The development of mental health courts

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Question:  Individuals with mental illness comprise what percentage of the criminal justice system?

A) 2%

B) 7%

C) 10%

D) 16%

Answer: D) 16%

Photo of a partial view of the pillars of a court building

Mental health courts

People who have a mental illness are much more likely to have contact with the criminal justice system than those who do not, and sixteen percent of those currently in the criminal justice system have some form of mental illness. Many American court systems have turned to the trend of creating mental health courts to serve individuals with mental health needs in a more holistic way. Although mental health courts are a relatively new development, they are growing in popularity and frequently boast success stories.

So what are mental health courts (MHCs)? They are a specialty court in which a collaborative court system encourages the use of “therapeutic justice,” wherein the root cause of the contact with the criminal justice system is addressed. MHCs are collaborative, rather than the more adversarial nature of traditional courts. Benefits of the MHC system include the emphasis on a harm-reduction model of justice, the defendant being the center of the court process, and the court’s emphasis on holistic healing (Kurth).

Historical context lead to the development of mental health courts. Several developments over the course of the 20th century led to the deterioration of resources for individuals with mental illness, and this in turn led to the trend of these individuals having more interaction with the criminal justice system.

After the inhumane conditions of institutions, including those designed for people with disabilities and mental illness, were exposed in the mid-20th century, there was a public outcry for the closure of such institutions. The deinstitutionalization movement promised more humane community based treatment facilities, but such resources were never actually created, at least in the numbers promised (Macleod-Ball). This meant that a large number of people who had previously been housed in state institutions now had limited options of places to go. As a result, many wound up without resources and homeless, leaving them much more likely to have police contact.

Other historical factors behind the deinstitutionalization movement led to increased connection between criminal justice and mental illness. The first antipsychotic medication, Thorazine, was developed in 1952 (Slate 29). It was marketed as a quick fix for many symptoms that accompany mental illness and as a low-cost alternative treatment for those who had previously been in the care of the state (ibid). Around the same time, the antipsychiatry movement began to grow in popularity, espousing the belief that psychiatric gains were being used to quell political dissent (32).

The combination of poor conditions, antipsychotics, and bad public images all contributed to the deinstitutionalization movement. However, as institutions closed down and disappeared, so did resources for individuals with mental illness. Without adequate health care, state institutions, or enough accessible community-based mental health treatment, many people find that their only way to access mental health services is through the criminal justice system, although the services there are not high quality either (60).

In response to these trends, many cities are introducing mental health courts to their justice systems. The MHC model is based on the drug court model, the first of which was implemented in Dade County, Florida in 1989. The first MHC followed in Broward County, Florida in 1992 (131). In years since, the number of MHCs has grown to be closer to one thousand across the country (ibid). Although not a solution to the unforeseen problems brought on by the deinstitutionalization movement, mental health courts are a step forward in reducing some of the harm experienced by people with mental illness in the criminal justice system.

Works Cited

Kurth, Russell and the Honorable Judge Willie Gregory. “10 Benefits of Mental Health Courts.” WSBA-CLE. 2012.

Macleod-Ball, Michael W. “Human Rights at Home: Mental Illness in U.S. Prisons and Jails.” The American Civil Liberties Union Written Statement for a Joint Hearing Submitted to the U.S. Senate. 2009. Print.

Slate, Risdon and W. Wesley Johnson. The Criminalization of Mental Illness: Crisis and Opportunity for the Justice System. Durham: Carolina Academic Press, 2008. Print.