Conference of Chief Justices President Loretta H. Rush Stresses Importance of Mental Health Crisis and Civics Education in ABA Address

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 new resources for courts and our partner stakeholders. Going forward each Behavioral Health Alerts will revisit a Task Force recommendation and an accompanying resource.

Finding: Changing the Law and Process for Civil Commitment. Most state laws for the involuntary commitment of persons with mental illnesses in existence today were adopted in the 1970s. As part of an effort to deinstitutionalize the treatment of mental illness, this generation of statutes favored “dangerousness” standards and individual rights-oriented court processes for involuntary treatment. As a result, in many states today, individuals with mental illnesses who do not clearly present an imminent risk of harm may not be subject to involuntary treatment. If there are no other pathways to treatment, these persons are more likely to experience homelessness, poverty, serious health consequences, and involvement in the criminal justice system.

Recommendation: Courts should develop and provide multiple civil court options that are easily accessible by individuals, families, and behavioral health systems. Courts have a central role in ensuring that these responses appropriately balance individual autonomy and choice in compelled treatment with the state’s parens patriae interest and public safety.

Most mental health treatment is appropriately provided in the community. Courts should order that involuntary treatment be provided in an outpatient setting unless outpatient treatment will not provide reasonable assurances for the safety of the individual or others or would not meet the person’s treatment needs.

Conference of Chief Justices President Loretta H. Rush stresses importance of mental health crisis, civics education in ABA address “Jails are not treatment centers, and they were never intended to be,” Chief Justice Rush said in her speech to the ABA’s House of Delegates. Chief Justice Rush, who also chaired a work group of the multi-year investigation of the National Judicial Task Force to Examine State Courts’ Response to Mental Illness, noted that nearly one in five adults across the country live with a mental illness with more than 13 million adults living with serious mental illness. “These individuals are 10 times more likely to be incarcerated than they are to be hospitalized,” she said. To affect change, state court leaders collaborated with the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Center for State Courts and other local and state mental health providers to develop best practices and policy recommendations for courts and communities.

Research and Resources

County Funding Opportunities to Support Community Members Experiencing a Behavioral Health Crisis This funding chart can help county leaders identify possible funding streams to build and strengthen local behavioral health crisis response continuums. The funding sources reflect opportunities across behavioral health, criminal legal and related systems. Due to the cross-sector nature of crisis response, some sources focus on certain populations, like youth, while others target a certain supportive piece of the crisis continuum, like workforce or training.

New Opportunities to Implement the National Guidelines for Post-Conviction Risk and Needs Assessment In partnership with the Bureau of Justice Assistance, The Council of State Governments (CSG) Justice Center worked with a group of 26 national experts, including researchers, practitioners, and policymakers, to develop practical guidelines that advise criminal justice agencies on the use of post-conviction risk and needs assessment. The guidelines prioritize accuracy, fairness, and transparency in the communication and use of risk and needs assessment.

New NRI State Profiles report: Workforce Shortages Across the Crisis Services Continuum: 2022 Almost every state is reporting shortages of behavioral health workforce for their behavioral health crisis system.  A new NRI State Profiles report highlights the different types of workforce that are in the greatest shortage at different components of the crisis services continuum.

Policing the Unhoused Data was collected from all misdemeanor-only criminal complaints filed by the Albuquerque Police Department (“APD”) in the Bernalillo County Metropolitan Court (“metro court”) in 2020. However, the shocking discovery that nearly one-third of these misdemeanor complaints filed in the metro court by APD were filed against unhoused individuals prompted a shift in the intended focus of this article from the policing of petty crimes, generally, to the policing of the unhoused, specifically.

Michigan's Mental Health Code Reforms Michigan’s former code, like most states’, required immediate danger to self or others, such as threatening suicide or homicide, before a court could order treatment. Michigan’s new standard focuses on the risk of harm due to the individual’s lack of insight into their need for and refusal to accept treatment. The immediacy of the risk of harm governs whether hospitalization or AOT is the least restrictive and most appropriate form of treatment. The Code uses the same standard for ordering treatment whether it is inpatient, outpatient, or a combination of the two.

TAC Research Weekly: February Research Roundup, Black History Month Black patients are 1.6 times more likely to experience an involuntary psychiatric hospital admission than non-Black patients, even when taking into account differences in housing status, psychiatric diagnosis, gender and insurance status. Recent research also found disparities in outpatient mental health care, and that stigma presents a prominent barrier to mental health services for Black immigrants.

Culturally Responsive Services for BIPOC Youth & Families and How to Implement Anti-Racist Practice in Treatment and Services Youth and families who identify as Black, Indigenous, and People of Color (BIPOC) have been continually underserved in mental health services and treatment settings due to the stigma and racism that exists within the mental health System of Care (SOC). On Thursday, March 2, please join NTTAC for a free, hour-long webinar. The featured speakers will explore incorporating anti-racist practices and culturally responsive services in the mental health system and other SOC settings.

A New Podcast on Racism, Mental Health, and the Importance of Tough Conversations There’s a chasm between the momentum of 988 and how it’s reaching Black people, said Victor Armstrong. He’s the Chief Diversity Officer at RI International and the former mental health commissioner of North Carolina. “Many people in Black and Brown communities aren’t even aware of 988 or the transition from 911 to 988 for mental health and substance use emergencies,” he emphasized. For those who know of 988, there’s skepticism on how a 988 response differs from that of 911. “In the Black community, when we hear about emergency systems, we think of 911 and policing.”

Competence to Stand Trial and Competence Restoration: The Basics Across the United States today, defendants found IST are waiting for restoration services-often in jails-- and yet there is frequently a misunderstanding about the purpose of restoration. This SMI Advisor webinar will review the basics related to criminal processes pertaining to competence to stand trial and competence restoration. It will cover some of the case law and some of the current system dynamics at play across the country leading to waits for services. It will also give providers a better sense of what it means when individuals they are treating are in the competency and forensic system.

Wellbeing Wednesdays - Adding Up the Cost of Health Inequity It’s well understood that our nation’s health care system too often leaves people of color and other minorities behind. Chronic under-funding also has devastating effects on health care outcomes. Join us as we speak with the primary author of a compelling new study, The Economic Burden of Mental Health Inequities in the United States Report. The comprehensive study addresses the failures in our health care system, consequences of health inequity on Black Americans and presents strategies to overcome this long-standing problem. Join us for the tenth episode in our Wellbeing Wednesday virtual learning series on March 15, where the best minds in health care share their thoughts on current issues.

JPLI Newsletter This edition of the Judges and Psychiatrists Leadership Initiative newsletter highlights the 2023 Judge Stephen S. Goss Memorial Awards nomination process, grant funding for programs that support cross-system collaboration to improve public safety responses and outcomes for people with mental health conditions and co-occurring substance use disorders, and other recent resources.

CSG Justice Briefing How states can address crime; new guide for responding to a federal funding opportunity; assessment tool helps jurisdictions build community responder programs; and more.

Do's and Don'ts: Free Grant-Writing Webinar for FY23 BJA Solicitations On Thursday, March 2, NADCP and the National Drug Court Resource Center (NDCRC) will co-host a webinar on how to prepare a competitive grant proposal narrative and budget for the FY23 Adult Treatment Court and Veterans Treatment Court Discretionary Grant Program solicitations. This free webinar will discuss new proposal requirements as well as creative proposal ideas such as addressing emerging issues, adding new tools, improving operations, meeting clients' needs, and more.

New eCourse on Fentanyl Facts and Overdose Risk JCOIN is proud to announce the launch of the free, evidence-based online course, Fentanyl Facts and Overdose Risk, developed by the Addiction Policy Forum in partnership with the Drug Enforcement Administration (DEA) Educational Foundation. This course covers facts about fentanyl in the U.S., emerging trends, responses to protect communities, as well as myths and misconceptions about fentanyl.

Bureau of Justice Assistance Seeks Peer Reviewers The Bureau of Justice Assistance (BJA) is seeking individuals from diverse backgrounds and regions to serve as grant application peer reviewers. Reviewers will participate remotely and will review 5 to 15 applications within a 2-week period, earning $125 for each completed review. Some reviews may include a collaboration call to discuss applications with fellow reviewers.

In the News

National Association of Counties (NACo) announces a new Commission on Mental Health and Wellbeing The 14member group, unveiled at NACo’s Legislative Conference, is tasked with leading the development of policy and programmatic recommendations at the federal, state, and local levels to address systemic issues contributing to the ever-growing mental health crisis. Judge Steve Leifman is among the members.

Chief justice says mental health issues a festering problem for Nebraska courts Nebraska Supreme Court Chief Justice Mike Heavican on Tuesday outlined a series of ongoing efforts to improve the state's judicial system by further addressing issues such as the needs of children and minority defendants, along with mental health challenges. Heavican pointed to "an ongoing and long-standing problem of mental health determinations for criminal defendants to stand trial."

US Plans to Allow Medicaid for Drug Treatment in Prisons The federal government is planning to allow states to use Medicaid funds to provide drugs to combat addiction and other medical services for people at state jails and prisons in an effort to help some of those most at risk of dying in the nation's overdose epidemic. Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, announced Tuesday that states would be encouraged to submit proposals for how to use money from the joint federal-state low-income health insurance program for incarcerated people. Those that do would be required to provide mental health and drug treatment and would have the option to add some other services.

NYC has found a way to balance mental illness and criminal justice, but it’s a path closed to most New York City has actually figured out a model to better balance law enforcement and mental health treatment, a problem that has long vexed the criminal justice system, according to both experts and data. But access to this program, despite its successes, is highly limited, with most defendants who need psychiatric help stuck in a nightmare loop that has turned Rikers into what many have described as the city’s largest de facto mental health facility. Judge Matthew D’Emic has presided over the borough’s mental health court for 21 years and stretches resources to accommodate 300 participants at a time. “If anything, they turn us down,” D’Emic told The News. “We look for reasons to help people.”

Behavioral health issues and the legal system: 5 fixes People with untreated behavioral health issues experience perpetual punishment because of our failure to implement a proactive effective strategy. Our communities are, in turn, punished by proxy when the same people commit the same crimes for the same preventable but untreated reasons. Solutions?  First, devote more resources to timely restoration and/or allow private mental health providers to perform restoration treatment.

Mental health needs are exploding in Dallas, but new jail diversion center underutilized In response to the need for mental health care — and to tackle a stubbornly high jail population — officials in Dallas County opened a diversion center last year. Police officers can take nonviolent people accused of criminal trespass to the center, where they get mental and physical health assessments and connect to services. But numbers from the center’s first five months show it’s underutilized. “There are days when there’s just nobody in the building,” said Dallas County Administrator Darryl Martin. “That’s not good.”

766 San Francisco Residents may be Eligible for Referral to CARE Court The research team identified a larger sample of 1,700 San Francisco residents who had at least two instances of a psychosis diagnosis, and either at least one 5150 involuntary hold, or four or more urgent or emergent visits for Serious Mental Illness (SMI) in Fiscal Year 2020. The brief focuses on the subgroup of 766 people in the larger sample who had four or more SMI visits as potentially eligible for referral to CARE Court.

Nashville to expand program matching mental health workers with police on crisis calls Six mental health clinicians accompanied Nashville police on 247 calls during the pilot program's second quarter, 43.8% of which required crisis assessment. Of those calls, 3.9% resulted in arrest, and 0.7% resulted in use of force. Nearly 35% resulted in someone being transported to a hospital or the Crisis Treatment Center, and clinicians gave people referrals to resources in nearly 22% of those 247 calls for service.

The Downward Spiral: How Omaha’s Criminal and Mental Health Systems Break Down — And Ways We Could Fix Them Many people with serious mental illnesses get trapped in cycles of arrests and incarcerations spurred by systemic issues in the mental health and criminal justice systems — not enough space, not enough workers, not enough money and too many problems to tackle. But there are reasons to be optimistic.


Creating a Culture of Wellbeing Leads to Better Leadership Multiple studies have shown that wellbeing in the workplace leads to greater levels of engagement, productivity, and creativity. But self-care alone is not enough to create wellbeing in the workplace. Discover why a focus on community, connection, and belonging is crucial for true wellbeing, and learn the 6 keys to leading with wellbeing that can help everyone in the organization thrive.

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