Academic journal article Best Practices in Mental Health

Mental Health Courts and Adult Offenders with Developmental Disabilities and Co-Occuring Diagnoses

Academic journal article Best Practices in Mental Health

Mental Health Courts and Adult Offenders with Developmental Disabilities and Co-Occuring Diagnoses

Article excerpt

The emergence of mental health courts (MHCs) in North America, particularly in the United States, was the result of a paradigm shift as court personnel became increasingly sensitive to the state of mind of offenders charged with criminal offenses, specifically defendants with developmental disabilities and mental health diagnoses. Ennis, McLeod, Watt, Campbell, and Adams-Quackenbush (2016) acknowledged that MHCs emerged across North America in an effort to address the criminalization of persons with mental illness. The evolving statistics on these individuals were alarming: a 1999 study (Ditton, 1999) reported that, in prisons and jails in the United States, there were 283,800 offenders with mental illness experiencing co-occurring diagnoses including 10 percent with a mental or emotional condition. Among these offenders 10 percent reported staying overnight in a hospital or mental health program, 53 percent were incarcerated for violent offenses, and 13 percent for drug-related offenses.

The inception of MHCs was considered a favorable opportunity to deal with this specific population. As the Council of State Governments Justice Center (CSGJC, 2008) pointed out, "mental health courts serve a significant role within the collection of responses to the disproportionate number of people with mental illnesses in the justice system" (p.3). Further, Steadman, Davidson, and Brown (2001) promoted a working definition of MHCs based on four criteria:

1. Initial booking and handling of individuals with mental illness identified from a single court docket for referral to community-based services

2. Use of a courtroom team, including a professional whose role is to create service linkages within the team, to make treatment recommendations and supervision plans

3. Availability of treatment slots to provide services to these offenders

4. Court monitoring of offenders to guarantee compliance and when necessary initiate sanctions for noncompliance

Subsequently, Steadman and colleagues stated that an MHC may be a diversion program with all staff and services circulating around a single judge or a court of jurisdiction within a broader jail diversion program. They acknowledged that today's MHCs "are led by innovative judges looking for creative alternatives for the defendants and the community" (p. 458).

This article will focus on a unique MHC that deals with adult offenders eligible for services from a forensic unit of a county developmental disability agency in a large urban Midwestern metropolitan community. Previous studies (Tsagaris, Seck, Keeler, & Rowe, 2015, 2016) have documented characteristics of these offenders and a geographic information system analysis of service provided to this population. Further, a number of researchers have published articles providing more information on MHCs and offenders diagnosed with mental illness and other co-occurring disorders.

Literature Review

The development of MHCs was the result of the increasing number of serious mentally ill offenders in jails and prison. A 2006 study (James & Glaze, 2006) reported that, at mid-year 2005, more than half of all prison and jail inmates had a mental health problem, including 705,600 inmates in state prisons, 78,800 in federal prisons, and 479,900 in local jails. In addition, James and Glaze reported high recidivism rates among these inmates, showing that nearly 25 percent had prior incarcerations. When compared to non-mentally-ill inmates, these inmates were at least three times more likely to have spent time in prison. Analyzing the gender variable, James and Glaze noted that female inmates were incarcerated at a higher rate than males in prisons (73% vs. 55%) as well as in jails (75% vs. 63%). Almost three-fourths of mentally ill state prisoners and jail inmates, including a substantial number of adult offenders with developmental disabilities, met substance abuse or dependence criteria, and nearly two-thirds used drugs before their arrest as compared to only one-half of inmates without a mental health problem. …

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