Civil Liberties and the Mentally Ill: The New Concept of ‘Mental Health Courts’
Oct 16th, 2007 | 9 responses
There’s a timeless American Rorschach, a set of ideas meant to have symmetry. They’re called Civil Liberties: originally meaning that we be subject only to laws established for the good of the community… and… and that our individual rights be protected by law from unjust government. Too often an balancing act made to go awry in our times, for certain.
But there is a group of people who surely deserve to be protected from unjust standards in weighing their alleged crimes and sentencings: The mentally unstable, the severely addicted, and those defendants who have ‘retardation.’
Often, the best way to keep justice just is to just question justice:
1. Should defendants suffering from mental illness be treated the same as any other mentally competent defendant in court? Or should there be a special court for defendants suffering from mental disorders that appear to possibly have driven them to their offenses?
2. Is it legal lunacy or legal sanity to arraign and try, via usual court procedures, any individual on, say, misdemeanor charges, when he or she also displays significant signs of inordinate obsession, or compulsion, disorganized thoughts, inability to suppress aggressive impulses, inability to comprehend or follow procedures, delirium tremens, etc., because she or he is, severely mentally unable?
3. Should defendants professionally evaluated as suffering from a significant mental disorder be released on bond and be expected to not re-offend…?
4. …and to also show up for their trial date? Should such defendants be punished by the same standards as those who willfully re-offend and willfully commit another actionable offenses by not showing up for trial?
5. Is it reasoned to release an adjudicated mentally ill defendant on bond and without mental health intervention, and thereby potentially put others and the defendant themselves at risk for more mayhem or injury?
6. Is it legal logic or legal illogic to release a mentally disordered defendant convicted of a crime back out onto the streets after jail or on probation, yet with no intervention or help for their afflictions and addictions which cause continued mind disorganization and disintegration?
The answers more and more jurisdictions are coming to are causing them to create ‘mental health court’ for defendants who suffer from untreated medical and mental disorders.
This unusual step creates ‘a special court aside from usual court’ wherein a defendant’s case is heard… but also the stricken person is given medical and psychological diagnoses, treatments, medicine, education and job assistance…with the idea that this decreases re-offending by giving/ offering some intervention in disabling disorders, increases public safety, and is far more efficient with municipal resources.
The outcome thus far appears to have measurably unburdened municipal courts from long backlogs occurring from large amounts of time needed to process cases of defendants who are mentally unstable. There also appears to be a notable decrease in the number of re-offenses among the formerly mentally unstable.
From the Bureau of Justice Assistance, which has given grants to over 130 municipalities to create Mental Health Courts:
The coordinated delivery of services…includes:
Continuing judicial supervision—including periodic review—over preliminarily qualified offenders with mental illness, mental retardation, or co-occurring mental illness and substance abuse disorders who are charged with misdemeanors and/or nonviolent offenses.
Specialized training of criminal justice personnel to identify and address the unique needs of offenders who are mentally ill or mentally retarded.
Voluntary outpatient or inpatient mental health treatment, in the least restrictive manner appropriate as determined by the court, that carries with it the possibility of dismissal of charges or reduced sentencing on successful completion of treatment.
Centralized case management involving the consolidation of cases that involve mentally ill or mentally disabled defendants (including probation violations) and the coordination of all mental health treatment plans and social services, including life skills training, placement, health care, and relapse prevention for each participant who requires such services.
Continuing supervision of treatment plan compliance for a term not to exceed the maximum allowable sentence or probation for the charged or relevant offense and, to the extent practicable, continuity of psychiatric care at the end of the supervised period.
The idea of some kind of set aside, be that ‘mental health court’ or other effective way to process and assist the ill, is long overdue. It is painful to watch a defendant with the DT-s try to represent themselves, or a defendant with full-blown and unmedicated bi-polar mania, attempting to make a circular argument about “How I did what I didn’t do,” as one truly pitiful, shaking, and confused defendant put it in his less than able defense.
I have questions about ‘who decides’ who is ill or suffers from dementia or ‘retardation,’ and how the scenario might be manipulated by perfectly sane people who are criminals… like the Mafia king feigning mental illness and wandering about New York for years in his bathrobe while blathering…
or manipulation of the system by family members– or enemies — with an agenda for adjudicating as ill someone perfectly compos mentis, or by courts or law enforcement via personal grudges. There would need to be clear constraints and unrelenting oversight to prevent abuse and misuse.
Yet, it seems to make little sense to know that many defendants so badly in need of psychological and medical mental help and not able to defend themselves well, and by letter of law are given harsher sentences often, only to — un-medicated, undiagnosed — come out and re-offend almost immediately… And again. And again.
It may be as important to look at ‘mental health court’ as an act of mercy, the same kind of mercy we’d give if we discovered someone bleeding … Before we did anything else, we’d first tend to and bind up the wound.
But also, mental health court seems equally merciful to the innocent public, the ones most likely to be harmed when an ill person or a person with not full mental capacity suddenly takes a right angle turn from the broad consensual reality in a way that endangers or harms.
You can read more about The Mental Health Court Program, here at the Bureau of Justice Assistance Site, including an updated list of municipalities they’ve given grants to for the development of ‘mental health court.’ Also, press on “about BJA.”
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9 Responses to “Civil Liberties and the Mentally Ill: The New Concept of ‘Mental Health Courts’”
Unfortunately, those who suffer from serious mental illness are caught up in a perennial ongoing debate here in the United States over what should be voluntary and what mandatory. For the last nearly 40 years the pendulum has swung over to the “everything is voluntary” side, abetted by a coalition of civil rights activists (left and right) and people who just don’t want to pay for other people’s mental health care.
The underlying rationale is actually fairly convincing: if you’re responsible enough to be on your own, you’re responsible enough to take the consequences for transgressions. The problems you quite correctly point to appear when we extend the notion of “responsible enough to be on your own” too far.
thanks Dave: For families who have ‘wandering loved ones’ on the streets, in California for instance, many are beside themselves that they cannot get their ill family member the help they need… the state has many firewalls preventing family members from seeking adequate help for their loved one, either humanely or legally. You summed up the the controversy well. Common sense would be a powerful additive to the idea of “responsible enough to be on your own.”
Yet, when I was present in one of the Western state’s legislature’s debates back in the 1980s about this very matter, I saw that many who are ‘making the laws’ with regard to mental health, have never been on the streets, not even as ‘a tourist’ …the lawmakers have no idea what consequence they wroth. Again, it would have helped so much to have had law wrought by people of insight into this issue, and common sense… not just lobbyist hearsay/ lures.
And you’re right about some not wanting to foot the bill for mental health care; but all taxpayers wind up paying the enormous bill for insurance claims re damages and physical harms, hospital ERs, incarcerations, judges, court staff and police cover; these installations to deal with the issues cost huge dollar amounts.
I’m thinking this morning too of the poor radio commentator who was assaulted badly in Manhattan yesterday, and wondering if that’s another case of assault by an ill person on a mental tear who just lashed out without reason. In that case this morning, there is much speculation, and we’re still watching the newswires for more facts. It may or may not be a case in point. Regardless, that public situation bears watching, I think… even though there are many other assaults in the big apple in the last day that will not reach the level of ‘news’ this one has.
dr.e
Re Randi Rhodes’ case, see UPDATE at the top of
TMV this hour: “Randi Rhodes: Media Mixmaster Ignites.
What actually occurred and how Miss Rhodes became injured
remains unsettled. There’s much speculation about actual causes. We’ll wait and see further.
dr.e
Dr. E:
I wholeheartedly agree with your conclusion that the implementation of mental health courts can provide a merciful result for both the defendant, and the public, at the same time. Court systems which operate in substantially the same way in which they operated 50 years ago – and surely this is the case in countless jurisdictions – quite likely fail to make meaningful use of the vast array of diagnostic and treatment opportunities which may have been unheard of when the laws those courts are upholding, and the procedures being to uphold the laws, were authored. As such, court personnel have to think, and act, outside of the box in order for certain cases to receive the appropriate care, and style, of attention.
While I thoroughly agree with you regarding the formation of such courts, I also advocate a median position which would still represent a meaningful step forward in the march to mental health courts. And that would be to insure greater training of the judiciary, and court personnel, including lawyers, on mental health issues.
Judges who have never been trained on issues relating to mental health, other than to perhaps ask a few questions of an allegedly unfit defendant who stands before the court unable to prove even that they are alert and oriented, do a disservice to their judicial colleagues, and to society as a whole, by not recognizing the mentally ill defendant, and making that recognition part of their decision making process when it comes to questions of bail, scheduling, and the resolution of cases.
So were I to have a say in this matter, I’d say YES, mental health courts would be a true benefit to the entirety of society.. But absent that giant step (keeping in mind the typical resistance to change which can be seen in countless governmental bureaucracies) , the smaller step of training, and creating greater awareness of mental health issues in the entirety of the criminal justice system, is an idea for which the time has come.
Regards,
Stolios
This might be only peripherally related but Larisa Arap was on CSPAN this weekend, speaking about punitive psychiatry & her experiences. There is a video of it online at CSPAN but you need real player (free) to view.
She begins at about 1 hour 5 minutes into the video. CSPAN expires their videos – so it might go away.
stolios, from your lips to God’s ears: “training, and creating greater awareness of mental health issues in the entirety of the criminal justice system, is an idea for which the time has come.” I aslo appreciate your p oint of view about how the courts in terms of process and procedure are living anachronistically. (You spell it, I cant, but you know what I mean; it’s 1957 in a lot of courtrooms today. But, how, how how? That’s the question I have for how to gain access to future lawyers, future judges, future court staff to ‘train’ them.
Jilly D: I’ll go look. Thank you.
The misery and heartbreak of having a mentally ill adult child is compounded when the only essential response in the community is to incarcerate them. My son wandered the streets – delusional – but lived with me for a few years during that time. I don’t remember how long this time was (I’ve tried to forget it), but he suffered a psychotic break when we were alone on Christmas eve one year.
As a therapist I knew what I was witnessing, and I was totally alone in dealing with it. Eventually when his illness began to be inflicted on me and I questioned that I could continue on with my own life I had to kick him out of the house. Then he broke windows to come back inside. I called for help, and instead of being hospitalized he was arrested. He spent months in jail, frankly psychotic, without medication. His father, who worked in another city in a jail… Was able to advocate for him to receive needed medications and eventually he was released. But he then had a criminal record.
How many people’s children did I help into the hospital in my career as a mental health therapist?
Why was my son made into a criminal when he could have been given humane medical care, medication, and his psychosis brought under control within weeks? I advocated for him to be a part of the mental health court, and my son was “assessed” and they labelled him as sociopathic. I am certain he was psychotic when he was assessed, rendering their judgement subject to much question. He told me later that he did not bathe more than twice during the time he was incarcerated.
Conveniently enough, the mental health courts in my community do not accept people whom they assess as sociopathic. He has never been in trouble with the law whatsoever other than when his illness caused me to draw a boundary for self-preservation. He is a gifted musician and has been able to reconnect with many friends who love him and who knew him before his illness, and at his worst.
The response of the community to the person who is affected has wide and far-reaching ripple effects which include the family members. I am happy to say that today life is improving and better (largely due to relatively open and free access to very expensive medications through the community mental health system) but the painful mantle of being labelled criminal and locked away is still with my son.
I remember as a young girl reading the biography of Dorothea Dix and how she championed the cause of the mentally ill of her era who were chained and locked away and treated as less than human. Her humanity inspired me to help others… And of course to help myself.
The county jail here dispenses more psychotropic meds than any other organization in this state. Have we progressed at all?
linmacha
linmacha; I am glad to hear your son is doing better; I’ll hold you both in my prayers.
dr.e
Thank you for your prayers. I am constantly aware of God’s grace in every situation.
I posted my story to put a personal face on this issue. I know it is not just my own story but that of many mothers…
I came across a quote from the Talmud recently: “The virtue of angels is that they cannot deteriorate; their flaw is that they cannot improve. The flaw of humans is that they can deteriorate; and their virtue is that they can improve.”
Thanking heavens that we humans can and do improve…and that complete healing is possible in this flawed and rocky world.
linmacha