Putting Therapeutic Jurisprudence into Practice: The Growth, Operations, and Effectiveness of Mental Health Court*

Lurigio, Arthur J., Snowden, Jessica, Justice System Journal

Thisarticlefocusesonacourtinnovationforcriminallyinvolvedpeoplewhoareafflictedwithseriousmentalillnesses,suchasschizophrenia,bipolardisorder,ormajordepression.Itdescribesarecentlydevelopedstrategyfordealingwiththechallengesofworkingwithmentallyillindividualsduringthepre-andpost-adjudicationstagesofthecriminaljusticeprocess:mentalhealthcourt(MHC).Thearticlealsodiscussesthehistoricalandlegalunderpinningsofthesecourts,theirgrowth,andthedefiningelementsandoperationsoftheearliestMHCs,whicharebestviewedasevolvingmodelsofpractice.Finally,thearticlereviewsstudiesofMHCoperationsandeffectivenessandsuggestsfuturedirectionsforMHCs.Fundamentalchangesinmentalhealthlawsandpolicieshavebroughtcriminaljusticeprofessionalsintocontactwiththeseriouslymentallyillateverystageofthecriminaljusticeprocess.Policearrestpeoplewithseriousmentalillnesses(PSMI)becausefewotheroptionsarereadilyavailabletohandletheirdisruptivepublicbehaviorortoobtainforthemmuch-neededtreatmentorhousing(Teplin,2000).Jailandprisonadministratorsoftenstruggletotreatandprotectthementallyill,judgesgrapplewithlimitedsentencingalternativesforPSMIwhofalloutsideofspecificforensiccategories(e.g.,guiltybutmentallyill),andprobationandparoleofficersscrambletoobtainscarcecommunityservicesandtreatmentsforPSMIandattempttofitthemintostandardcorrectionalprogramsortomonitorthemwithtraditionalcasemanagementstrategies(LurigioandSwartz,2000).Whenthementallyillaresentencedtocommunitysupervision,theirdisorderscomplicateandimpedetheirabilitytocomplywiththeconditionsofreleaseandcompoundthedifficultiesofprisonerreentry(CouncilofStateandLocalGovernments,2002).OtherPSMIenterthecriminaljusticesystembecausetheyhaveengagedinseriouscriminalbehaviorthatisoften-butcertainlynotalways-relatedtotheiruntreatedpsychiatricandsubstance-usedisorders.Indeed,thegrowthofspecializedpoliceanddiversionaryprogramsthataddresslow-levelcriminalbehavior(e.g.,disorderlyconduct)bydeflectingthementallyillawayfromthecriminaljusticesystemandintothementalhealthsystemhaslikelyreducedtheactualcriminalizationofthementallyill(Lurigio,Smith,andHarris,inpress).Nevertheless,thelackofaccessibleandaffordablementalhealthcareinthiscountryhascontributedtothetransinstitutionalizationofthementallyill,whoaremorelikelytoreceivepsychiatrictreatmentinajailorprisonthaninahospital(CouncilofStateGovernments,2002;Lamberti,2007).PSMIoftenresideinhighlycriminogenicandimpoverishedenvironmentsthatexertpressuresonthemtoengageincriminalbehaviors.Thefactorsthatcharacterizetheseenvironments(e.g.,joblessness,ganginfluences,failededucationalsystems,andresidentialinstability)alsoaffectpoorpersonswithnoseriousmentalillness(Sliver,Mulvey,andSwanson,2002).Draineetal.(2002)suggestthatPSMIhavemanytypesofproblemsbecauseofthesocialsettingsorcontextsinwhichtheytypicallylive(pooranddisadvantagedcommunities).Homelessness,crime,undereducation,andunemploymentareendemictosuchneighborhoods.Alargepercentageofpoorpersonsexperiencethesedifficulties-irrespectiveofwhethertheyhavementalillnessornot-whichrenderthemmoresusceptibletocriminalactivitiesandvictimization(Lamberti,2007).Thisarticledescribesarecentlydeveloped-butfast-growing-strategyfordealingwiththechallengesofPSMIduringthepre-andpost-adjudicationstagesofthecriminaljusticeprocess:mentalhealthcourt(MHC).ThiscourtinnovationisforcriminallyinvolvedindividualswhoareafflictedwithseriousAxisIdiagnoses,suchasschizophrenia,bipolardisorder,ormajordepression-chronicbraindiseasesthatcauseextremedistressandinterferewithsocialandemotionaladjustment.The rest of this article is only available to active members of Questia