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CSG Justice Center Primer on Mental Health Courts
Psychiatric Services 2009; doi:
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The Council of State Governments (CSG) Justice Center has released Mental Health Courts: A Primer for Policymakers and Practitioners. The primer provides the first comprehensive introduction to this increasingly popular specialty court model, in which individuals with mental illnesses are linked to treatment and receive treatment services while under court supervision. In the late 1990s only a handful of mental health courts were in operation. The Justice Center estimates that more than 200 such courts have now been established in large and small jurisdictions across the country, with many more in the planning phases. A 2007 survey found 18 mental health courts for juveniles in operation; 20 jurisdictions reported plans for such courts.

Mental health courts are one of many approaches taken to address the high level of justice system involvement in this population. Prevalence estimates of serious mental illness in jails range from 7% to 16%, four times the rate for men in the general population and eight times the rate for women. In addition, studies have found that people with mental illnesses are more likely to be arrested than those without mental illnesses when they commit similar crimes and are incarcerated longer than other inmates. These courts also address the consequences of justice system involvement for families and communities. As the authors note, "Like drug courts and other 'problem-solving courts,' mental health courts move beyond the criminal court's traditional focus on case processing to address the root causes of behaviors that bring people before the court. They work to improve outcomes for all parties, including individuals charged with crimes, victims, and communities."

The 25-page primer, which was supported by the Bureau of Justice Assistance of the Office of Justice Programs at the U.S. Department of Justice, provides an overview of this approach for policy makers, practitioners, and advocates. It describes mental health courts' goals and processes, summarizes research findings about their effectiveness, identifies issues to be considered in designing them, and lists resources for jurisdictions interested in starting a program, including sources of grants and other funding, training and technical support centers, written policy guides, and Web sites.

One chapter focuses on the differences between mental health courts and drug courts. More than 2,000 drug courts are in operation in the United States. In many jurisdictions, drug courts paved the way for mental health courts. Some of the earliest mental health courts were created when drug courts needed a more targeted approach to defendants with co-occurring substance use and mental disorders. However, mental illness, unlike illicit drug use, is not in itself a crime, and mental health courts admit participants with a wide range of charges, whereas drug courts focus on drug-related offenses.

Because the features and processes of mental health courts vary so greatly, some have commented, "If you've seen one mental health court, you've seen one mental health court." However, the primer describes a typical afternoon session held in a mental health court that has several features deemed essential to such courts. A 2008 companion publication, Improving Responses to People With Mental Illnesses: The Essential Elements of a Mental Health Court, describes ten core elements in more detail and is available for download along with the primer at consensusproject.org.

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