David Meyer, J.D.
Institute of Psychiatry, Law and the
Behavioral Sciences
U.S.C. Keck School of Medicine
David Meyer, J.D.
dmeyer@usc.edu
Institute of Psychiatry, Law and the Behavioral
818-257-1221
Sciences
U.S.C. Keck School of Medicine
dmeyer@usc.edu
818-257-1221
Problem-Solving and
Collaborative Mental Health
Courts: An Adjustment to
Justice
David Meyer, J.D.
Institute of Psychiatry, Law and the Behavioral Sciences
U.S.C. Keck School of Medicine
dmeyer@usc.edu
818-257-1221
Objectives
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Describe MHCs, their operations and
related outcomes data
I.D. some specific anomalies of MHC
operations compared to traditional justice
Observe the apparent ethical and practice
boundary “issues”
Propose resolutions and solutions to the
anomalies and issues
Welcome to My Bias
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I strongly believe in Problem-Solving,
Collaborative approaches to justice
A legal systems/lawyer perspective
(adjusted for error)
Opportunities/Change
My focus: rationalize practice boundaries
and ethical challenges in Collaborative
Courts
Adversary Courts
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Opposing “Sides”
 Polarized
 Secrets
Conflict
Binary processes
Constrained by arcane historical rules
Passive judicial role
Limited outcomes potential
Why Think Differently?
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Insanity (Einstein definition)
Adversary justice is inadequate to address
mental health problems
Institutional treatment does not work (in most
cases) in terms of recovery and LTC
Cost:
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Systems redundancy
Expensive default
Poor systems linkage
Time to follow the evidence
MHC Evidence
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Decreased:
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Re-arrest rate
Number of arrests
Incarceration days
Increased:
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Linkage to services (all of them)
Non-custodial housing
QoL satisfaction
History
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An iteration of Problem-Solving Justice
derived from Drug Courts
Created in Broward County Florida by
Judge Ginger Lerner-Wren
Early support from DOJ and Consensus
Project
Losing their identity to other specialty
courts, viz: veteran’s courts, community
courts, homeless courts, elder courts…
Commonalities of MHCs
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A team approach that involves information sharing
among judges, attorneys, probation staff, and mental
health professionals
Screening and assessment of the problem(s)occurs
early in the criminal justice process
Diversion from traditional criminal justice processing into
treatment
Early intervention in the criminal justice process
An emphasis on problem solving and developing
interventions/ treatment to reduce the likelihood of
reoffending
A focus on continuity of care with treatment tailored to fit
individual needs and circumstances
Commonalities of MHCs
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A strong focus on supervision
Defendants' understanding that the primary focus of the
mental health court is on treatment and not adjudication
of their case
Understanding by mentally ill defendants that their
participation in the mental health court is voluntary
More personal interaction between the judge and the
mentally ill defendant than in a traditional court
The use of rewards and sanctions
Restorative justice and victim involvement
*Recovery, wellness & long-term mentality
Ref.-- https://www.bja.gov/evaluation/programadjudication/problem-solving-courts.htm
Variability
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There are as many different types of
MHCs and there are MHCs
Entry criteria vary widely
Different levels and types of staffing
Dependent on judge’s (everyone’s)
personality and approach
Measures and outcomes
Sources of funding
Legal Sacred Cows
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Equal access/Equal Protection
Sixth Amendment issues:
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Confrontation
Public proceedings
Negates fact-finding function of criminal court
Role of counsel; attorney no-no’s
Nature of “counseling”
Voluntary?
Categorical funding
Clinical Sacred Cows
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Clinician-Patient bond
Confidentiality and privacy
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HIPAA, W.I.C. §5328
Informed consent
Breadth of consent
Clinical practice limitations (boundaries)
Therapeutic no-no’s
MHC Processes
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Consensus decision-making
Judicial “activism”
Boundary jumping
Role distortion
Long-term focus
Interim and terminal rewards
Mild and moderate sanctions
Tolerance for failure
“External” individual and agency integration
Rationalizing MHC Conflicts
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Joint practice guidelines
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“Internal” supervision
“External” approval
Ethical and practice safe harbors
Effective consents
Blended and joint-agency funding
Adversary system safety nets
Resources
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National Center for State Courts (NCSC)-http://www.ncsc.org
Council on State Governments Consensus
Project-- http://consensusproject.org
U.S. Department of Justice Bureau of Justice
Assistance-- https://www.bja.gov
Problem-Solving and
Collaborative Mental Health
Courts: An Adjustment to
Justice
David Meyer, J.D.
Institute of Psychiatry, Law and the Behavioral Sciences
U.S.C. Keck School of Medicine
dmeyer@usc.edu
818-257-1221