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.
Reentry Practices People who are leaving incarceration face a significantly higher risk of relapse, overdose, or exacerbation of their mental health condition. Effective reentry practices are critical to provide rapid access to pre- and post-release treatment and to ensure that those who provide supervision are trained and informed in evidenced-based practices. The challenges for individuals with behavioral health needs who are reentering the community can often have dangerous and life altering consequences. In addition to health and personal safety risks, there can also be public safety concerns as individuals without appropriate services are more likely to relapse and engage in criminal activity than those without behavior health challenges. Collaboration between the court and community partners is essential.
Task Force Recommendations Implementation - Resources and News
Courts NAVIGATING the Behavioral Health Continuum Court Navigator Programs are gaining popularity in jurisdictions across the country. These programs guide people through the legal process and play a crucial role in establishing connections to a variety of community-based behavioral health, social, and human services. Please join us on October 24th at 12:00 ET for this NCSC webinar where we will learn more about three jurisdictions using court navigators to assist court users with their court experience. You will also gain insights into the role that Behavioral Health Administrators within the Administrative Office of the Courts play in coordinating and supporting Court Navigator Programs.
Leading Change: Improving Illinois Courts’ Response to Mental Illness and Co-Occurring Substance Use Disorders One year ago in October 2023, pursuant to direction from the Illinois Supreme Court, the Special Supreme Court Advisory Committee for Justice and Mental Health Planning (JMHP) announced its role as steward of the Illinois Courts’ Leading Change: Improving Illinois Courts’ Response to Mental Illness and Co-Occurring Substance Use Disorders initiative. To meet this directive, JMHP reorganized to prioritize Mental Health Action Plan recommendations within the scope of its subcommittees. This reorganization allowed the JMHP, made up of 29 judges, to work with key Administrative Office of Illinois Courts staff members to lead efforts in effectuating the Action Plan. As a result, notable progress was made to further several strategic initiatives including Courts as Conveners and Leaders, expanding training, technical assistance, and awareness activities, and obtaining external funding support to lead change.
State Courts’ Responsibility to Convene, Collaborate, and Identify Individuals Across Systems Acknowledging the Illinois CST/CR system has room for improvement, with support from the Illinois Supreme Court, the Special Advisory Committee for Justice and Mental Health Planning’s (JMHP) Competency and Education Subcommittees planned and hosted “Rethinking the Intersection of Competency to Stand Trial, Competency Restoration, and Mental Health Systems.” This convening of approximately 85 multi-disciplinary and inter-governmental leaders was held on September 26, 2024, and brought to life the Mental Health Action Plan’s strategy to assemble stakeholders to identify and implement effective responses to issues causing negative impacts on the courts. The primary goal of the convening was to explore shared policy and practice commitments to improve mental health, financial, and justice outcomes across the Competency to Stand Trial and Competency Restoration process. Attendees included judges, attorneys, sheriffs, mental health providers, policy makers, and advocates.
Research and Resources
Implementing the Medicaid Reentry Waiver in California In January 2023, California became the first state in the nation to receive approval from the federal Centers for Medicare and Medicaid Services (CMS) for a Medicaid Section 1115 demonstration request to amend Medicaid’s inmate exclusion. People detained in jails and prisons have high rates of chronic and acute health needs, including physical, mental health, and substance disorders and reentry is a high-risk time. A key to addressing these reentry risks is addressing people’s health needs while they are incarcerated and building continuity of care from jail to community when they are released.
Medicaid and Corrections Resources Recent Medicaid guidance and legislative developments offer new opportunities for correctional leaders to leverage Medicaid to enhance outcomes for people who are incarcerated. With the passage of the SUPPORT Act, the Consolidated Appropriations Acts of 2023 and 2024, and new guidance around the Medicaid Section 1115 Reentry Demonstration Opportunity, prisons and jails have more opportunities to work with their state Medicaid agencies to support individuals not only during incarceration but also during the critical transition from incarceration to the community. This webpage provides a curated list of resources to support correctional leaders in taking full advantage of these new opportunities.
Mapping Medicaid Reentry Medicaid reentry refers to the concept of using federal Medicaid funds to pay for transitional health care services as people return home from prison and jail. Currently, federal law prohibits federal Medicaid dollars from being used to fund health care for people who are incarcerated. But in April 2023, the federal Centers for Medicare and Medicaid Services (CMS) released a State Medicaid Director letter outlining the opportunity for states to develop Section 1115 demonstration projects to strengthen care transitions for people preparing to leave incarceration, and for the first time allows for federal Medicaid dollars to finance care provided to people who are preparing to return home from jails, prisons, and juvenile carceral settings. Health and justice stakeholders nationwide can refer to this living resource to stay up-to-date on Medicaid reentry work underway in each state, including plans for implementation and opportunities for public engagement.
A Decade of CCBHCs Enhances Access to Mental Health Care Across the U.S.
A decade after the establishment of the certified community behavioral health clinic (CCBHC) model, more than 60 percent of the US population has access to such facilities and the mental health and substance use disorder treatment services they provide, according to a new study led by researchers at the NYU School of Global Public Health. Moreover, these clinics are expanding the availability of crisis mental health services, including mobile crisis response teams and stabilization.
Map of State SMI Resources Treatment Advocacy Center reviews and analyzes each state’s laws on emergency evaluation and involuntary treatment (inpatient and outpatient) to identify statutory barriers that can block access to timely and effective treatment for people with serious mental illness (SMI).
The Role of Certified Community Behavioral Health Clinics in Crisis Services and Systems This white paper informs CCBHCs, crisis providers, local systems, state authorities and funders about how to maximize CCBHCs’ effectiveness in crisis services, with specific sections addressing the unique interests of each group. It focuses on how CCBHCs can meet the Substance Abuse and Mental Health Services Administration (SAMHSA)’s certification requirements for crisis services and how they can provide maximum value to state and local systems responding to the growing demand for comprehensive behavioral health crisis response.
Dementia and Competency to Stand Trial in the United States: A Case Law Review Dementia is increasingly prevalent in the United States, and older adults are becoming involved with the U.S. criminal legal system at unprecedented rates, which carries significant implications for legal professionals and clinicians involved in CST cases. Unfortunately, CST research to date has largely excluded considerations of dementia and aging. The present study addressed this gap by reviewing U.S. case law related to dementia and CST.
Mental Health Courts in an Era of Criminal Justice Reform This brief assesses mental health courts’ future in an era of criminal justice reform. It considers how sentencing, bail, and discovery reforms threaten the structure of mental health courts. It also evaluates attempts to “co-opt” the model, through New York’s “Treatment Not Jail Act.” Overall, the brief argues that mental health courts will retain their relevance for the foreseeable future, owing mainly to their small scale. Mental health courts serve only a small fraction of the universe of mentally ill offenders. They will therefore never contribute significantly to mass decarceration, the goal of progressive reformers. But that also means that they are likely to retain their relevance, even if the use of criminal sanctions declines, as long as the population of mentally ill offenders remains substantial. This brief will conclude with suggestions on how to sustain mental health courts in the future.
Outpatient Civil Commitment: A Look at Maryland’s New Legislation Maryland is one of only three states that had not had civil outpatient commitment, also called assisted outpatient treatment (AOT). Legislation has been repeatedly proposed over the last 23 years and defeated. This year was different. The bill requires that all 23 counties in Maryland have outpatient commitment, and if a county does not implement it, the Maryland Department of Health is required to do so. The bill had bipartisan sponsorship and the strong support of Maryland Gov. Wes Moore. Maryland may be the first state to require a statewide rollout with the specific requirement for a care coordination team—specified as a psychiatrist, a case manager, and a certified peer specialist—and a $3 million fiscal note. The Maryland Association of County Health Officers has estimated that each county will spend from $250,000 to up to $5 million annually on associated costs. The hope is this will be a mechanism for offering services more than forcing care and that the state will bear the burden if the counties cannot.
HOMELESSNESS PREVENTION SERIES: Spotlight on the Jail-to-Homelessness Pipeline It is a vicious cycle: People who have been incarcerated are up to 13 times more likely to experience homelessness, and people without a home are more likely to be jailed simply for existing, especially in places that criminalize homelessness. Despite these facts, the Supreme Court issued a June 2024 ruling that may only worsen the revolving door between homelessness and incarceration. USICH promotes alternatives to criminalization and encourages communities to use USICH’s 19 encampment strategies to invest in evidence-based solutions, including housing and services, that help people avoid and overcome homelessness.
Creating a People-First Court Data Framework Most court data are maintained—and most empirical court research is conducted—from the institutional vantage point of the courts. Using the case as the common unit of measurement, data-driven court research typically focuses on metrics such as the size of court dockets, the speed of case processing, judicial decision-making within cases, and the frequency of case events occurring within or resulting from the court system. This Article sets forth a methodological framework for reconceptualizing and restructuring court data as “people-first”—centered not on the perspective of courts as institutions but on the people who interact with the court system.
Join BJA and the other Byrne SCIP TTA Providers to Get Your Questions Answered The Bureau of Justice Assistance (BJA) will host open Office Hours in the Fall of 2024 to provide support, training and technical assistance (TTA) to grantees through the Byrne State Crisis Intervention Program (Byrne SCIP). During these office hours, attendees can bring questions or concerns related to the administration of the Byrne SCIP grant and have them answered by either BJA staff or the Byrne SCIP training and technical assistance providers. The first session is October 17th.
Identifying and Addressing Behavioral Health Needs in Encampments 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 SAMHSA webinar will discuss core principles and engagement techniques for providers to serve as a bridge to care for mental health, substance use, and medical needs.
Meeting Crisis with Care: Transforming Mental Health and Justice In this PEW episode, "Meeting Crisis With Care: Transforming Mental Health and Justice," we ride alongside an interdisciplinary response team in Abilene, Texas, to learn how they're helping residents in need, keeping people out of jail, and strengthening access to care.
Centering the Voices of People with Lived Criminal Legal Experience in JCOIN Research Please join us for the webinar Centering the Voices of People with Lived Criminal Legal Experience in JCOIN Research on November 1, 2024 at 2pm ET. The live webinar will focus on how the JCOIN Clinical Research Centers (Research Hubs) empower people with lived experience (PWLE) and the critical role of including their voices in research. Speakers will discuss the importance of integrating firsthand perspectives to enhance the relevance, equity, and impact of research design and outcomes.
October Web Chat: AOT Judges This month’s specialized web chat is scheduled for Thursday, October 24 at 3 p.m. ET and is specifically for judges, magistrates, hearing officers, and other judicial leaders. We kindly request that those not in this group refrain from registering, but we assure you that the recording will be made available to everyone.
October Webinar: AOT in NYC Join us Thursday, October 17 at 3 p.m. ET for AOT in NYC, presented by William Fisher, M.D. The webinar will focus on how AOT is implemented in New York City and review findings from recent outcomes data collection. This presentation will highlight a program that does not rely on an active judge since AOT programs in New York — mandated under state law — do not typically include regular court check-ins. Rather, the success of AOT in New York City is the result of effective treatment team engagement and diligent monitoring in the community.
NRI State of Mind Newsletter SMHA support for Mobile Crisis Teams; 988 successes; upcoming webinars, and more.
CSG Justice Briefing New reentry resources; Expanding Medicaid to improve reentry transitions; Shaping crisis response; and more.
In the News
In Oklahoma, People in Need and First Responders Get iPads for Rapid Face-to-Face Mental Health Response Grand Mental Health has distributed more than 11,000 mental health iPads in north central and northeast Oklahoma, reducing inpatient hospitalization by over 90 percent — 9,000 of the iPads are in clients’ hands and first responders have 1,600. Cantwell and his team have also distributed 500 to community locations such as schools, libraries and museums. They’ve also recently placed iPads in sober-living houses, homeless shelters and community centers. The iPad interface system is HIPAA compliant and allows patients and first responders to communicate face-to-face with a mental health professional. “We can immediately do assessments on the iPads,” says Cantwell, “making it easy for a first responder who comes across a person experiencing a mental health situation—they just press a button and get a secure and direct connection to us.”
Mental Health Competency Settlement Rejected, Attorney General Fired as Counsel A board chaired by Gov. Kevin Stitt rejected a landmark mental health settlement, pushing back against the opinions of the Oklahoma Attorney General’s Office and a federal judge. The settlement was unveiled in June and given preliminary approval by a federal judge in September. It’s intended to settle a lawsuit alleging that the mental health department is failing to provide timely court-ordered competency restoration treatment and violating the rights of defendants, who are mostly indigent, declared incompetent to stand trial, and being held in county jails. AG Drummond said that 244 people continue to “languish in jails” waiting for necessary mental health services. He said 35 have waited more than a year, while seven have been waiting for over two years. Drummond said Tuesday that his client is “the state of Oklahoma, not the government agency that put us in this indefensible position.” He said the commissioner “did not hire” him, and therefore could not fire him. During Tuesday’s meeting, Governor Friesen repeatedly said the consent decree, as written, would prevent the Mental Health Department from providing competency restoration treatments in jails. But nothing in the decree prevents jail-based competency restoration, in fact three provisions legally require competency restoration services and allows them to be provided in jail.
Washington Counties Drop Mental Health Lawsuit Against State The counties sued the state last August in Pierce County Superior Court, concerned about psychiatric patients being sent back to their communities because there wasn’t room at Western State Hospital and other state facilities. The counties also said they were not properly informed that patients would be returning. Bound by a federal court settlement, the state was prioritizing placements for patients facing criminal charges, who needed mental health evaluations and treatment before their cases could move forward. But the counties said that left no room for another group of patients — “civil conversion” patients who were found mentally unable to stand trial and then moved to a separate system. The state hospitals began discharging some of these patients, and while the state said it would try to find them appropriate placements and care, the counties feared that releasing these patients could affect public safety in their communities. Just over a year later, the counties agreed to drop the lawsuit after the state agreed to once again begin working with all civil conversion patients and to give counties adequate notice before sending those patients back to their communities.
Bridging Justice and Mental Health: Considerations for a Journey in Forensic Programming Working in the clinical field for more than 15 years, I often see how mental health intersects with the legal system in ways that demand not just compassion, but also specialized expertise. At critical legal junctures, obtaining a forensic evaluation can be the difference between undesirable outcomes and justice. Forensic clinicians transform the justice system’s understanding of mental health, addiction and trauma. By combining forensic expertise with a holistic, trauma-informed approach, you can create a pathway to justice that sees the whole person.
Opinion: Why New York Must Embrace the Treatment Not Jail Act I lead the CASES Nathaniel Assertive Community Treatment (NACT) Team, the nation’s first alternative-to-incarceration program for people with felony charges related to serious mental illness (SMI). For over two decades, we have proven that successful recovery and reintegration are highly likely when people receive appropriate, evidence-based community support – in fact, 100 percent of our clients, many of whom are court mandated through the Brooklyn and Manhattan Mental Health Courts, have no new violent felony convictions in the two years after program completion.
Wellbeing
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.
Comments or feedback about Behavioral Health Alerts?
Related news or resources from your state or jurisdiction?
Please contact Rick Schwermer.
