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 Sixty-three percent of judges have at least one symptom of vicarious trauma and 50 percent of child protection staff experience high or very high levels of compassion fatigue. 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. Most courts have little training or resources to respond to secondary trauma. If left unaddressed, secondary trauma may have an adverse effect on the ability of practitioners and systems to effectively work with individuals, children, and families. Other potential negative justice system effects include increased absenteeism, lower productivity, higher staff turnover, and decreased morale. Justice systems that aim to be trauma-informed must recognize and understand the impact of secondary trauma on judges, employees, and other practitioners in the system.

Task Force Recommendations Implementation - Resources and News

Responses to the Mental Health Crisis in the Justice System A virtual panel event on Tuesday, April 16 will feature New Jersey Supreme Court Justice Lee Solomon and a lineup of experts covering a broad range of topics related to mental health in the justice system. The free event will take place from 3 to 5 p.m. ET and is sponsored by the William J. Hughes Center for Public Policy at Stockton University. The livestream can be viewed on the Hughes Center’s website and YouTube channel. A video recording of the program will also be archived on the center’s website and YouTube for later viewing. The panelists include:

  • Justice Lee Solomon, associate justice of the New Jersey Supreme Court. He is chair of the court’s Committee on Wellness in the Law.
  • Timothy McGoughran, president of the New Jersey State Bar Association.
  • Judge Nan Waller, Multnomah County Circuit Judge in Portland, Oregon. She presides over a mental health court and competency docket.
  • Judge James Bianco, judge of the Superior Court of Los Angeles. He presides over a full-time mental health courtroom and works with a program that diverts those with mental illness from the criminal justice system.
  • Retired Recovery Court Judge Mark Sandson. He is vice chair of the N.J. Judiciary Opportunities for Building Success (JOBS) program, which aims to secure employment for probation clients.

The panel will explore initiatives and diversionary programs that aim to assist those with mental health issues who enter the criminal justice system. Waller and Bianco, members of the National Judicial Task Force to Examine State Courts’ Response to Mental Illness, will provide their insight.

$50M Proposal for Reforming Baker and Marchman Acts The bill would, among other things, give mental health service providers and judges easier access to records that would help them determine the most appropriate care, create an “Involuntary Services” statute and a streamlined petition process to make it easier for people to access treatment, give law enforcement more discretion, lift a 30-bed cap for “crisis stabilization units” and dedicate half of the $50 million appropriation to enhancing “involuntary services.” Maney said the reforms were inspired by his experience on the bench, his service on a Supreme Court committee, and his collaboration with Miami-Dade County Judge Steven Leifman, a noted expert on mental health and the courts. Leifman spent the past 23 years promoting the Miami Center for Mental Health and Recovery. Set to open later this year, the center will treat people who would otherwise cycle through the courts.

Research and Resources

Effectiveness of Substance Use Disorder Treatment as an Alternative to ImprisonmentNationwide register data from Sweden was used to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism. The cohort included 11,893 individuals who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points in substance misuse, 5 percentage points in adverse mental health events, 9 percentage points in adverse somatic health events, and 3 fewer charges for crime in difference-in-differences analyses.

The Restatement of Law on Juveniles' Adjudicative Competence and Rights in Interrogation: Evidence of Progress Part 3 of the Restatement of Children and the Law, “Children in the Justice System,” reflects recent dramatic reform in juvenile law and practice. The reform recognizes that kids are different, requiring special attention to protecting due process when the justice system must make decisions in delinquency cases. The Restatement’s analyses use neuroscientific and psychosocial developmental research that has improved our understanding of children’s and adolescents’ immature decision-making capacities and psychosocial vulnerability compared to adults. This developmental perspective has led to extensive reform of laws and practices that seek to better protect juveniles’ due process rights when in custody of the juvenile justice system.

Conceptual Framework and Strategic Considerations for Modernizing Behavioral Health Systems Experts identified the organizing principle for a modern behavioral health system as one in which people get “what they need, when and where they need it.” This moves away from a disconnected and under-resourced system with limited access to high-quality interventions. The principle harkens to the core vision of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Description of a Good and Modern Addictions and Mental Health Service System” that outlines the essential services needed for a “transformed and integrated system” and provides clarity, guidance, and support to federal and state agencies involved in regulating, purchasing, expanding, and financing services. This resource rests on that vision and reflects the evolving behavioral health landscape.

New Resource: Financing Peer Recovery Support: Opportunities to Enhance the Substance Use Disorder Peer Workforce This report and webinar explores and summarizes the financing, utilization, and regulatory structures of providing peer recovery support services (PRSS) for substance use disorder (SUD) recovery process within federal grant programs and state Medicaid programs. Based on analyses and input from an expert panel of behavioral health peer services experts, the report identifies challenges and opportunities to finance and strengthen the PRSS workforce.

Center for Financing Reform & Innovation (CFRI) The Center for Financing Reform and Innovation (CFRI) is a SAMHSA contract that seeks to understand financing mechanisms of behavioral health care to identify opportunities, innovations, and challenges to service delivery and access. CFRI provides SAMHSA with a dynamic mechanism to further its leadership and the field on immediate and relevant behavioral health financing and delivery issues.

New Release: Dismiss Upon Civil Commitment with AOT Handbook The Treatment Advocacy Center (TAC) has developed a handbook to help communities move quickly from the discussion phase of this process to the “just do it” phase. “Dismiss Upon Civil Commitment with AOT: One Alternative to the Competency Restoration Crisis” is a handy resource for advocates and implementers who are struggling to find a thoughtful solution and path forward in responding to this growing crisis. Also please join us next Thursday, April 18 at 3 p.m. Eastern as TAC staff present a webinar on "Dismiss Upon Civil Commitment with AOT: One Alternative to the Competency Restoration Crisis".

CSG Justice Briefing Funding opportunities for reentry services and housing; Police-mental health collaboration handbook; Black women’s health forum; and more.

Cross-sector Collaboration Site Visit Opportunity: Justice and Community Partnerships to Address Substance Use The Institute for Intergovernmental Research (IIR), on behalf of the State Justice Institute (SJI), is pleased to announce a peer exchange opportunity on June 13–14, 2024, in partnership with the Bureau of Justice Assistance’s Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP). Up to six communities will be selected to receive travel scholarships through SJI to participate. These travel scholarships will allow each community to send a team of three to four practitioners to participate in the structured, 2-day peer exchange at no cost.

Training Treatment Court Teams: Navigating Harm Reduction in Drug Courts Building on the previous webinar, Harm Reduction Practices in Treatment Courts: What Fits and What Doesn’t, this webinar will discuss ways to apply what fits in the treatment court setting and how each team member can play a role in supporting harm reduction. Attendees will receive guidance on ways to implement harm reduction measures without compromising the fundamental principles of drug courts and with respect to the role that each team member plays on the treatment court team.

In the News

What Martin Luther King Jr. Knew About Crime and Mental Illness In the past few years, I’ve committed $9 million to two programs, Neighborhood Navigators and Court Navigators. In both programs, individuals with lived experience — designated “navigators”— help guide our struggling neighbors through the complex landscape of social services. For those who cannot be safely diverted from incarceration to treatment in the community, Hope House, which recently broke ground in the Bronx, will soon offer a safe and humane alternative to the Rikers Island jail complex, with 24-hour security and therapeutic treatment. Supportive housing provides essential stability to those with mental illness who have been justice-involved. Thousands of individuals returning to New York City from state prison go straight to shelters. Homelessness increases the risk of incarceration, which in turn increases the risk of homelessness.

Should People With Severe Mental Health Needs Get Court-Ordered Treatment? State Senate to Decide Maryland’s Senate is set to vote on a bill that could impose court-ordered mental health treatments for people whose significant mental health needs lead to frequent hospitalizations or interactions with law enforcement. House Bill 576 would create so-called “Assisted Outpatient Treatment” processes across the state in which a circuit court can order a specified mental health treatment regimen for someone with severe and persistent mental health needs — potentially without their consent. Maryland is one of three states without an assisted outpatient treatment law, along with Connecticut and Massachusetts.

Despite Mental Health Crisis, Many Beds Are Empty in Jails' Treatment Program Despite an increased need for mental health care, many beds at a Nashville treatment program inside the Davidson County Jail go unused. The Behavioral Care Center (BCC) has received national attention as a model for mental health care in county jails. But my investigation found the 60-bed facility is rarely even half full. The unused beds concern Davidson County's Mental Health Court Judge Melissa Blackburn. “The BCC does not run at full occupancy, and that's very concerning. It runs at about 20% capacity at best,” Judge Blackburn said.

Governor DeWine Convenes New Work Group on Competency Restoration and Diversion Ohio Governor Mike DeWine today convened a new working group to address the increasing number of criminal justice-involved (forensic) patients being treated at Ohio’s six regional psychiatric hospitals. “Nine out of 10 beds at our state psychiatric hospitals are occupied by forensic patients, which challenges our ability to keep pace with court referrals for forensic admissions,” said Governor DeWine. “This limits our state psychiatric hospitals’ ability to serve citizens with serious mental illness who are not criminal justice involved. My hope is that through this working group we will reach a consensus around recommendations that alleviate the strain on our hospitals and ensure that Ohioans living with serious mental illness get access to the care they need to get well, be well, and stay well.”

Colorado Lawmakers Eye $11 Million Plan to Keep Mentally Ill Defendants Out of Jail, Improve State’s Competency System Colorado lawmakers hope to improve the state courts’ long-troubled competency system by creating a program aimed at moving mentally ill criminal defendants out of courtrooms and into mental health care. The sweeping diversion program would create a pathway for thousands of people who are charged with mid- to low-level crimes to receive mental health care instead of facing criminal prosecution if they are mentally ill or developmentally disabled in such a way that they are likely to be found incompetent to proceed — that is, that they cannot understand the court process or participate in their own defense. “Our competency system in Colorado is broken,” Mabrey said during a news conference to announce the bill last week. “…This bill will divert eligible individuals into wraparound community-based services that support their stability and improve health outcomes while decreasing the competency waitlist, improving recidivism rates and making more intelligent and efficient use of state resources.”

Experts: Lack of Mental Health Services Is Spurring a ‘Capacity Crisis’ in NC Jails Across North Carolina, more than 200 people with serious mental illnesses are waiting in jail for a bed in a state psychiatric hospital before their criminal cases can proceed. “Many people do sit months and months, over a year, not getting the treatment that they need,” said Dr. Robert Cochrane, the statewide director of the Forensic Services Division of State-Operated Healthcare Facilities at the Department of Health and Human Services. “And the jails… just don’t have the resources. You know, they’re not hospitals, they’re not clinics.” “We refer to it as the ‘competency crisis’ or the ‘capacity crisis,'” said Dr. Debra Pinals, a professor at Michigan Law School and the University of Michigan Medical School, during the panel discussion. “And everywhere, pretty much, in the country, there are challenges with people with mental illness sitting in jails.”

Mental Health Advocates: Virtual Hearings May Harm Minnesota's Civil Commitment Process Several mental health advocates sent a letter to Minnesota court administrators Monday raising concerns over a policy that holds civil commitment court hearings virtually instead of in person, which the letter's authors say is exacerbating an already-confusing legal process for people with severe mental illnesses. The letter says holding these hearings remotely could be negatively affecting people going through this system. Some don't believe they have an illness, the letter says. Others don't understand the court system as well because of their illness. “Additionally, family members may be extremely concerned about their loved one's health and safety and cannot be in the room with the individual to offer comfort or advice if the individual wants that support.”

After Decades of Imprisoning Patients, Idaho Approves Secure Mental Health Facility After decades of detaining psychiatric patients in maximum security prison cells, Idaho is finally on the verge of building a secure mental health facility that would house those with serious mental illness more humanely. The action follows a ProPublica article in December that found that Idaho lawmakers and state officials were told at least 14 times since 1954 that the state needed a secure mental health unit, separate from a prison, and at least eight times since 1974 that locking away patients without a conviction could violate their civil rights and invite a lawsuit. The patients haven’t been convicted or, in many cases, even charged with a crime.

Oregon Governor Signs Law Recriminalizing Drug Possession The law makes personal use possession a misdemeanor punishable with sentences of up to six months in jail. However, it also creates avenues for treatment instead of criminal penalties by encouraging law enforcement agencies to start programs that would move defendants toward addiction and mental health services. In 2021, Oregon became the first state to decriminalize drug possession. However, the state has recently faced a large rise in overdose deaths and had the second-highest rate of substance abuse disorder in the U.S., according to a 2023 audit report.

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