Secondary Trauma and the Courts

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.

Secondary Trauma and the Courts Witnessing family tragedies, hearing stories of violence, and listening to difficult testimonies are recurring and persistent experiences for judicial officers and practitioners working in the justice system. In fact, 63 percent of judges have at least one symptom of vicarious trauma2 and 50 percent of child protection staff experience high or very high levels of compassion fatigue.3 It is easy to see how these daily interactions with individuals, children, and families who are reliving trauma takes an emotional toll on justice system practitioners and places them at high risk for experiencing secondary trauma. Courts should focus on developing a justice system culture that mitigates the effects of working with survivors of trauma and violence. This type of culture serves as a foundation to implement strategies to address secondary trauma on both the systemic and individual practitioner levels.

Task Force Recommendations Implementation - Resources and News

Multnomah County judge in center of Oregon’s mental health crisis Judge Nan Waller sits in the center of Oregon’s mental health crisis. She oversees the mental health court for the state’s largest county, a voluntary program that helps people stay on treatment, receive social services and reduce their time on probation. She also presides over competency hearings for hundreds of defendants a year to determine whether they need community programs or treatment at the Oregon State Hospital to stand trial.

NSSC Pro Talk - AOT The National Shattering Silence Coalition's premier educational live professional talk featuring the Honorable Judge Milton Mack presenting on Assisted Outpatient Treatment (AOT) successes and how to implement AOT in your state.

Research and Resources

More Than 1 in 9 Adults With Co-Occurring Mental Illness and Substance Use Disorders Are Arrested Annually As this PEW analysis showed, adults with co-occurring disorders in the United States from 2017 to 2019 were over-arrested and undertreated. Given that 60% of those who are arrested with mental illness also have co-occurring substance use disorder, focusing on this intersection is important for both policy and practice. In fact, this analysis found that adults with co-occurring disorders were more likely to be involved with the justice system than those with mental illness alone, and few received treatment for both substance use and mental illness. Implementing evidence-based solutions that increase and improve treatment for co-occurring disorders could reduce justice system contact and produce better public health outcomes for those with co-occurring disorders.

New Resource: Maintaining Fidelity to ACT: Current Issues and Innovations in Implementation SAMHSA has issued a new practical guide on Maintaining Fidelity to ACT: Current Issues and Innovations in Implementation. To support continued efficacy of Assertive Community Treatment (ACT), it is critical to reaffirm its fundamentals and promote awareness of new developments relevant to implementation of the model.  Serving as a follow-up and companion product to SAMHSA’s Assertive Community Treatment (ACT) Evidence-Based Practices (EBP) KIT, this product reviews the principles of ACT; summarizes contemporary issues impacting ACT teams; and examines aspects of ACT implementation and outcomes when teams extend the model to specific target populations and settings.

New Resource: Best Practices for Recovery Housing This document updates a prior Recovery Housing Guideline and now outlines best practices for the implementation and operation of recovery housing that is intended to serve as a tool for states, governing bodies, providers, recovery house operators and other interested stakeholders to improve the quality of housing programs, protect residents’ rights, reduce incidence of overdose, and promote long-term recovery from substance use and co-occurring disorders.

New Guides Available to Help Communities Respond to the Opioid Overdose Crisis SAMHSA released two important resources intended to aid community practitioners in the ongoing work to end the overdose crisis. “Engaging Community Coalitions to Decrease Opioid Overdose Deaths” and "Opioid-Overdose Reduction Continuum of Care Approach (ORCCA)” are available for free online. These products will equip public health practitioners, coalitions, nonprofits, and other groups working to prevent opioid-related death in their local communities with knowledge and best practices.

New Resource: Best Practices for Successful Reentry from Criminal Justice Settings for People Living with Mental Health Conditions and/or Substance Use Disorders This SAMHSA guide examines the types of interventions that support successful reentry for adults with mental health conditions and/or substance use disorders who are leaving jail/prison.

Seeking shelter from mass incarceration: Fighting criminalization with Housing First For this briefing, we examined over 50 studies and reports, covering decades of research on housing, health, and incarceration, to pull together the best evidence that ending housing insecurity is foundational to reducing jail and prison populations. Building on our work detailing how jails are (mis)used to manage medical and economic problems and homelessness among formerly incarcerated people, we show that taking care of this most basic need can have significant positive downstream effects for public health and safety.

Alternatives to Prosecution and Incarceration for Justice-Involved Veterans: A Model Policy Framework The policy framework outlines alternative sentencing options that not only recognize veterans’ service, but also that their criminal behavior may have been influenced by that service. The options, which include expanded use of pretrial supervision and probation in lieu of a record of conviction or incarceration, are grounded in evidence-based practices used in problem-solving courts and community supervision. The Commission also encouraged jurisdictions to pass laws enabling veterans whose cases are processed through such options to file for record expungement.

TAC Research Weekly: Trade-offs between civil commitment and competency restoration A new study by Dr. Joe Bloom and colleagues examined the relationship between individuals found in need of competency restoration and civil commitment admissions in Oregon. They found a strong negative correlation between these two admission types, suggesting “neglecting civil commitment may well have contributed to the CST [competency to stand trial] crisis in Oregon.” While correlation does not mean causation, these data are the closest evidence to suggest that the increase in the number of people needing competency restoration, and the subsequent lawsuits requiring speedy admissions to state hospitals, may be inadvertently criminalizing serious mental illness.

Webinar: Navigating the Bipartisan Safer Community Act (BSCA) The Bipartisan Safer Community Act (BSCA) became law in June 2022 with the aim of preventing firearms from getting into the hands of individuals who pose a potential threat to themselves or others. One aspect of the BSCA focuses on individuals aged 18 to 20 who might be restricted from purchasing firearms if they have disqualifying juvenile adjudications or mental health records. The FBI's National Instant Criminal Background Check System (NICS) collaborates with state and local authorities to enforce this provision.  NCSC invites state courts to join us for an insightful webinar to hear from the FBI about their processes for accessing juvenile data for NICS and from SEARCH on how to access technical assistance.

Maximizing Public Funding Streams to Expand Access to Evidence-Based Substance Use Disorder Services This Center for Health Care Strategies (CHCS) webinar, made possible by and in partnership with The Pew Charitable Trusts (Pew), will showcase a new resource to guide states in strengthening SUD treatment services by maximizing available public funding sources, such as Medicaid – which has greatly expanded coverage of SUD services under the Affordable Care Act – and new funding streams, including opioid settlement dollars.

LEAP & AOT (Assisted Outpatient Treatment) - With TAC LIVE 2.5 hour webinar, sponsored and co-presented by the Treatment Advocacy Center, is created for Criminal Justice and Mental Health Professionals to attend at for FREE — including Judges, Attorneys, Court Staff, Social Workers, Case Managers, and others who work with people with severe mental Illness (SMI). Participants will be introduced to a novel communication approach (LEAP), and a court-ordered treatment practice (AOT) that lead people with SMI to engagement and recovery.

Justice, Treatment, & Recovery: The Intersection of Behavioral Health and the Justice System Join this Harmony Foundation webinar to gain insight from Jessica Swan into the US’s Justice System and how we respond to mental illness and substance use disorders. We will consider: What is Justice? And how does this relate to mental illness and substance use disorder? We will inspect the numbers and what they tell us about our responses to mental illness and substance use disorder. Additionally, we will discuss what types of treatment are being integrated into the corrections system, their effectiveness, and the alternatives to incarceration.

In the News

Judge rules against Marion County over Oregon State Hospital patients, but county fights back Marion County judges have tried to bypass a federal court order in a dispute about treating suspects in the Oregon State Hospital. But on Monday, the federal judge involved in the case lashed back, saying that, according to the U.S. Constitution, federal courts are higher than local courts and thus their orders can’t be ignored. In his ruling on Monday, Mosman wrote that these orders from Marion County judges are “void” when the patients are eligible for release under his order because under the U.S. Constitution, federal law takes precedence over state or local law.

Montana State Officials Seek More Control Over Judicial Involuntary Commitments State health officials are asking lawmakers to change criminal commitment laws so the Montana Department of Public Health and Human Services has a say before a judge orders a patient committed to the Montana State Hospital or another state-run facility. But Republican Rep. Jennifer Carlson, a member of the interim committee, said that there is nowhere else to send patients facing criminal charges for evaluation and treatment, and that the health department should focus on improving patient care instead of denying patients access.

988 mental health crisis line adds sign language services The U.S. Department of Health and Human Services (HHS) announced Friday that it would add American Sign Language (ASL) services to the government’s 988 Suicide and Crisis Lifeline as part of efforts to expand behavioral health care services for underserved groups. Those seeking to be connected with a 988 Lifeline counselor who is trained in ASL will now be prompted to click on the “ASL Now” button on and follow the instructions.


APA calls for removal of mental health questions on applications to practice law People seeking to be licensed as attorneys should not be required to reveal their mental health history, including whether they have ever had a mental health diagnosis, according to the American Psychological Association. “[S]tatistical data reveal that there is no connection between bar application questions about mental health and attorney misconduct and that such questions have not been empirically shown to work as a successful screening tool for who can and cannot practice law in a competent manner,” the resolution states. Thirty-seven states and the District of Columbia include one or more questions on their character and fitness questionnaire referencing the mental health status of applicants

The Rise and Fall of the Mental Health Inquiry for Bar Admission The legal profession suffers from a mental health crisis, and it continues to lose lawyers to suicide and substance abuse. The mental health crisis not only affects the lawyer, but also their career, loved ones, clients, employers, and the justice system. This Article discusses the profession’s attention to the mental health crisis. From its origins as an exclusionary characteristic to its more humane considerations of lawyer and law student well-being, this Article traces the evolution of the legal profession’s challenge in addressing the real concerns of mental health among its members.


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