Implementation in action: Advancing state court behavioral health strategies

Introduction

The National Council of State Court Behavioral Health Administrators convened its third annual in-person meeting on Aug. 4-5, hosted by the Indiana Supreme Court's Office of Behavioral Health in Indianapolis. Supported by NCSC, the annual gathering brought together state court behavioral health leaders to share emerging practices, address system challenges, and advance effective responses at the intersection of behavioral health and state courts. Currently, 25 state courts have state court behavioral health administrators, with several more states looking to hire.

Strategic alignment with national state court leadership

Discussions focused on translating national policy frameworks into concrete state court action, directly supporting recommendations from national judicial mental health and opioid task forces as well as the Conference of Chief Justices (CCJ) and Conference of State Court Administrators (COSCA) Behavioral Health Committee. 

Indiana Chief Justice Loretta H. Rush offered a national perspective on CCJ/COSCA Behavioral Health Committee priorities and the evolving role of state court behavioral health administrators (SCBHA). The vision aligns directly with CCJ/COSCA Resolution 1, which calls on court leaders to establish state court behavioral health administrators and exert their "power to convene" and drive systemic improvements. The resolution acknowledges that while many courts have initiated successful programs and improved practices, all state and local courts still have a profound responsibility to lead systemic changes in how courts and communities respond to individuals with behavioral health needs.

Leading consistency  & coordination

Integrating the operational philosophy of courts acting as community conveners to collaboratively map and bridge systemic gaps, discussions were organized into four action-oriented topics reflecting the core mandates of the CCJ/COSCA resolution:

• LEAD: Creating and supporting state-level, inter-branch mental health task forces and appointing behavioral health administrators within the administrative offices of the courts to drive improved responses for all court-involved individuals. 
• EXAMINE: Assessing court systems and policies across all case types while encouraging judges to use their "power to convene" to map resources and identify gaps through community mapping. 
• EDUCATE: Providing cross-system training to better equip judges and court staff to address the impact of mental illness and co-occurring substance use disorders on litigants and court operations.  
• ADVOCATE: Supporting strategies to utilize a public health model to guide court and community behavioral health practices and funding, including efforts to, when appropriate, deflect or divert cases involving individuals with behavioral health needs from the court system and into treatment and recovery support services.

State court achievements, challenges & priorities

Administrators engaged with and inspired each other by sharing top achievements, priorities, and ongoing challenges – ensuring that local, ground-level insights continuously inform national strategies. Common themes included civil court opportunities, court-based behavioral health navigators, and court engagement with certified community behavioral health clinics. Through cross-state collaboration and grounding their work in established national directives, state court behavioral health administrators continue to lead the movement from policy recommendations to sustained action across the nation's courts. 

Additional resources

• Promoting state court behavioral health staffing & collaboration for improved response  (June 2025)
• Latest news and behavioral health resource library