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Mental Health Courts: Promise and Problems
Speech to Illinois Academy of Criminology
May 19, 2004
- Lots of mentally ill persons in the criminal justice system
- DOJ study found 12 to 18% of prisoners were mentally ill
- Illinois DOC has 6,000 mi's v.5500 in all public and private mental hospitals
- Cook County Jail : 1,000 to 1,500 persons with mental illnesses
- Getting exact number depends on definition--what is mental illness?
- Problems caused by mi's in criminal justice system
- Costs:
- Processing: lawyers, judges, bailiffs, court reporters, clerks
- Jail (pre-trial detention) costs (with or without treatment)
- Convicted prisioners: $20,000/person/year Dixon (with or without treatment)
- Lack of treatment–conflict between world view of criminal justice system and the mental health system
- Recidivism–criminal justice/mental health
- Costs to victims
- History of Mental Health Courts
- Patterned after drug courts
- Broward County , FL (Indianapolis/King County,WA/Alaska)
- Federal demonstration grants
- Local initiatives: Cook, DuPage, Kane, Winnebago
- Goals of Mental Health Courts
- Main goal–reduce jail costs
- Reduce other criminal justice costs
- Reduce recidivism
- Increase medication/treatment compliance
- Increase community mental health funding (They've stolen all our clients; let's steal all of their money)
- Model(s) of Mental Health Court(s)
- Send mentally ill criminal defendants to one or more dedicated courtrooms
- Which crimes (usually limited to non-violent misdemeanors)
- Which diagnoses–do we include dual diagnosis (MISAs)
- Usually not Axis II
- Plea bargaining model
- Probation/supervision
- Judicial involvement (hard/soft)
- Who provides treatment/who pays for treatment
- Liaison to court/TASC model/probation officer
- Do they work? What does that mean? Reference to goals
- Anecdotal support–counties who start mh courts do not terminate them
- UVA/MacArthur Foundation study
- Reduce recidivism–compared to what?
- Reduce criminal justice costs (jail costs)
- Increase treatment compliance
- Problems/Concerns
- (Improper?) Coercion
- Only way to get mental health services is to commit a crime/compare to substance abuse services in criminal justice system
- May confuse role of criminal defense counsel
- Other interventions may be better
- Provide discharge planning services (jails and prisons)
- See Thresholds/DHS/Cook County Jail award winning model which reduced recidivism by more than 60%
- Police training
- Just more mental health services–why target criminals
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