This post is part of the Mental Health Monday series, in which iustitia examines one aspect of the intersections between mental health and the law. You can find previous posts here.
In federal prisons, 60% of women and 44% of men have at least one mental health problem. The situation is worse in state prisons where 73% of women and 55% of men suffer from mental health related issues. In local jails, the numbers increase to 75% of women and 63% of men. In the United States, prisons and jails often operate as de facto mental health institutions, and people with serious mental illness are far more likely to be incarcerated than receive medical treatment from hospitals.
Public health officials and researchers state that the closure of state psychiatric hospitals in the late 1960s helps to explain this increase. Moreover, privatization of mental health services has contributed to the increase because the proper support from the government is severely lacking. The justice system needs to implement new strategies to handle offenders who have mental health problems, as the current practice of criminalization is not working.
In response, Congress empowered the Bureau of Justice Assistance, in coordination with the Substance Abuse and Mental Health Services Administration (SAMHSA), to establish the Mental Health Courts Program. This program seeks to implement collaborative efforts that bring improvements to the treatment of criminal offenders with mental disabilities or illnesses. Mental health courts, a relatively recent phenomenon, involve a partnership between judges, prosecutors, and defense attorneys to deal with nonviolent offenders who have been diagnosed with a mental illness or co-occurring mental health and substance abuse disorder. The goal of these courts is to provide courts with resources to improve social functioning of clients with disabilities by offering treatment as an alternative to the prison system.
As many are incarcerated because of behavior that resulted from their psychiatric disabilities and are suffering from poor treatment, that may even amount to torture, such as solitary confinement, their mental health illnesses are deeply exacerbated. Questions remain around mental health courts, in particular whether they can fulfill the lofty expectations of their proponents. Will they actually reduce the number of people with mental health problems in the prison system?
On the one hand, mental health courts begin with a treatment option rather than criminal charges. This allows individuals with mental health disabilities and substance abuse problems to obtain help. However, if the individual fails to comply with the treatment program, they face the original sentence as well as further punishment for their failure to complete the program. This could lead to further criminalization of people with disabilities.
In California, the first mental health court was established in 1999. Participation in these courts is voluntary and the courts only accept persons with “demonstrable mental illnesses,” a term that is very difficult to define. Additionally, the crime, or behavior associated with the offense, must be attributed to this mental illness. This creates a situation in which certain individuals who suffer from mental illness, but do not meet this strict definition, may be left out, as the rules are not inclusive.
Mental health courts could provide individuals with a route to obtain help and avoid the prison system. However, these courts need to have the proper checks and balances to ensure fair and responsible treatment of all individuals. Moreover, harsher sentencing consequences should not be a result of unsuccessful completion of treatment programs.
Iustitia Legal Center encourages the use of mental health courts that provide realistic and obtainable treatment goals for offenders with mental health problems as well as more comprehensive participation guidelines and appropriate staffing by independent mental health professionals.
Also posted on Medium here