What State Court Leaders Need to Know About State Behavioral Health Systems

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.

What State Court Leaders Need to Know About State Behavioral Health Systems State behavioral health systems and structures are as varied as state court systems! This Court Leadership Brief is intended to provide state court leaders an overview of state behavioral health systems based on research and analytics. Understanding the complexity of state behavioral health systems is an important step in strengthening the state courts’ relationship with your state behavioral health authority.

Task Force Recommendations Implementation - Resources and News

North Carolina State Leaders Hold Behavioral Health Roundtable The roundtable was an opportunity for North Carolina state leaders to use the Miami-Dade Criminal Mental Health Project as a model. The goal of the roundtable was to learn about best practices relative to the intersection of individuals with serious mental illness and co-occurring substance use disorders as they interact with the justice system and how these best practices can be implemented in North Carolina. Utah State Court Administrator (Ret.) Richard Schwermer, now a court consultant with the National Center for State Courts, gave an overview of effective strategies that are the framework for the Sequential Intercept Model which included a description of effective practices and examples of how those practices have been implemented across the country, then keynote speaker Judge Steven Leifman spoke about Miami-Dade County's Criminal Mental Health Project (CMHP).

South Carolina Judicial Branch to Host a Statewide Mental Health Summit Supported by the National Center for State Courts and the State Justice Institute, keynote speakers include S.C. Judge Steven Leifman, an Associate Administrative Judge of the Miami-Dade County Court, and chair of the Florida Supreme Courts’ Steering Committee on Problem Solving Courts, and Dr. Margie Balfour, with the University of Arizona and Connections Health Solutions. The summit is the first of its kind, creating a new collaborative approach between law enforcement, healthcare providers, advocates and organizations, and state and local leaders to improve the administration of justice for court-involved individuals experiencing severe mental illness.

Ontario County Judge Named Co-Chair of Behavioral Health Task Force Hon. Matthew D’Emic, Administrative Judge for Criminal Matters, Kings County Supreme Court, will lead the New York State Judicial Task Force on Mental Illness with co-chair, Hon. Jacqueline Sisson, Canandaigua City Court judge and acting Ontario Family and County Court judge. In addition, all members of the Task Force’s panel are now in place, representing a diverse and deeply experienced group of judges, lawyers, mental health experts and others from around the State. The new Task Force assignments are in line with the work of the Conferences of Chief Justices and State Court Administrators’ (CCJ/COSCA) National Judicial Task Force to Examine State Courts’ Response to Mental Illness, which issued its report after a multi-year effort by over 40 judges, courts and national behavioral health experts. The report and its expansive recommendations emphasize the unique role that state courts and judicial leaders can play as conveners, with community and governmental partners, to close the gap between the behavioral health and justice systems in addressing the needs of justice-involved individuals with mental illness.

Search for solutions continues in Illinois' treatment of inmates with mental illness Starting in the early 1960s, state law required inmates unfit to stand trial to be transferred to a state-operated mental health facility within 20 days of a court order for inpatient treatment. The deadline was extended to 60 days after inmate transfers were delayed at the height of the COVID-19 pandemic, which prompted a lawsuit last year from sheriffs of six counties. As of Oct. 19, 199 inmates were waiting for beds at DHS and another 80 were waiting to be evaluated to determine whether inpatient admission is necessary, according to IDHS. Lane said one of his jail's inmates had been waiting more than six months to be transferred to a DHS inpatient facility. This month, the longest wait was about four months and counting.

The Administrative Office of Illinois Courts earned a $50,000 grant in December to evaluate the best legal practices regarding competency of inmates to stand trial. The money will allow the Illinois Supreme Court, in collaboration with the National Center for State Courts, to improve the court system's response to individuals with serious mental illness.

New Mexico looks for mental health solutions Judge Steven Leifman from Miami-Dade’s Eleventh Judicial Circuit Court in Florida was once just a regular judge. Now he is a certified celebrity in the world of behavioral health treatment. He became a celebrity just by his sheer ability to bring people to the discussion table, determination and use of best practices to make something happen that had never happened before. Now, a group of 15 leaders from across the state, including Roswell, Santa Fe, Deming, Las Cruces, Albuquerque, Clovis and Gallup, will be attending a two-day training at the leading facility and program model of recovery in the U.S. That’s the Miami Center for Mental Health and Recovery.

Research and Resources

Promoting Well-Being in Family Court: Mental Health Considerations In this November 9th webinar, jointly sponsored by NCSC, the Kansas Judicial Branch, and the National Center on Domestic Violence, Trauma, and Mental Health, we delve into the multifaceted challenges families often face, from mental health issues to trauma, violence, and substance use disorders. Family Courts play a pivotal role in overseeing such intricate cases, deciding parenting-time, and discerning genuine concerns from potential misuse or weaponization of diagnoses.

Building State and Local Partnerships to Support Familiar Faces This webinar will address how New Mexico and Georgia draw on the strengths of multidisciplinary state and local practitioners and leaders to create sustainable collaboration, drive meaningful system change, and measure the impact of their efforts to inform future decisions. The discussion will be led by Georgia Supreme Court Chief Justice Michael Boggs and New Mexico Supreme Court Justice Briana Zamora with state and local practitioners who are making policy changes in their states. Attendees will leave the webinar with practical ideas for building a broad state and local coalition to drive action on strategic policy priorities and strategies for measuring impact to build a foundation for sustaining political and funding support.

CSG Justice Briefing Addressing the justice staffing crisis; community response toolkit; and upcoming events.

Judges and Psychiatrists Leadership Initiative newsletter Navigating the New Medicaid Section 115 Demonstration Opportunity, Revisiting a Reentry Case Plan Tool, and more.

Adverse Childhood Experiences and Arrest Rates among Individuals with Serious Mental Illnesses We examined the impact of ACEs on arrest among individuals with SMI while controlling for age, gender, race, and educational attainment. The prevalence of prior arrest was very high (77.3%) and was predicted by male gender, African American race, lower educational attainment, and mood disorder diagnosis. Arrest rate (number of arrests per decade, which thus accounted for age) was predicted by lower educational attainment and higher ACE score. Diverse clinical and policy implications include improving educational outcomes for individuals with SMI, reducing and addressing childhood maltreatment and other forms of childhood or adolescent adversity, and clinical approaches that help clients reduce the likelihood of arrest while addressing trauma histories.

Self-binding directives in psychiatric practice: a systematic review of reasons Self-binding directives (SBDs) are an ethically controversial type of advance decision making involving advance requests for involuntary treatment. This study systematically reviewed the academic literature on psychiatric SBDs to elucidate reasons for and against their use in psychiatric practice. Reasons for SBD use were promoting service user autonomy, promoting wellbeing and reducing harm, improving relationships, justifying coercion, stakeholder support, and reducing coercion. Reasons against SBD use were diminishing service user autonomy, unmanageable implementation problems, difficulties with assessing mental capacity, challenging personal identity, legislative issues, and causing harm.

The prevalence of traumatic brain injury (TBI) among people impacted by the criminal legal system: An updated meta-analysis and subgroup analyses This study estimated high rates of lifetime traumatic brain injury (TBI) history among people impacted by the criminal legal system. We also found that TBI rates significantly differ depending on how researchers define and measure TBI. These findings emphasize the importance of standardized TBI research methods and support the need for increased TBI screening procedures for individuals in criminal legal settings.

TAC Research Weekly: Experiences of Black adults in a locked emergency psychiatric unit Black adults have greater barriers to accessing psychiatric care, such as a higher prevalence of intergenerational poverty and underinsurance, than their white counterparts. However, Black adults simultaneously remain overrepresented in acute inpatient care. The authors of a study published this month in “Psychiatric Services” sought to better understand the lived experiences of Black adults who received psychiatric evaluations on a locked emergency psychiatric unit.

SAMHSA 988 Social Media Shareables These shareables were designed for use as social media posts, stories, and threads. The audiovisual content on this page is free to download and share but may not be edited or altered.

Reaching Rural: Advancing Collaborative Solutions Reaching Rural is a one-year planning initiative designed for rural justice and public safety practitioners; public health and behavioral health practitioners; city, county, and tribal leaders; and community groups. The planning initiative empowers rural practitioners to build deeper networks, particularly across sectors; adopt bold solutions to the persistent challenge of substance use and misuse in rural communities; and reimagine how diverse systems with different missions can engage with one another to more effectively serve justice-involved individuals with substance use or co-occurring disorders.

Trends in State Mental Health Policy This NAMI report details state-level legislation enacted in 2022. Responding to the ever-growing mental health crisis, state lawmakers passed critical legislation in 2022 to build and reform mental health care systems. While the gap between the need for mental health care and its availability remains significant, policymakers are facing increasing pressure to ensure that their constituents can access mental health care when and where they need it. In fact, a 2022 public opinion poll from NAMI, conducted by Ipsos, showed that more than 8 in 10 people agree that elected officials need to do more to improve mental health care and treatment.

In the News

'Existential crisis': There's a mental health problem in B.C.'s courts This is the first story in a five-part series looking at how mental health issues are pervasive in B.C.'s courts. First we look at those accused of crimes, then move on to how the courts operate, then examine lawyers and court staff and, finally, outline possible solutions. “Canadians with a mental or substance use disorder are nine times more likely to come into contact with police for problems with their emotions, mental health or substance use, and four times more likely to be arrested than Canadians without a mental or substance use problem,” then federal attorney general and minister of Justice David Lametti said in a November 2022 statement. “When the health-care system fails to treat mental illness, the criminal justice system punishes the symptoms,” the society said.

Manhattan DA awards $3M to program connecting New Yorkers in need with services in court A new program that aims to provide an exit ramp from the revolving-door justice system will boost access to services for New Yorkers in need with $3 million from Manhattan District Attorney Alvin Bragg’s office. The investment in the Fortune Society-run program aims to fill holes in the city’s social safety net where they’re perhaps most clearly displayed — in arraignments. It will see courtroom-based outreach workers engage people arrested on low-level offenses when they would otherwise leave the courthouse with only a subway ticket, a return date and nowhere to go. Bragg told the Daily News the “courtroom navigators” program seeks to recognize and remedy the life challenges that cause so many to remain tangled up in the criminal justice system, released time and again back into the circumstances that led them to offend.

Federal judge blasts Marion County in a scathing Oregon State Hospital ruling An obviously angered federal judge ruled this week that a criminal defendant in Marion County cannot return to the Oregon State Hospital, months after efforts to treat the person’s mental illness at the psychiatric facility failed. In a ruling Tuesday, Mosman took exception with Marion County’s efforts to return a defendant to the state hospital, because those efforts violated the temporary admission standards state health officials, several district attorneys, disability advocates and county leaders — including those in Marion — all reaffirmed just four months ago.

St. Louis courts to invest $455,000 to help people get services while awaiting trial The St. Louis Circuit Court announced Wednesday it is distributing $455,000 to help people awaiting trial connect with housing, job training and mental health services. Court officials say the programs are designed to make sure people show up for court while their cases are pending, and to improve their lives so they don’t come back once their charges are settled. Officials estimate more than 100 people will be able to take advantage. “We’ve never done anything like this before,” said Sarah Phillips, the pre-trial services coordinator with the St. Louis Circuit Court. “This is a huge shift, and it is out of recognition that we want to be part of people’s success.”

Washington faces steep path closing mental health bed gap for jailed defendants Defendants with psychiatric conditions often sit in Washington’s jails for weeks and sometimes months, waiting for mental health services before they can stand trial. That’s despite a 2015 federal court order, stemming from a lawsuit known as the Trueblood case, that found the state’s wait times unconstitutional. Washington’s been in contempt of the court order ever since. In July, Judge Marsha J. Pechman fined the state $100 million for violating the court order — the third time the state’s been found in contempt. But Washington’s officials still don’t know when the backlog in mental health services will end. Thomas Kinlen, who directs the state Department of Social and Health Services’ division in charge of Trueblood, said the state doesn’t have an exact timeline for when it expects to be in compliance with the court order — but that the department is on an “amazing trajectory.” His “optimistic hope” is to reach anywhere from 85% to 90% compliance with Trueblood a year from now.

Padilla, Tillis, Smith, Ernst Launch Bipartisan Senate Mental Health Caucus Amidst a national mental health crisis, the Senate Mental Health Caucus will serve as a forum for Senators to collaborate on and promote bipartisan legislation and solutions, hold events to raise awareness of critical mental health issues, and destigmatize mental health. The caucus will work to improve prevention and early intervention efforts, expand the country’s mental health professional workforce, enhance our nation’s crisis response services, and increase access to evidence-based mental health treatment and common-sense solutions for all Americans.


Task Force Recommends Steps to Improve Lawyer Well-Being, Professional Performance, and Public Trust in the Legal System The Task Force on Well-Being in the Law (Task Force) today released a comprehensive report with 21 detailed recommendations to address the high rates of depression, anxiety, and substance use in the legal profession. A collaboration between the Michigan Supreme Court and State Bar of Michigan, the Task Force emphasizes in the report that improving well-being is critical to professional performance, client service, and the public's trust in the legal system itself. “Our profession must take concrete, substantial steps to address lawyer well-being because well-being is an essential component of competence,” said Michigan Supreme Court Justice Megan K. Cavanagh, co-chair of the Task Force.


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