Leading Reform: Competence to Stand Trial Systems – Questions State Court Leaders Should Ask First

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.

Leading Reform: Competence to Stand Trial Systems – Questions State Court Leaders Should Ask First As state courts consider initiating reform in their competency to stand trial systems, they should first be sure that they have a clear understanding of how the current system operates. This system survey should provide a consensus vision of current system gaps, strengths, and weaknesses as measured against the Task Force recommendations. Chief Justices and other partner entities should ask the following questions about current policies (statutes and rules), and procedures.

Task Force Recommendations Implementation - Resources and News

The Criminalization of Mental Illness and Substance Use Disorder: The Criminalization of Mental Illness and Substance Use Disorder: Addressing the Void Between the Healthcare and Criminal Justice Addressing the Void Between the Healthcare and Criminal Justice Systems The criminal justice system has become enmeshed with a population it is not built to support. The punitive nature of the criminal justice system is not conducive to the therapeutic and holistic approach required to support individuals with mental illness and substance use disorder. As an individual in recovery from substance use disorder and underlying mental illness imbalances, I can attest that the issues presented in this Note are mere snapshots of the larger systemic issue. The problems and solutions presented are so interwoven, there is rarely one sweeping solution that addresses every issue. Although this Note magnifies the complexity of the general issue, I am optimistic in the continued awareness and advocacy efforts that have grown significantly over the past 20 years, especially through the efforts of the National Judicial Task Force. It is my hope that the paradigm will continue to shift, one day at a time, and a safety net will ultimately fill the void swallowing so many individuals like myself who live with the diseases of addiction and mental illness.

Research and Resources

Bureau of Justice Assistance Funding Opportunities for Courts NCSC is pleased to offer state and local courts a chance to learn about upcoming Bureau of Justice Assistance (BJA) funding opportunities for fiscal year 2024. Presenters in this April 4th webinar will detail the primary initiatives that BJA will fund and describe eligibility requirements, estimated funding amounts, and application resources.

OJJDP FY24 Family Treatment Court Program With this solicitation, OJJDP seeks to build the capacity of state courts, local courts, units of local government, and federally recognized Tribal governments to establish new family treatment courts, enhance existing family treatment courts, or expand family treatment courts at the larger state and county levels.

Trends in Mental Health and Criminal Justice State Policy This NAMI brief is intended to provide legislators with policy recommendations that support individuals with mental health conditions who are at risk of being or are justice system-involved. Recommendations are provided in five categories: Diversion, Juvenile Justice, Conditions in Custody, Competency Restoration, and Civil Commitment. Each category includes a description of policymaking trends for that topic followed by highlighted legislation passed in the prior year and links to additional legislation.

Justice-involved Individuals With Substance Use Disorder are at a Higher Risk for Suicide, Even With Just One Night in a Criminal Justice Facility The overrepresentation of suicide risk, compounded by a high prevalence of SUD/MHD in the criminal legal system, presents significant challenges in implementing evidence-based practices to prevent, identify, and provide linkages to care for individuals with a history or who are at risk of suicide.2 Given that high rates of suicides occur in the context of a recent criminal or legal stressor (often arrest and jail detention), reducing the risk of suicide after incarceration, court, or police contact could have a noticeable impact on national suicide rates.

How to Reform Correctional Mental Health Care Correctional mental health care now stands as one of the most important mental health care systems in the nation. Jails and prisons are legally obligated to serve the seriously mentally ill, whereas community-based systems are not. More effective community-based mental health remains an important goal to pursue. But equally important is the reform of corrections-based systems. Better correctional mental health care systems will benefit both community systems and the seriously mentally ill themselves. This report will explain how corrections-based systems function. It will place those systems in the context of debates around “jail abolition,” explain their workforce and financial challenges, and recommend reforms.

Criminalization of the Unhoused: A Case Study of Alternatives to a Punitive System The web of laws that criminalize homelessness is one of the systemic barriers that prevents unhoused people from transitioning to a more stable situation. This criminalization is part of a long history of exclusionary laws that furthers the oppression of marginalized groups and contributes to higher rates of homelessness. This article provides a roadmap for practitioners, academics and community activists to compel reform at the local level through a community centered advocacy strategy that redirects local governments away from punitive approaches toward more humane, community-based solutions. The proposed reforms are supported by empirical analysis, lawsuits that have successfully challenged local laws that disproportionately impact the unhoused, as well as ordinances and policies enacted in certain jurisdictions in an effort to decriminalize homelessness.

Neuroscience and the Criminal Legal System: A Humanitarian Application Framework Advancements in neuroscience call our intuitive notion of free will into question—and by implication, invite a reassessment of the United States criminal legal system and its reliance on radical personal agency. In the backdrop of the evolving landscape of neuroscience and neurolaw is an inquiry: how do we appropriately and ethically incorporate advancements of these fields into law and policy? This paper pulls that question to the forefront, advocating for a humanitarian-forward framework to guide the process. The framework emphasizes the Daubert standard, addresses the “G2i” problem, and includes a balancing test to ensure the protection of neurorights.

Protect and Redirect: America’s Growing Movement to Divert Youth out of the Justice System After decades of neglect, the youth justice field is awakening to the importance of diversion in lieu of arrest and formal court processing for many or most youth accused of delinquent behavior. Even amid rising concerns over youth crime nationwide, jurisdictions across the country are heeding the evidence by taking concerted action to address more cases of alleged lawbreaking behavior outside the formal justice system. This momentum to make diversion a centerpiece of juvenile justice reform is encouraging given powerful research showing that youth who are diverted from the justice system are far less likely to be arrested for subsequent offenses and far more likely to succeed in education and employment than comparable youth who are arrested and prosecuted in juvenile court. Greater use of diversion is also essential to reduce the persistent racial and ethnic disparities that pervade youth justice systems.

Empathetic Policing: Mason City Police Department Launches Virtual Reality Training Program to Help Officers Better Understand Behavioral Health Crises During the virtual reality training, Mason City officers are immersed into simulated scenarios to take on the perspective of the person in crisis so that they can better understand their needs, how it feels to be in crisis, and how they can support them in the moment.

Virtual Community of Practice Sessions on the Organizational Readiness for Peer Recovery Support Services (PRSS) BJA’s Access and Recovery Peer Recovery Support Services Training and Technical Assistance Center, Altarum, will begin hosting a four-part learning series that will highlight key factors and considerations in preparing organizations for the implementation of peer recovery support services (PRSS). The sessions will include an overview of PRSS services and will highlight specific models of implementation within various intercepts. Steps for successful integration and familiar challenges and barriers will also be highlighted. The sessions will offer an opportunity for attendees to share with each other and raise critical issues related to implementing a PRSS program.

Getting to Know the EBPRC Welcome to the inaugural Evidence-Based Practices Resources Center (EBPRC) e-newsletter! In an effort to more widely disseminate information on evidence-based practices, SAMHSA will now release bi-monthly updates on the EBPRC’s latest resources. The EBPRC is part of SAMHSA’s comprehensive approach to identifying and disseminating clinically sound and scientifically based policies, practices, and programs in a timely manner. It provides communities, clinicians, policymakers and others with the information and tools needed to incorporate evidence-based practices into their communities or clinical settings.

CSG Justice Briefing State-by-state criminal justice priorities; technical assistance opportunity for post-conviction assessments; community responder expansion; and more.

In the News

With Prop. 1 Passage, Gavin Newsom Again Changes How Californians With Mental Illness Get Help The Associated Press on Wednesday declared that Proposition 1 passed by the narrowest of margins, 50.2% to 49.8%. The initiative includes a $6.4 billion bond to pay for treatment beds and permanent supportive housing. Counties are now required to invest 30% of the money they receive from the state’s “millionaire’s tax” into housing programs, including rental subsidies and navigation services. Half of that will be used to target individuals who are chronically unhoused or living in encampments. Up to a quarter of the money could be used to build or purchase housing units. The second part of the measure, the bond, is divided into two parts. About $4.4 billion will go toward inpatient and residential treatment beds. The rest is earmarked for permanent supportive housing, half of which would be set aside for veterans.

400 People With Mental Illness Are Sitting in Colorado Jails. Some State Lawmakers Want to Divert Them to Treatment Instead. The legislation, House Bill 1355, would cost $1.7 million next year and nearly $5 million per year by 2027, as the program expands across judicial districts. District attorneys, public defenders and judges could refer people to the new statewide program, called Bridges Wraparound Care. The program is intended mostly for people who have been found mentally incompetent in the past, and when the alleged crime is a misdemeanor or lower-level drug felony. If the defendant agrees to enter the program, the defendant would be released on a personal recognizance bond and the judge would assign a care coordinator who would create a mental health care plan for the defendant to follow. The judge would review the person’s progress within 182 days, and could dismiss the case if the person has followed the treatment plan.

Specialty Courts Address Overload of Mentally Ill Inmates The 12th Judicial District has started a Competency Court run by a judge which meets, most of the time with the inmate virtually or in person, twice a month for an assessment. “It’s keeping the defendant top-of-mind to find effective solutions for long-term goals,” said Kelly. She said that the extra attention doesn’t cost anything because staff already has the meetings in their job descriptions. The San Luis Valley program is the ninth on-board of the 22 Colorado judicial districts, with two others on the way to establishing similar programs.

‘Lost Patients’ Podcast Episode 2: The Ethics of Involuntary Commitment Episode 2 of “Lost Patients,” the new six-part podcast from The Seattle Times and KUOW, looks at involuntary commitment in Washington state. As host Will James put it, this is one of the most delicate questions our society faces. “When does our own belief that we know what’s best for someone override their rights to decide what happens to their own bodies and minds?” he asks. “What is the right balance between those two things?”

On the Law: Problem-solving Courts Address Roots of Crime “It is easy, through institutional indifference, to allow a life to waste. It is much harder to nurture a life in trouble. We want to work harder and do better.” This quote was taken from the remarks delivered by Chief Judge Rowan Wilson during the State of the Judiciary address on Feb. 27 at the Court of Appeals in Albany. “It is time to expand that approach — in which courts, parties and other participants work to achieve results superior to those that can be obtained by merely deciding who is right or applying a stock response to problems that superficially seem identical. When one takes enough time and care to understand the human beings enmeshed in those problem, we see that each case is different and calls for a highly tailored, careful and compassionate response,” Wilson explained. During the hour-and-a-half presentation, several problem-solving courts from across the state were highlighted, including showcasing successful participants who were willing to share their experiences.

State Launching Program to Increase Access to Forensic Fitness Evaluations Under the new system, a county attorney may request a judge specify that a court-ordered forensic fitness evaluation be completed locally. If approved, the county attorney’s office can select from a list of providers currently performing these services. The state said the community-based evaluations can occur in jails, the provider’s office, in private hospitals, other community-settings, or via telehealth. Once the evaluation is done, the county attorney will complete a form allowing the provider to bill DPHHS.

Pretrial Diversion Programs Are Effective. And Expensive for Participants. A 2020 Alabama Appleseed report that surveyed over 1,000 Alabamians who had been in the criminal justice system found that the median cost of enrolling in a diversion program was $1,600. Meeting that obligation was a struggle for many of the survey participants because most were on the lower end of the economic scale. Roughly 55% were earning less than $15,000 annually. About two thirds of the participants made less than $20,000 per year. Jefferson County is trying a different approach. In March 2022, the local district attorney’s office launched the Reset Program. For no charge, people who had a run in with the law could spend one Saturday participating in a workshop.

States Seek Ways to Keep Veterans out of the Criminal Justice System Last year, the Veterans Justice Commission published its first set of recommendations for changes that could help veterans avoid prosecution and incarceration. This begins with identifying veterans as such when they come into contact with law enforcement. Most do not volunteer their veteran status, feeling they have dishonored it. Police rarely ask. VA search services do exist but are seldom used. Confusingly, federal and state regulations and statutes have varying definitions of “veteran.” The commission has called for changes to federal and state policy that could improve identification processes in criminal justice systems and courts.

Kansas Inmates Wait in Jail for Months for Mental Health Treatment. That Might Change. The state hospitals have long been plagued by a waitlist that leaves some inmates languishing in jail up to 14 months before they are ever treated. Douglas County Sheriff Jay Armbrister said inmates can spend more time in jail waiting – without ever being convicted – than the prison time they are ultimately sentenced to. The county has long provided mental health services to Douglas County inmates, but they have not been able to help when an inmate refuses care. Only the state hospitals had the authority to mandate mental health care to restore competency. The recent law change means the local mental health care providers can also administer those mandated services at their community facility. Schmitz said it’s an important step to shortening the waitlist at the state hospitals.

Mental Health Funding Removed in Kentucky Lawmakers in Kentucky have removed funding that keeps people dealing with mental illness out of jail. Funding for mental health programs such as Assisted Outpatient Treatment (AOT) was cut from the current Kentucky House budget.


The Origin and Evolving Mission of Lawyer Assistance Programs Today, nearly every state has a Lawyer Assistance Program (“LAP”). Some are funded through bar dues, some through the Administrative Office of the Courts, and others through the financial contributions of legal malpractice insurance carriers, to name a few. The structure and operating practices of the LAPs can be as wide-ranging as the funding of our programs. But no matter the structure or source of funding, the intention is to help the lawyer who may have issues that impair or could likely impair their ability to practice law.

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