NEW RESOURCE: Judges' Guide to Mental Health Diversion

Implementation of the National Judicial Task Force to Examine State Courts' Response to Mental Illness Report and Recommendations

The Task Force made a number of important findings with corresponding recommendations supported by over 100 resources for courts and our partner stakeholders. Each Behavioral Health Alerts revisits an original Task Force resource or a new resource that supports a Task Force recommendation.

NEW RESOURCE: Judges' Guide to Mental Health Diversion This new guide is intended to serve as a resource framework for courts and judges to use to promote and implement diversion strategies for individuals with behavioral health needs in their communities. Ideally, judges would collaborate with a range of system stakeholders to examine the entire diversion continuum but could also focus on one step of the process at a time. This guide focuses on jail diversion systems, post arrest, and pre plea.

Research and Resources

Incorporating Peer Recovery Support into Treatment Courts These practice guidelines provide treatment court professionals with a working understanding of the value of peer support and a framework for successfully integrating peer recovery support specialists into the treatment court setting. These guidelines support various stages of integrating peer recovery support services, including planning, implementation, and maintenance. They apply to adult drug treatment courts, impaired driving treatment courts, hybrid courts, opioid intervention courts, veterans treatment courts, and co-occurring courts.

Bail and Mental Illness As a first step towards addressing the mutually destructive relationship between pretrial justice and mental health treatment, this Article argues for a disaggregation of mentally ill and traditional defendants within the pretrial criminal justice system in all respects: in arrest decisions, in pretrial screening, in judges’ determinations of pretrial release and conditions for release, and in data collection and reporting. Moreover, bail reformers should call for increased mental health funding to accompany reductions in pretrial detention. This will address only a small facet of the nation’s massive mental health crisis. But it will help to produce a more just bail system for all and move towards ending the cycling of mentally ill defendants through the U.S. criminal justice system.

SAMHSA Advisory: Low Barrier Models of Care for Substance Use Disorders The advisory emphasizes the importance of low barrier care in overcoming substantial gaps in access to SUD treatment and engaging more people in care. Despite robust evidence showing the effectiveness of SUD treatment, fewer than 10% of individuals who need care receive it. Barriers such as lack of treatment availability, strict program requirements, stigma, and discrimination have resulted in treatment gaps, especially among marginalized communities.

Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit Across America, the double standard created by the Medicaid Inmate Exclusion Policy (MIEP) is putting undue strain on our local judicial, law enforcement, public safety and human services systems. This error in legislation and federal policy results in higher rates of recidivism, increased healthcare costs and poorer health outcomes for residents. This policy drives the over-incarceration of those suffering from mental health and substance use disorders, as county jails have become the largest behavioral health facilities in the nation. Below, find resources designed to help county officials educate Congress, the administration and the public on the importance providing access to federal health benefits for those awaiting trial and verdict decisions.

Engaging and Leveraging Community-Based Organizations in Your Crisis System This December 11th webinar will discuss how to build robust crisis systems of care and how community-based organizations, such as the National Alliance on Mental Illness (NAMI), are enhancing community response to care.

NACo Opioid Settlement Summit: Opportunities for County, State & Federal Partnership As of 2023, state and local governments have negotiated over $50 billion in settlements from companies in the pharmaceutical industry. The national opioid settlements reflect years of coordinated legal action and intergovernmental cooperation within and between states. As the settlements are paid out over the next 17 years, continuous intergovernmental coordination is key to achieving the maximum impact of these investments. This webinar event will bring together leaders from all levels of government to discuss effective strategies for investing opioid settlement funds and to explore opportunities to strengthen intergovernmental coordination in our nation’s response to the opioid epidemic.

CSG Justice Center Justice Briefing Spotlight on call triage protocols for emergency calls; Davidson County (TN) Behavioral Care Center tour; and the latest events.

AOT Judges Chat Greetings Judges, Magistrates, and Hearing Officers, Happy Holidays! Before the hustle and bustle of the season sets in, we want to get an important date on your calendar. Please plan to participate in the next Assisted Outpatient Treatment Judge’s web chat on Thursday, January 25 at 3 p.m. ET. The goal of these chats is to give you an opportunity to make connections, bounce ideas off of one another and ask those questions only a seasoned peer can answer. Whether you’ve been involved in AOT a long time, a short time or are still on the fence, this meeting is for you! Please note this is a closed group for members of the judiciary only.

In the News

Washington Pays $100M Fine for Neglecting Mental Health Services Months Earlier Than Expected Washington late last month paid a $100 million court-ordered fine for failing to provide mental health services to people in jail, even though the state wasn’t required to hand over the money until next year. The fine stems from what’s known as the Trueblood case, a years-long legal dispute in which a federal court found the Department of Social and Health Services’ long wait times for mental health treatment and evaluations violated the constitutional rights of people in jail waiting for those services before they can be deemed competent to stand trial. In July, U.S. District Judge Marsha J. Pechman ordered the state to pay the roughly $100 million fine for failing to comply with a settlement agreement in the case.

Gov. Cox Proposes $186 Million to Address Homelessness, Behavioral Health in 2025 Budget Gov. Spencer Cox announced he is asking the Utah Legislature for around $186 million in the 2025 budget to address homelessness and behavioral health. “Too often, those with serious mental illness or addictions are ending up in jail for a night and then released right back onto the street instead of getting the help that they need,” Cox said. Cox’s proposal contains $128 million for the current shelter system, $10 million for affordable housing preservation, $8 million for behavioral health, $30 million for “deeply affordable housing” and $10.6 million for a new “HOME” court system to move mental health cases out of criminal justice courts. During Monday’s press conference, the governor emphasized the need for more behavioral health workers and to allow individuals with mental health conditions to receive treatment and stay out of the criminal justice system.

Even More Missourians are Stuck Waiting in Jails for Court-Ordered Mental Health Treatment Missouri has 285 people waiting in jails to be transferred to state-run psychiatric hospitals, potentially for months, without having been found guilty of a crime. And that number has been going up over the last few months, despite new mitigation efforts.

Mental Health Team Responds to Crises Without Police in Indianapolis In Indianapolis, a new mental health team responds to mental health crises without law enforcement The new community response team is led by clinicians without police involvement. Advocates say this is a good step forward for safe interventions during mental health crises. However, there are concerns that the team currently responds to calls only in the downtown district and needs to be expanded.

Failures In Colorado’s Courts, Mental Health System Strand Hundreds in ‘Vicious Cycle’ of Competency Process By law, the most-sick defendants are supposed to be admitted for treatment within seven days, and less-ill defendants within 28 days. But between August and October, the most-sick defendants waited an average of four months — 128 days — to be admitted, and less-ill defendants waited nearly five months. Those are the longest average waits on record and are “wildly out of compliance,” according to the special masters’ report.

Colorado Family Says Criminal Justice System is Best Option for Daughter Struggling with Mental Health Crisis Through her life, Olivia was different, her mother recalls, but in her late teens, Olivia began to show the signs of the schizoaffective disorder, bi-polar disorder and depression that came to change her life. She began hearing voices that plagued her life. As she became an adult, she would leave home and disappear, spending time on the streets. There were strange people she would bring home. She would be combative and physically attack family members, then leave again, disappearing for weeks at a time. The family tried facilities to treat her and she was asked to leave because she was too hard to handle. Back to the streets she went, the family worrying and wondering. To get her help, explained counselors to her family, the best route would be to push her deeper into the criminal justice system. “We've had to make her a criminal to get her this help,” explained Kendra.

New California Mental Health Court Sees More Than 100 Petitions in First Two Months An alternative mental health court to compel treatment for people with severe mental illness has received more than 100 petitions since launching in seven California counties in October, state officials said Friday. The state believes between 7,000 and 12,000 people statewide will eventually be eligible for “CARE Court,” which launched on a limited basis before Los Angeles County became the latest and largest county to start the program on Friday.


Judge’s Candid Mental Health Fight Exposes Stresses Jurists Hide Michigan Supreme Court Justice Richard Bernstein wants to keep his seat on the high court until he’s kicked off at age 70. But to do it, he needed to leave the bench and treat his depression. Bernstein is opening up about his struggles in the hope that his example will make it easier for other judges to seek help. Under the black robes are people facing perpetual stress, long work hours, and exposure to human tragedy. Surveys indicate roughly a quarter of judges missed at least 10 work days in the last year due to stress—though they gave other reasons to their bosses—and nearly 50% of judges believe they’ve suffered secondary traumatic stress from exposure to heartbreaking court testimony and gruesome photographic evidence. However, fear of damaged reputations and voters’ rebukes lead judges to struggle in silence, with the public paying the price, experts say.

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