What is a mental health court?

Mental health courts are special courts that serve people who have committed crimes they may never have committed if they had not been mentally ill. Some of these courts specialize in adjudicating cases for people who are homeless due to serious mental illness. (There are other special courts in existence today including drug court and veteran’s court. Some states such as Florida and Hawaii have created girl’s court for teenage girls who were abused or “at-risk” prior to committing crimes, see Wikipedia.)

The purpose of mental health courts is to help participants rebuild their lives. Courts may require participants to attend doctor’s appointments, try new medications, engage in counseling or group therapy, or stay in a home or supported living (rather than choosing to sleep outside). Sometimes, mental health courts require participants to apply for Medicaid, social security income, or other benefits. Experts in the program offer help with the paperwork.

During summer of 2013 (five years after I recovered from mental illness) I spent two months auditing mental health courts in downtown Cincinnati. I met compassionate judges and health care providers who knew that serving jail time does not cure schizophrenia or other mental illnesses. The goal of the mental health court is to provide the treatment necessary to deal with the root of the problem. The phrase “treatment in lieu of incarceration” is used often to express this approach.

This is my experience observing these special courts:

Walking into the court room, I noticed the friendly atmosphere. There were ten to fifteen people on the docket for the day. Some attended court once a week, and others less frequently. Every week, chips, brownies, and other snacks were laid out on a table in the court room. Many of these people seemed comfortable, or even to be enjoying themselves.

When court was in session, participants interacted with the judge as though he were a teacher, a mentor, or a parent. For people sticking to their treatment plans and cooperating, the judge could even become a friend.

One week, I saw a female judge encouraging a young woman who was carefully following her treatment plan and making an effort to rebuild her life. The judge asked about her love of dance, playfully reminding her, “you never know who will become famous!” I also saw a judge reward members of the docket with gift certificates to McDonald’s and Skyline Chili.

Another week, after court was over, I watched a judge remove her robe, walk into the middle of the court room, and hug a young veteran who was on the docket.

Court did not always run smoothly. The most difficult issue that judges had to address was lying. When members of the docket honestly admitted they had used drugs, the judge suggested various coping mechanisms, including the use of medications such as Methadone. The judges were quick to offer second chances. However, when members on the docket used drugs and lied about it, the judges considered sending them to jail. I watched the judge send a few people to jail over the months that I audited court.

Overall, I was impressed by how honest most members of the docket were. They discussed doctors’ appointments, medications, living arrangements, and their goals for the future.

When participants reached a point of rehabilitation where they no longer needed the supervision of the judge, usually over the course of eighteen months or more, they “graduated” from the program. Graduates were acknowledged with a ceremony, and a reception with cake.

I attended two graduations, along with the family and friends of graduates. At one of the graduations, I watched a young man in tears, thanking the judge and his treatment team for essentially “saving his life.” Watching his gratitude for the treatment he received made me wish these courts were available in communities everywhere.

Some people on the docket liked the mental health court so much that by the time they graduated, they were hesitant to leave. Judges welcomed them to come back to visit.

Personally, I am thankful for my parents, who saved my life. When I was suffering from severe mental illness, I wanted to go back to the streets and continue living outside. A normal life seemed out of reach. Thankfully, my parents and doctor convinced me to begin medication that enabled me to rebuild my life. I graduated from college three years later.

Many mentally ill people who commit crimes do not have family or friends to become their advocates, or refuse contact with them. For people in this situation, mental health courts can act as a compassionate and effective support system. Also, these courts are far less expensive than the cost of sending people to jail.