Diversion - A Pathways Approach

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 an original Task Force resource or a new resource that supports a Task Force recommendation.

Diversion - A Pathways Approach The often siloed relationship between the criminal justice, civil, and the mental health treatment systems needs to be redesigned so that all stakeholders work together as partners to use resources more efficiently, make the most effective services the norm, and thereby achieve the best outcomes for this population more consistently. At each point of interaction with each these systems, beginning with crisis response and continuing through reentry, active efforts to find diversion pathways – offramps from the traditional criminal justice road – should be systematically undertaken, and a continuum of diversion options and access to treatment and recovery must be developed and available in every jurisdiction.

Task Force Recommendations Implementation - Resources and News:

Judges and Psychiatrists Convene for the JPLI  Train-the-Trainer Event Teams of judges and psychiatrists from 13 states participated in a train-the-trainer event in Washington, DC, earlier this month. JPLI offers training for judges, titled Judicial Work at the Interface of Criminal Justice and Behavioral Health, to any interested state or territory in the United States. The project is a collaboration among the American Psychiatric Association Foundation, the Council of State Governments, and the National Center for State Courts. Jurisdictions can apply for this judicial training online.

Research and Resources

Juvenile Competency Restoration Researchers now find mental health disorders prevalent among juveniles in the justice system, with up to 70% having a diagnosable mental health problem. It is inappropriate to think of adolescents as younger versions of adults whose behaviors can be viewed through the same lens as adult behaviors. This Lewis and Clark Law Review Article will explore some of the causes and conclusions about why many juveniles are not competent and why many of them may not become legally competent.

Rewriting Kendra’s Law: A More Ethical Approach to Mental Health Treatment While New York’s current AOT statute has proven effective in its intention, it does not practically allow afflicted persons suffering from a severe and persistent mental illness to receive the benefits that modern medicine can provide. There is demonstrable evidence that proves modern medicine can effectively provide these persons with the clarity to make an informed decision to accepting treatment, but such ability is predicate on the medical community having the opportunity to deliver such persons the clarity to so decide.

Out of Sight, Out of Mind: Removing Unhoused People by Proxy of Mental Illness Across the United States, various legal mechanisms have subjected unhoused people to cruel practices that seek to remove them from public view. Since 2022, a second wave of removal has emerged. California and New York City have both enacted initiatives, shrouded under the guise of a "compassionate" and "transformative" framework of moral obligation, that continue to target and remove unhoused people, this time by proxy of mental illness. This article argues that this trend, which attempts to circumvent the unconstitutional criminalization of unhoused people, is concerning and misguided. Although touted as a mechanism for moving away from police interaction, conservatorship, and involuntary treatment, the practical effect of both initiatives is to create a new quasi-criminal framework that will likely increase the use of these measures.

When Specialized Housing Providers Lead Reentry Case Planning Did you know that specialized housing providers can serve as the lead agency in a reentry case planning process? CSG’s newly updated web tool offers a glimpse into the kinds of information that specialized housing providers and their partners will need to share to build collaborative case plans and spotlights a program in Pima County, Arizona, already seeing success.

Public Health Meets Public Safety – A New Tool for California Policymakers In California, policymakers are using data to inform efforts that reduce the number of people with behavioral health needs in the criminal justice system. As part of this innovative work, the Council on Criminal Justice and Behavioral Health (CCJBH) commissioned the development of a research-based framework to help stop what is often referred to as the “revolving door” of involvement in the justice system. This first-of-its-kind effort marks a significant step toward data-driven policymaking in a notoriously complex subject—the intersection of criminal justice and behavioral health.

Six Strategies to Prevent MOUD Diversion in Jail-Based Treatment Programs Diversion of medication for opioid use disorder (MOUD) treatment is often cited as a concern and a reason for not offering the medications in jails and prisons. Researchers from the University of Massachusetts published a study in 2023 that detailed promising practices in program design to help limit medication diversion.  The study also details guidance for corrections and lawmakers as they consider implementing MOUD treatment in correctional settings.

Essentials of Care for Individuals with Serious Mental Illness: A Learning Lab Series Fall 2023 Learning labs are brief instructor-led virtual sessions that are focused on a particular topic area relevant to recovery-oriented care for SMI in a range of clinical settings. This series is appropriate for direct service providers and allied professionals who help support individuals living with SMI; particularly for individuals just entering the field in positions such as case manager, peer support, SUD professionals, nursing, and housing and employment specialists. This is an entry level training opportunity to learn best practice strategies that can be implemented in your work with individuals experiencing SMI to support recovery.

Courts’ Hidden Reliance on Interpersonal Influence Affects Individuals with Psychosocial Disabilities Researchers from the Mental Health, Ethics and Law Research Group at King’s College London explored the intricate ways that interpersonal relationships influence legal judgments on decision-making capacity. The study was published in the Medical Law Review. Their insights show that legal assessments of capacity are not made in isolation but are deeply influenced by the context of personal relationships. The article emphasizes the need for more precise guidance and understanding in this area, to ensure that the rights and autonomy of individuals, particularly those with intellectual and psychosocial disabilities, are properly protected and respected in legal proceedings.

TAC Research Weekly: NIMH funding priorities still failing people with SMI To determine the current state of NIMH funding for SMI research, the authors of this study reviewed the ClinicalTrials.gov and NIH Research, Condition, and Disease Categorization (RCDC) databases to identify research funded by NIMH from 2017 to 2022. Findings suggest that throughout this six-year period, NIMH has funded only one drug trial for schizophrenia and one for bipolar disorder. In addition to this low number of drug trials, NIMH has also reduced its funding for all SMI research. While NIMH decreases funding for SMI research, people with schizophrenia and bipolar disorder continue to experience homelessness, incarceration, and premature death at rates much higher than the general population.

JPLI Newsletter A pretrial behavioral health diversion program and the recent JPLI Train the Trainer event (above) are highlighted.

CSG Justice Briefing Stepping Up participation linked to robust behavioral health care delivery systems; call for All Rise session proposals; specialized housing provider infographic; and more.

Sozosei Summit 2024 Save the date: April 16-17, 2024. The Summit brings together a diverse, global audience, including thought leaders, people with lived experience, medical professionals, lawyers, judges, advocates, artists, and funders, to build a world where mental illness is not a crime.

In the News

People With Mental Illness Are Now Waiting Less Than a Week in Jail Before Admission to Oregon State Hospital The Oregon Health Authority, which runs the state’s psychiatric hospital, tells WW it believes it’s once again in compliance with the 2002 “Mink Order.” That order, made by a federal judge more than two decades ago, requires the hospital to admit people deemed too mentally ill to defend themselves in court within one week. The milestone is a step toward ending this latest round of legal scrutiny of the hospital. Judge Mosman’s order requiring the hospital to discharge patients early ends if an external expert determines the hospital has been in compliance for three months—and that eliminating the new release policy wouldn’t jeopardize continued compliance.

22 Wash. Counties Sue the State Over Lack of Mental Health Care The legal challenge deals with what are known as “civil conversion” patients, criminal defendants whose competency to stand trial can’t be restored and who are then handed over to DSHS to evaluate whether they should be civilly committed to a psychiatric facility. The lawsuit contends that DSHS has “selectively refused admission to civil conversion patients since at least December 2022 and, on information and belief, has refused to admit any civil conversion patients for statutorily required civil commitment evaluations” since July 13.

States look to involuntarily hospitalize people to confront growing mental health crisis Across the country, states are trying to tackle the growing mental health crisis. Some are enacting laws and policies that would make it easier to hospitalize or detain the severely mentally ill against their will or through voluntary court-ordered treatment. California is taking steps toward compelling more mentally ill patients into care. PBS News Hour looks at how that is playing out in San Diego.

NV Supreme Court upholds fines against state for delaying defendants’ mental health care The Nevada Supreme Court on Thursday upheld a lower court’s decision to impose fines against the state agency responsible for delays in providing treatment to criminal defendants found mentally unfit to stand trial. The case centered around contempt orders involving 11 criminal defendants who were deemed incompetent to stand trial and set to be transported to psychiatric facilities for treatment. As of court filings from last October, one defendant, Dana Gee, had waited at Clark County Detention Center for more than 116 days to be transferred. Another defendant, Carlos Guzman, waited more than 101 days. The Division of Public and Behavioral Health must continue paying $500 for every day that a criminal defendant's transfer to a psychiatric facility is delayed.

Judicial commission on mental health schedules 9 town hall meetings As a follow-up to Kentucky’s first mental health summit held earlier this year, the Kentucky Judicial Commission on Mental Health will host a series of nine town hall meetings in communities across the state, Aug. 30-Nov. 29. The meetings are being held to garner input for changing how the justice system addresses people with challenges involving mental illness, substance use and/or intellectual and developmental disabilities.  The commission wants to hear from people and/or their families with lived experience in this area as well as business owners, civic leaders and anyone else with an interest.


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.


COSCA logo

NCSC logo