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Mental Health Courts, Treatment Improve Lives

— October 10, 2019

Switching from non-therapeutic punishment to treatment with therapy as managed by problem-solving courts is more humane and reduces recidivism.

We need better mental health treatment throughout society, maybe nowhere more than the court system. Mental health courts may be the answer.

According to Mental Health America, a nonprofit advocacy organization, as many as 400,000 people with a mental health problem are incarcerated on any given day when they should be receiving treatment. The normal criminal justice system prefers to punish deeds rather than parse the why behind the deeds.

Mental illness and substance use disorder frequently co-occur.

At least 83% of mentally ill inmates don’t receive treatment, and after release, they often don’t have insurance to seek mental help on their own. In addition to the added criminal justice costs, each year, serious mental illness costs the U.S. almost $200 billion in lost earnings, as well as losses to worker productivity, and suicides. 

Mental Health Courts

One solution might be more problem-solver courts including drug courts and mental health courts. Such problem-solving courts focus less on punishment and more on rehabilitation for defendants whose crimes are related to their drug or mental health issues. 

From the first four mental health courts formed in 1997, today there are more than 300 in almost every state. For example, since the first mental health courts pilot program in Michigan in 2009, the number has increased to 35. (The first drug court in the US predated them in 1989.)

While defendants in mental health court are much more likely to get treatment, spend less time in jail, and are less likely to get arrested again, these courts should not be considered a substitute for community services. 

Making community mental health services more widely available – before, during, and after involvement in the criminal justice system – would reduce the financial, health, and human costs of such incarceration. 

Mental Health Treatment

There’s no good reason such treatment need wait until an arrest. Even if your state doesn’t rank very highly on per capita mental health spending – the national average is $125.90 – treatment is available. 

Under the essential health benefits mandate of the Patient Care and Affordable Care Act (ACA), most insurance plans now cover “mental health and substance use disorders”, including dual diagnosis (having both mental health issue and a substance use disorder at the same time). 

One in five Americans has experienced some form of mental illness, and one in 25 a serious mental illness – causing a disability or impairment to normal activities – such as bipolar disorder or schizophrenia. About 7.9 million people, half of all people with a mental health issue, also have a substance use disorder – some from trying to self-medicate for their mental health problems and becoming addicted – and vice versa.

Three signs on a chain link fence, reading (in order) “Don’t Give Up,” “You Are Not Alone,” and “You Matter.” Image by Dan Meyers, via
Three signs on a chain link fence, reading (in order) “Don’t Give Up,” “You Are Not Alone,” and “You Matter.” Image by Dan Meyers, via

Why People Don’t Seek Treatment

Despite the extent of the problem and the ACA protections, 56% of adults with a diagnosable mental illness don’t receive treatment. The reasons include:

  • A lack of money, insurance, or transportation. 
  • Not having the energy or motivation because of the mental health issue. People with suicidal ideation or depression are less likely to seek treatment. 
  • Unwilling to trust a stranger therapist to keep things confidential.
  • Not realizing how bad their mental health issue has become.
  • Embarrassment or the stigma associated with needing mental health treatment. 
  • Bad influences. Some family and friends might not “believe” in mental health problems or be more concerned about guilt by association than the sufferer’s health and well-being.
  • Many defendants with mental health issues don’t realize they have mental health issues and so refuse their attorneys’ attempts to get them treatment instead of incarceration.

Mental Health Treatment Works

The good news is that when they do seek proper treatment, the vast majority do see improvement, from more than 80% for depression, as much as 90% for panic disorders. 

Proper treatment for mental health issues includes one or more of the following:

  • Counseling with therapies such as psychotherapy (“talk therapy”), cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) to learn new coping skills and patterns of thought.
  • Medication, such as antidepressants, antipsychotics, and opioid antagonists, that relieves the symptoms of your mental health issue. They can’t cure mental illness, but they can control it. 
  • Social support.from family, friends, and peers with similar mental health issues. 
  • Education on how to avoid behaviors that can trigger or exacerbate your mental health issues. 

Just moving some people with mental health problems from a cycle of incarceration for a nonviolent crime into treatment would save money. A month in a county jail can cost an estimated $10,000. That same $10,000 in a problem-solving court has a 65% graduation rate. 

Switching from non-therapeutic punishment to treatment with therapy as managed by problem-solving courts is more humane and reduces recidivism. The earlier defendants with mental health issues get help, the better their odds for recovery and the more likely they are to keep their jobs, homes, social status, and to stay out of the criminal justice system. 

Editor’s note: Today is World Mental Health Day “organized by the World Federation for Mental Health. This year’s Day is supported by WHO, the International Association for Suicide Prevention, and United for Global Mental Health.” 

In support of those struggling with mental health issues – and those who care about them – Legal Reader is sharing the following guides regarding sleep and mental health. Crafted by friends of Legal Reader, along with a panel of doctors and sleep experts, we’ve created a few guides that help those coping with a mental health issue get a better night’s sleep – a critical factor in reducing symptoms of mental illness:

Sleep After Trauma

Sleep and Mental Health

Sleeping with Anxiety

Sleep and PTSD


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