Juvenile Justice Mental Health Diversion Guidelines and Principles

Task Force and Task Force Member Activities

Juvenile Justice Mental Health Diversion Guidelines and Principles This State Court Leadership Brief proposes eight strategies for improving outcomes for youth in the juvenile justice system with trauma histories and mental health disorders.

The National Judicial Task Force also approved the publication of the essential elements for Pillar 1 of the Collaborative Caseflow Management Interim Report to strengthen community responses and minimize criminal justice involvement. The following resources were adopted:

1.1 Comprehensive Behavioral Health Crisis Systems Includes the core structural elements that a comprehensive behavioral health crisis system must include.

1.2 Deflection Keeping people who should not be in the justice system out, and redirecting them to treatment leads to cost savings and better outcomes for those with behavioral health needs and for the justice system.

1.3 Stop the “Revolving Door” Into the Justice System All courts should strive to identify and cultivate relationships to develop alternate resources for persons with behavioral health needs who cycle through the justice and behavioral health systems, including law enforcement, crisis stabilization units, emergency rooms, hospitals, behavioral health providers, jails, and the courts.

1.4 Prosecution Alternatives Prosecutors’ offices function as public safety agencies and part of their core mission should involve reducing recidivism and its root causes.

Hiding in Plain Sight: Youth Mental Health Several Task Force members appear in the full version of this Ken Burns film, which will be released in June. This trailer is well worth the four minutes, and this one minute version includes an appearance by Task Force member Dr. Sarah Vinson.

Judges and Psychiatrists Decriminalizing Mental Illness Together Partnership between Judges and Psychiatrist as experts in their respective areas is crucial to improve judicial, community, and systemic responses to community members with Serious Mental Illness. Today we bring to you two of those experts, Dr. Michael Champion and Judge Steven Leifman, to have a candid conversation around the importance of addressing the over incarceration of community members with mental illness through partnerships between judges and psychiatrists.

Using Collaborative Court Case Processing to Help People with Behavioral Health Needs: Q&A with Former Chief Justice Paula M. Carey In the Fall of 2021, The Council of State Governments (CSG) Justice Center and the National Center for State Courts facilitated a virtual Community of Practice for interdisciplinary teams seeking to implement criminal case management for people with behavioral health needs. During the Community of Practice, Task Force member Chief Justice Paula M. Carey—former chief justice of the Trial Court of Massachusetts—provided opening remarks, describing the role of the courts in helping people work toward their recovery. The CSG Justice Center interviewed former Chief Justice Carey to learn more about how effective court case processing can benefit people with behavioral health needs and support them around their recovery, as well as her perspective as a judge on the importance of court-based stakeholder collaboration.

2022 Texas Tech Mental Health Law Symposium Webinar The program features an array of outstanding speakers who are leaders in their fields. Judge Steven Leifman from Miami and Dr. Kenneth Minkoff of ZiaPartners, Inc. will present on Redesigning and Modernizing Civil and Criminal Pathways to Improve Access and Services for Persons with Mental Illness: New Model Proposals. In addition, Judge Milton Mack, State Court Administrator, Emeritus, from Michigan, and Dr. Debra A. Pinals, Director of the Program in Psychiatry, Law, and Ethics in the Department of Psychiatry at the University of Michigan will discuss Modernization Initiatives and Alternative Criminal Justice Pathways in Michigan.

Mental Health and the Courts: The Collaborative Court and Community Effective Criminal Case Management Currently, state courts do not generally have systems in place to help those with behavioral health issues. This need is made even more urgent with the pandemic and the resulting case backlogs. We must find a new model to strengthen the collaborative court and community response to individuals with behavioral health needs.  This NACM podcast explores ways to create a fair and effective caseflow management system that meets the challenges of those with behavioral health needs. Thank you,  Chief Justice Carey and Don Jacobson for a great Podcast!

State Resources and Publications State and local resources of note are continuously being added to this Task Force web page. If your jurisdiction has a new resource of note to contribute, please forward it to ptobias@ncsc.org

The Behavioral Health Alerts has a new Wellbeing section!  Many courts are focusing now more than ever on the wellbeing of judges and court employees and the Wellbeing section focuses news and resources that address this important issue.

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Research and Resources

Community-Based Diversion Reduces Collateral Consequences of Involvement in the Criminal Legal System — CUNY Institute for State and Local Governance Project Reset offers voluntary post-arrest, pre-arraignment diversion programming. The program originally engaged young adults and adults arrested for low-level nonviolent offenses who did not have a criminal record. In July 2019, it expanded to include individuals with prior convictions. A recent RAND evaluation found that Project Reset’s benefits extend beyond reducing court involvement and its collateral consequences. Participants overwhelmingly felt that they made the right decision in participating and had learned useful information about the legal system.

The Impact of Misdemeanor Arrests on Forensic Mental Health Services: A State-wide Review of Virginia Competence to Stand Trial Evaluations Findings reveal that defendants who are referred for competence evaluation and facing only misdemeanor charges are more likely than those facing felony charges to manifest symptoms of serious psychiatric illness, be opined incompetent, and referred for inpatient competence restoration. Though restoration services may indeed provide much-needed treatment, there may be better ways to provide appropriate treatment more promptly and more affordably. Likewise, there may be better ways to mitigate the broader competency crisis by exploring new restoration policies, or prioritizing diversion, for defendants facing only misdemeanor charges in the competency system.

Registration for BJA's FY22 Funding and Resources Webinars Now Open This link includes registration information for all four events, including BJA Funding and Resources for Courts and Prosecutors. In this webinar, attendees will learn the primary initiatives BJA plans to fund in FY22 that support courts. Solicitation eligibility requirements, examples of allowable uses of funding, estimated funding amounts, as well as training and technical assistance opportunities will be highlighted.

Overcoming Barriers and Recognizing the Unique Value of Including Peer Support Specialists with Prior Justice Involvement in Recovery This SMI Advisor webinar will bring together individuals with lived experience of prior justice involvement, as well as state leaders who have hired individuals with prior justice involvement to discuss the significant positive impact these individuals can have on recovery, the value they bring to the behavioral health workforce, and how they worked to affect change in their states to increase acceptance of individuals with lived experience and prior justice involvement.

TAC Research Weekly: Interventions in Prison Show Promise for Individuals with Serious Mental Illness Interventions targeting individuals with serious mental illness in the criminal justice system show promising results for improving several criminogenic risk factors, according to new research published in Psychiatric Services. Results for the impact of the treatment programs on substance abuse were mixed, but generally showed decreases in substance use and lower odds of committing a substance use-related offense after reentry into the community for those who were in a treatment program compared to those who were not.

Use of State Psychiatric Hospitals This survey of state psychiatric hospitals in 49 states reveals the different structures, oversight, populations served, and legal status of patients served. For example, in 2020, over 56% of state hospital residents had a forensic legal status.

Tackling Structural Discrimination in Healthcare Policy is Necessary to Achieve Parity for People with Substance Use Disorders and Mental Health Conditions Even with progressive legislative, court, and community-based changes, lawmakers in the United States are continuing in the fight to bring full parity in care for people with mental illness and substance use disorders, but sometimes their policy approaches have had the opposite effect.

Building a More Equitable Juvenile Justice System Sadly, racially disparate treatment of youth within the juvenile justice system is far too common. Black youth are overrepresented across all aspects of the juvenile justice system. Black youth account for 30 percent of all referrals to juvenile court, though they only make up 16 percent of the youth population overall. CSG is helping many states and counties make an honest assessment of the disparities and create a more equitable juvenile justice system for everyone. Across the country, jurisdictions are employing numerous strategies, including the following list.

AOT Research Roundup Webinar Join us for our next webinar, Thursday, March 17 at 3 p.m. EST, and hear from Treatment Advocacy Center's Research and Policy Manager Kelli South on the entire body of AOT research. South will review the literature that makes AOT an evidence-based practice and share what Treatment Advocacy Center's Office of Research and Public Affairs is focused on right now. In addition to learning what we do know about AOT, you will also learn what research is still needed and how your program can contribute to the knowledge base.

Leveraging Resources and Relationships to Develop New Housing for People with Justice Involvement This webinar will introduce participants to housing development concepts essential for serving people with justice system involvement, key funding sources, and strategies for engaging with development partners. Participants will also hear from communities that are undertaking development efforts focused on people with justice system involvement.

Mental Health, Excessive Sentencing, & the Death Penalty: Virtual Conference Series 2022 This free conference – hosted by The Equitas Project and 8th Amendment Project – will offer one 60-minute panel each day for five days to explore the intersection of mental health, excessive sentencing, and the death penalty. Panelists will cover topics such as legislative reform; the importance of mitigation investigation and story-telling through the various phases of a case; the role of mental health in resentencing efforts and challenging conditions of confinement; the impact of trauma and adverse childhood experiences; the impact of racism on mental health, access to services and care, and criminal sentencing; and a 360 degree look at how these issues affect the mental health of everyone involved—including individuals facing excessive sentencing, as well as jurors, corrections officers, prosecutors, defense attorneys, judges, mental health providers, advocates for social change, and political actors.

Criminal Justice Guide to 2022 State of the State Speeches In 2021, states across the country continued to grapple with challenges caused by the ongoing COVID-19 pandemic. Despite these concerns, this year’s State of the State addresses show that governors are prioritizing criminal justice and behavioral health issues. So far, 19 governors mentioned behavioral health needs in those speeches - view them all here.

Addiction Policy Forum Newsletter Includes links to Improving Addiction Treatment Quality and Access for Black Patients, other recent publications, and related news.

HHS Announces Nearly $35 Million To Strengthen Mental Health Support for Children and Young Adults The Department of Health and Human Services (HHS)—through the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Office of Minority Health (OMH)—announced nearly $35 million in funding opportunities to strengthen and expand community mental health services and suicide prevention programs for America’s children and young adults. The American Rescue Plan funded $9.2 million. This announcement is part of a new Administration-wide initiative to tackle the nation’s mental health crisis.

Grants for Expansion and Sustainability of the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances The purpose of this program is to provide resources to improve the mental health outcomes for children and youth, birth through age 21, with serious emotional disturbances (SED), and their families. This program supports the implementation, expansion, and integration of the System of Care (SOC) approach by creating sustainable infrastructure and services that are required as part of the Comprehensive Community Mental Health Services for Children and their Families Program. For possible collaboration with NCSC contact Teri Deal

Needs Assessment to Inform a Rural Justice Roadmap This questionnaire is designed to collect information from rural justice and public safety practitioners (e.g., judges, law enforcement, pretrial and probation officers, corrections, prosecutors, defense attorneys), rural justice and public safety partners (e.g., substance use treatment providers, public health staff, child welfare staff), and rural project coordinators managing cross-sector projects. Your participation will help inform the development of a Rural Justice Roadmap that will communicate the funding, training, technical assistance, and research needs of rural justice and public safety practitioners.

In the News

California governor backs mental health courts that could compel people into care California Gov. Gavin Newsom is trying to fight homelessness with a proposal to create a mental health “CARE Court” in every county that could compel treatment for those with severe mental illness. People could be referred to the courts by people who include family members, first responders, social service agencies and mental health providers, according to a March 3 press release and fact sheet.

How S.F.’s court system fails to treat combined addiction and mental illness Newsom wants to create an alternative court for substance abuse. San Francisco already tried it. In the city it often takes weeks or months for individuals who are in jail to be placed into the mental health treatment they need. And most often, they are referred to a lower level of care because not enough beds are available for people struggling with both severe mental illness and substance use disorder. “Drug court treatment staff have basically abandoned hope of getting anyone into a dual diagnosis treatment program,” San Francisco Judge Michael Begert, who presides over San Francisco’s Adult Drug Court, said at a hearing to probe the city’s efforts to increase the availability of mental health care beds.

Pushing For Criminal Justice Reforms: Federal Advisory Panel Restarted After Being Put On Back Burner A federal panel created by Congress to advise it and the Substance Abuse and Mental Health Services Administration (SAMHSA) about serious mental illnesses and serious emotional disturbances is being reinvigorated by Health and Human Services Assistant Secretary Miriam E. Delphin-Rittmon, PhD. ISMICC is composed of 14 non-federal members, including Task Force member Judge Steven Leifman, who work with representatives from federal agencies that oversee mental health programs.

Can New 988 Number Handle The U.S. Suicide Crisis? Already, of the approximately two million phone calls to the Lifeline last year, about 330,000 — roughly 17 percent — were abandoned before a caller could get help. The texting and online chat lines, which together fielded another million contacts last year, lagged further behind, not attending to 41 percent of texts and 73 percent of chats.

Los Angeles County Develops 911 Call Matrix and Procedures to Divert Behavioral Health Calls In Los Angeles County, calls that come into 911 or even its non-emergency business lines are, by default, considered higher risk. Historically, these level four calls have resulted in law enforcement dispatch or a co-responder team. But while 911 call takers would ask the caller questions to determine the type of emergency the person was likely experiencing, what they could do next was limited. “Even if the person’s crisis was a level three or two, there was no other agency for us to contact, so law enforcement would keep the call.” Now, the county has developed a call assessment matrix and amended 911 call taker procedures to help triage the vast majority of 911 behavioral health calls to Didi Hirsch Mental Health Services.

U.S. mental health care needs an overhaul, argues former NIMH director Tom Insel For over a decade, psychiatrist and neuroscientist Dr. Thomas Insel headed the National Institute of Mental Health and directed billions of dollars into research on neuroscience and the genetic underpinnings of mental illnesses. But in the very first pages of his new book, Healing: Our Path from Mental Illness to Mental Health, he admits that the results of that research have largely failed to help Americans struggling with mental illnesses. NPR sat down with Insel to talk about how he came to realize where America had failed and his journey to find the answers to addressing the country's mental health crisis.

Lack of mental health facilities in Arkansas a continuing problem in the courts system There is only one mental health facility across the state of Arkansas to house criminals deemed unfit to stand trial. It leaves a limited number of beds and patients waiting up to several months to be transported to the Arkansas State Hospital in Little Rock.” There’s just not enough bed space for that type of service and jails are not equipped with the psychiatric and psychological staff,” said Dr. Lackey. “The governor has made progress with the four crisis stabilization units across the state, but it doesn’t address this when patients need long-term assistance.

Delays at state mental hospital continue to put strain on defendants, justice system Colorado attorneys and judges have increasingly expressed frustration at the delays associated with restoration efforts at the state hospital, where significant waits have led to lengthy delays in cases and inmates languishing in jail awaiting treatment. One client, now 21, was deemed incompetent April 6, 2020, almost two years ago. To date, the client has yet to get any restoration treatment and has been in the Boulder County Jail since July 10.


MHFA Monthly: Black Mental Wellbeing Matters MHFA sat down with Ruby Brown-Herring to discuss her experiences as a National Trainer, how she takes care of herself, and how to best support Black communities. Other tips, tools, and resources are also included.

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