches on determining who is high-risk/high-need, managing proximal and distal goals, understanding motivation for change, and building resource capacity to ensure that these individuals’ needs are met.
NASMHPD Update This newsletter of the National Association of State Mental Health Program Directors links to dozens of relevant resources and news.
Reaching Rural: Advancing Collaborative Solutions The one-year planning initiative is designed for rural justice and public safety practitioners; public health and behavioral health practitioners; city, county, and tribal leaders; and community groups. The planning initiative empowers rural practitioners to build deeper networks, particularly across sectors; adopt bold solutions to the persistent challenge of substance use and misuse in rural communities; and reimagine how diverse systems with different missions can engage with one another to more effectively serve justice-involved adults with substance use or co-occurring disorders.
CSG Justice Briefing Supporting crisis response; Expanding health care access; Strengthening reentry; and more.
Substance Use Monthly A National Council for Mental Wellbeing newsletter linking to resources, news, tools, and research.
National Council for Mental Wellbeing - Upcoming Webinars Screening, Brief Intervention and Referral to Treatment (SBIRT) Overview Training – Recognizing and managing substance use is often a missing link in the integration of mental health, substance use and primary care. SBIRT fills that gap by helping you identify, reduce and prevent risky or unhealthy alcohol and drug use among patients.
In the News
NYC Defendants Found Unfit for Trial Wait 60% Longer for psych beds, Meaning Extra Month on Rikers Island The lag means city defendants stay 35 days longer on average on Rikers Island, usually in special mental health units. An analysis based on 7,795 cases between October 2022 and October 2024 by New York County Defender Services indicates the courts may indeed be a key piece of the system that has contributed to the backlog. Of that amount, 15%, or 1,169 of the defendants, were flagged at arraignment as having an obvious mental health issue. Judges were more likely to send people with mental illness to Rikers to await trial in jail than those who did not have prior mental health issues. “Some of this is happening because information is not trickling down to the judges that are making the decisions of whether to send our clients to Rikers or not,” said Lupe Todd-Medina, a spokeswoman for the New York City Department of Correction.
New Report: Indiana Courts Face Mental Health Crisis Loretta Rush, Chief Justice of the Indiana Supreme Court, has released the 2023-24 annual report for the state's courts. The report shows Indiana's judicial system is taking big steps to tackle the mental health crisis. The Supreme Court recently launched the Office of Behavioral Health and hired Brittany Kelly as its behavioral health specialist, making Indiana the tenth state in the country to embed a mental health professional within its judiciary. Rush highlighted the strain on local courts, noting about 70% of people in jail have behavioral health issues. “How do we make sure we have diversion programs in place? How do we make sure that the services we’re ordering for people to do are the right services?” Rush asked. “We’ve done a lot at the national level with regard to substance abuse and mental health, realizing programs that are working.”
Oklahoma Lawmakers Want to Address Inmate Mental Health Cole Allen, policy fellow for the Oklahoma Policy Institute, said statute requires immediate treatment only for people who are determined by law enforcement to be an immediate threat to themselves or others. He said this leaves a gap for people who have serious mental health needs but might not be immediately threatening. “I think by expanding our diversion options before jail even becomes a choice, I think that is a big way to prevent that; and ensuring that once individuals get to jail, that we expand diversion services in our urban and especially our rural areas to ensure that those wait times are not as long,” Allen said, suggesting that funding from State Question 781, which is currently at $12.5 million, could be used by counties to invest in prevention and diversion services.
Scores Turn to New Court to Help San Diegans Struggling With Severe Mental Health Issues San Diego County received 209 CARE Court petitions in its first year of operation with 71 people choosing to meet with a judge and create collaborative agreements that delineate the treatments and other resources needed to address their severe mental illness. Launched on Oct. 2, 2023, CARE Court allows a wide range of individuals, from family members to first responders, to file petitions on behalf of adults diagnosed with schizophrenia spectrum or other psychotic disorders. Only those not currently enrolled in ongoing voluntary treatment qualify for the process, and the court must also find that they are “unlikely to survive safely in the community” or that they are “in need of services and supports in order to prevent a relapse or deterioration that would be likely to result in grave disability or serious harm,” in order to proceed.
Mississippi Mental Health Patients Have Been Jailed Without Being Charged, New State Law Aims to Change That The process that sends these patients to jail is completely legal. It’s called civil commitment. A court orders someone into mental health treatment, but when there’s no room for them at a health facility, Mississippi’s alternative was jail. “We never really intended for people to be in jail,” State Representative Sam Creekmore (R-Union County) said. “And, that’s been going on for a while.” Creekmore, who sponsored a bill that became law and aims to address the issue, said that Mississippi hasn’t been properly utilizing its mental health resources. The new law requires a mental evaluation from a health provider before the civil commitment process starts. If a judge deems it necessary, the patient can only be jailed if they are “actively violent.” And, jail is only an option for a maximum of 24 hours.
Wyoming Lawmakers Move Forward With Mental Health Reforms Wyoming lawmakers are advancing a bill with mental health reforms that would change how the state treats those considered to be a threat to themselves or others. The Wyoming Tribune Eagle reports that a legislative subcommittee voted on Monday to recommend a bill that would give courts the ability to order outpatient mental-health or substance-abuse care instead of only using involuntary hospitalization. Supporters of the changes say it should reduce state-funded health care costs while diverting less severe cases to community-based treatment centers.
Judicial Branch Expands Mental Health Courts System The judicial branch of the island government announced on Thursday the expansion of the Specialized Mental Health Courts to the judicial regions of Arecibo, Bayamón and Caguas, Puerto Rico Supreme Court Chief Justice Maite Oronoz Rodríguez stressed that the expansion will benefit residents of 26 municipalities, promoting the recovery and rehabilitation of people with mental health disorders through a therapeutic justice approach. “Cases under the Mental Health Act require a different approach, where treatment and rehabilitation are the central axis, because it is not about punishment, but rather about providing support, care and healing,” Oronoz Rodríguez said in a written statement.
National Organization Honors Wayne County Judge for Addressing Mental Health in Justice System Burton, who is the second Michigan recipient of the Treat Award since its inception in 1979, is being celebrated for his successful efforts in addressing mental illness in the criminal justice system, particularly for creating the WCPC Behavioral Health Unit, or BHU, which uses assisted outpatient treatment to reduce jail overcrowding and dramatically improve the treatment of individuals with significant mental illness.
Wellbeing
Chief’s Column: New Program Helps Judges Deal With Secondary/Vicarious Trauma Vicarious trauma is the emotional residue of exposure to traumatic stories and experiences of others through work; witnessing fear, pain, and terror that others have experienced (American Counseling Association, 2016). Vicarious trauma can hit any judge, anywhere, at any time and our vulnerability to it comes as a natural extension of our work in the judiciary itself. It is my plan to provide judicial training on secondary trauma in Cook County to all of our divisions and districts (about 400 judges) and I expect eventually to expand the training to judicial staff members as well. I believe that all judges, everywhere, will benefit from becoming aware of the danger of secondary trauma and to seek help from professionals and from each other when the need arises. We need to stay strong for ourselves, for our families, and for the people who come before us. In this way, we can protect ourselves and effectively deliver justice for those facing primary trauma in their own lives.
Mental Well-Being in the Workplace More than 80% of U.S. workers experience at least one symptom of a mental health challenge, and about two thirds say their mental health interferes with their ability to work. But workers aren’t getting the help they need. Less than half of adults with a mental illness receive care, and 8 in 10 workers say that shame and stigma prevent them from seeking treatment. Employers have a critical opportunity to take action. Over 9 in 10 workers expect their employer to help manage mental health challenges. Love, Your Mind – a campaign created by Huntsman Mental Health Institute and the Ad Council – aims to reduce stigma, break down cultural barriers, and inspire people to make taking care of their mental health a priority. Through simple messaging and easy-to-use tools, the campaign helps people recognize their emotions and understand how to care for themselves.
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