Violence and Mental Illness Myths and Reality

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.

Violence and Mental Illness Myths and Reality Even though mental health is more openly discussed and accepted today than in the past there is still an ongoing concern regarding issues of violence and the common misperception that people with mental illness are far more dangerous than others in society. With this misperception and all its associations, persons with mental illness are at risk for being over-incarcerated, over-institutionalized, and marginalized in society. This Mental Health Facts in Brief will provide an overview of the all too often over-emphasized relationship between mental illness and violence.

Task Force Recommendations Implementation - Resources and News:

Building a Better Mental Health Court: New Hampshire Judicial Branch Establishes State Guidelines Unlike drug courts, which have been informed by national standards for 10 years, mental health courts (MHCs) have developed without national guidance. This January, after receiving support from The Council of State Governments (CSG) Justice Center, New Hampshire became one of a growing number of states to establish statewide governing documents for MHCs, such as guidelines, principles, and best practice standards. Released by the New Hampshire Judicial Branch, the Guidelines for New Hampshire Mental Health Court Teams provides a framework of best practices to guide program development and operation.

Research and Resources

All Rise Expands Treatment Court Model to Lead Comprehensive Justice System Reform After nearly 30 years of leading the treatment court movement, the National Association of Drug Court Professionals (NADCP) announced today that the organization has rebranded as All Rise to better reflect its impact across the justice system. All Rise also announced a new structure to execute its vision to impact every intercept point of the justice system. Going forward, the organization will operate through four divisions:

  • The Treatment Court Institute, formerly known as the National Drug Court Institute
  • Impaired Driving Solutions, formerly known as the National Center for DWI Courts
  • Justice for Vets
  • The Center for Advancing, a new division for All Rise, identifies, assesses, and implements programs at every intercept of the justice system, with a focus on evidence-based and promising interventions for people impacted by substance use and mental health disorders.

Developing Consensus for Culturally Informed Forensic Mental Health Assessment: Experts’ Opinions on Best Practices The present study identified 28 practices that experts largely agreed are important for incorporating cultural considerations in forensic evaluations and a number of other relevant practices to consider implementing. Forensic evaluators and supervisors can use these practices to more effectively answer psycho-legal questions for examinees with a range of marginalized or minoritized identities.

Promoting Healing and Avoiding Retraumatization: A Proposal to Improve Mental Health Care for Detained Unaccompanied Minors Through a Best Interests of the Child Standard Although youth in general struggle with mental illness, a staggering “70% of youth in the juvenile justice system have a diagnosable mental health condition.” Providing mental health care to those UACs over whom the government has complete control will be a crucial step to resolving this nationwide problem. The best solution is for Congress to institute a best interests of the child standard by which to judge the sufficiency of mental health care provided to detained UACs, which courts will then interpret and apply in future cases.

Practical Guide for Implementing a Trauma-Informed Approach This new SAMHSA guide highlights the need for organizational assessment of readiness and capacity before implementing TIA and describes strategies for such assessments. The guide focuses on implementation strategies across 10 domains. The guide is intended for anyone involved in organization-level change, including practitioners, state and local officials, policymakers, federal and non-federal funders, peers, and family members.

TAC Research Weekly: ACT programs decrease substance use for people with SMI Substance use disorders are estimated to be present in 45% of people with serious mental illness. People with serious mental illness who use substances such as tobacco, alcohol, or drugs are more likely to have more frequent hospitalizations, more severe symptoms, poorer medication adherence, and a higher death rate. Decreasing the frequency and severity of substance use among people with serious mental illness is crucial. Overall, results from this review suggest that participating in ACT can decrease the severity of substance use for people with serious mental illness, but the results also suggest that ACT is not more effective than typical treatments at improving substance use outcomes for people with serious mental illness.

988 Implementation in Rural Communities Addressing and preventing suicide and other mental health and substance use crises in rural areas can be particularly difficult. Challenges include communities being spread across vast geographic areas with limited services (e.g., behavioral health, transportation), the low numbers of trained providers, the scarcity of emergency services (emergency departments, crisis centers, etc.), and ongoing stigma regarding mental health and substance use issues. Communities interested in learning more about implementing or improving 988 in rural areas have a number of resources available to them.

Using Responsivity Principles to Attain Better Results for People with Behavioral Health Needs in the Justice System The Council of State Governments (CSG) Justice Center and the Bureau of Justice Assistance (BJA) will host part two of the fieldwide webinar series on the risk-need-responsivity (RNR) model. Building on the first session, which covered the 18 components of the expanded model, session two will focus on RNR with individuals who have behavioral health needs and how responsivity principles can help address those needs as well as criminogenic needs.

Improving Police and Mental Health Partnerships for Youth in Crisis During this webinar, participants will learn about New Jersey’s Mobile Response and Stabilization Services (MRSS) program, which connects families anywhere in the state to a behavioral health worker at any time to provide immediate support for youth in behavioral health crisis.

AOT Judge's Web Chat Whether you’ve been involved in assisted outpatient treatment for a long time, are just getting started, or are still undecided as to whether AOT is right for you and your community, this discussion is for you. Use this opportunity to share what you’ve learned about how to engage participants in treatment, ask your peers questions about how they handle difficult situations, or just listen and take in what others are saying. Please join us on Tuesday, July 25 at 3 p.m. ET. Note that this is a closed group for judicial officers only.

Judges and Defense Attorneys:  Register Now for Practitioner Training Registration is open for practitioner training for treatment court judges and defense attorneys from NADCP's National Drug Court Institute (NDCI)! These four-day, in-person trainings will be held in Oklahoma City and facilitated by national experts. Research confirms that individualized training and role-specific education improves treatment court outcomes.

Free Police-Mental Health Collaboration Support Available Looking to build a data plan for police-mental health collaboration in your community? The CSG Justice Center is offering short-term, free support to agencies and jurisdictions that will focus on data collection and performance metrics. This opportunity will include online training, consultation with subject matter experts, policy review, and peer connections.

Catching Up with COSSUP This edition includes resources for Juvenile Deflection, best practices for retaining peer recovery support specialists, and a multisite study of Law Enforcement Assisted Diversion in North Carolina.

The Never-Ending Murder Case: How Mental Competency Laws Can Trap People With Dementia A report last year from the American Bar Association, which surveyed legal professionals, healthcare workers and corrections staff nationwide, found one of the biggest problems in dealing with dementia was “the almost unbending insistence of the courts to seek restoration.” The authors recommended that people with dementia no longer be hospitalized for competency restoration at all, as it “has little chance of success [and] may be harmful.” Instead, many healthcare workers and corrections officials said communities need more long-term nursing facilities with tighter security and well-trained staff. These homes could safely house people with a history of aggressive behavior, rather than locking them in jail or a psychiatric hospital — which may not be able to provide the specialized care they need.

In the News

Address the needs of the seriously mentally ill: N.Y.’s former top judge makes the case for better treatment for those like Jordan Neely Just a few months before his death, Neely had been released from jail after spending 15 months in pretrial detention on Rikers Island, an experience that undoubtedly exacerbated his mental health struggles. Upon his release, Neely was not simply cut loose into the city. Instead, a judge directed him to receive months of much-needed mental health support at an in-patient treatment center. After just two weeks though, Neely walked out the front door. Within months, he was dead. “Jordan would have been alive if they made sure he stuck around to get the treatment he needed,” his uncle, Christopher Neely, was quoted as saying. His uncle’s frustration reflects a refrain I heard constantly during my decades in the court system, first as a prosecutor and later as a judge. Rational and compassionate people who work in the criminal justice system have been frustrated as well. They know that our system is simply not equipped to deal with high-need people like Neely — the binary choice too often is unjust incarceration or insufficient support.

Chief Justice Paul C. Wilson delivers 2023 State of the Judiciary Increasingly, Missouri courts are finding themselves on the front lines of a growing mental health crisis in this country. Too often, we are confronted with individuals manifesting mental health conditions so profound they are not even competent to stand trial. Medication, case management, and treatment can often restore competency, but delays in getting defendants into traditional in-patient facilities leaves them - and our courts - stuck in limbo, unable to move forward or back. This is why the Missouri Justice Reinvestment Initiative recommends you strengthen efforts to bring competency restoration services to the defendants where they are. By using mobile medication and case management teams - and by empowering local behavioral health clinicians - we can get more help, sooner, to those who need it; restore their competence; resolve the charges against them; and return them to their communities - and to community-based care - as soon as possible.

Oregon State Hospital agreement would allow for flexibility on stay limits, pending judge’s sign-off A federal judge in Portland indicated Thursday he would sign off on new changes to the Oregon State Hospital’s admissions and discharge procedures for people charged with crimes who are deemed too mentally ill to assist in their own defense or stand trial. Broadly, these new changes before Judge Mosman provide more flexibility. They would allow some patients charged with serious crimes an avenue to potentially remain at the hospital longer. They would also prevent those charged with the lowest level crimes from ever going to the state’s psychiatric hospital in the first place.

Mental health center will bridge gaps in the Pee Dee A behavioral health hub in Florence is expected to improve the mental health of Pee Dee residents, provide jobs for Francis Marion University graduates, ease the burdens of finding treatment for probate courts and reduce crime, officials said June 15. The state will provide up to $100 million in staff funds and the city of Florence will provide $5 million for the project. A Florence-based behavioral health center also will help law enforcement and the probate court system. “We jockey with 45 other counties to get our patients on a waiting list for beds in Columbia,” Florence County Probate Judge Cartrette said. “They either have to go back home in the less volatile cases where they can wait, or go sit in a county jail until a bed becomes available.”

Bill Veto by Gov. Stitt Means Delays for Inmate Mental Health Evaluations The bill had support from offices across Oklahoma including law enforcement, the court system and mental health. Undersheriff Jon Sappington said the system is failing people with mental health issues who get arrested, because they are sitting in a jail cell for months, even years, before getting an evaluation or the help they need. "They wind up in a cell just like this [shows a small cell] and so this is where they sit for two years,” said Sappington.

A Murder Suspect Has Spent 7 Years in The Hilo Jail Without a Trial A Big Island man accused of murdering his wife and two children in 2016 remains locked up in the Hilo jail seven years later with no trial or resolution of the charges in sight, his case stalled by years of inquiries into his mental health. Retired Third Circuit Court Judge Ronald Ibarra, who served as a Big Island judge for 28 years, said he dealt with many cases that required mental exams, but never had a case drag on nearly as long as Hoffman’s with no resolution. “I don’t know the specific facts in this case, but on its face, seven years, the length of time is a long time,” he said. Ibarra also wondered why Hoffman remains at the Hawaii Community Correctional Center so many years after the murders if the authorities consider him to be mentally unfit for trial. “If the person is not fit to proceed, and the state is trying to medically get them fit to proceed, then it should be at the state hospital if (he is) in custody,” Ibarra said.


How Are You Holding Up? Recurrent experiences of serious stressors place judges at risk of burn- out, secondary trauma, poor mental and physical health, and substance use disorders. With this article, we aim to encapsulate the core findings of the National Judicial Stress and Resiliency Survey for a judicial audience. We also offer that came to a head as the survey was going to press in 2020 and that continue to affect judges and courts today.


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