Improving Responses to People with Mental Illnesses

The Essential Elements of a Mental Health Court

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Mental health courts are a recent and rapidly expanding phenomenon. In the late 1990s only a few such courts were accepting cases. Since then, more than 150 others have been established, and dozens more are being planned. Although early commentary on these courts emphasized their differences—and their diversity is undeniable—the similarities across mental health courts are becoming increasingly apparent. In fact, the vast majority of mental health courts share the following characteristics:

• A specialized court docket, which employs a problem-solving approach to court processing in lieu of more traditional court procedures for certain defendants with mental illnesses

• Judicially supervised, community-based treatment plans for each defendant participating in the court, which a team of court staff and mental health professionals design and implement

• Regular status hearings at which treatment plans and other conditions are periodically reviewed for appropriateness, incentives are offered to reward adherence to court conditions, and sanctions are imposed on participants who do not adhere to the conditions of participation

• Criteria defining a participant’s completion of (sometimes called graduation from) the program

The reasons communities give for establishing mental health courts are also remarkably consistent: to increase public safety, facilitate participation in effective mental health and substance abuse treatment, improve the quality of life for people with mental illnesses charged with crimes, and make more effective use of limited criminal justice and mental health resources.

As the commonalities among mental health courts begin to emerge, practitioners, policymakers, researchers, and others have become interested in developing consensus not only on what a mental health court is, but on what a mental health court should be. The purpose of this document is to articulate such consensus in the form of 10 essential elements.

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