Looking beneath the surface: Courts and mental health

Christopher Ajayi, a psychiatric technician, makes his rounds at Harris County Jail. (2/24/11) Photo by Todd Wiseman

We often think of mental illness as an invisible disease, but its effects can clearly be seen in our courts, as Texans with these challenges find themselves in the criminal justice, juvenile justice and child welfare systems. Because people in mental health crises are more likely to encounter law enforcement than medical professionals, the courts often serve as their point of entry to access mental health services.  Texas courtrooms are filled with children being parented by the state because their parents have unmet mental health needs.  Many times, these same children return to court as they face juvenile detention, homelessness and prison.  Our veterans often return from service with life-changing PTSD and land in court, struggling with employment, housing and family.

What is the scope of the problem? The Texas Judicial Council Mental Health Committee recently shared data that out of the 27 million people in Texas, about 1 million adults experience serious mental illness. Notably, up to 70 percent of youth coming into contact with the juvenile justice system meet criteria for a mental health disorder. Adults with untreated mental illness are eight times more likely to be incarcerated. Finally, the Meadows Mental Health Public Policy Institute estimates that every year, Texas spends $1.4 billion in emergency room costs and $650 million in local justice system costs to address mental illness that is not adequately addressed in the community.

Currently, courts and other institutions operate in silos with little interaction, at great expense to the individuals impacted by these systems and the community. Over the past few legislative sessions, lawmakers in our state have made great strides in bridging the gaps between these systems, instituting reforms and allocating funding for better screening protocols, jail diversion and competency restoration procedures. When the justice system serves as a safety net for individuals struggling with mental illness, courts also have an obligation to play an active role in expanding our state’s capacity to respond.

The Supreme Court of Texas and the Texas Court of Criminal Appeals are working together for a historic joint hearing (on Jan. 11) on how courts can better serve individuals with mental health challenges. This is an opportunity for the two highest courts in Texas to hear from people with professional and personal experience navigating the legal system and its intersection with unmet mental health needs. Texas has realized improvements in the administration of justice on other highly complex issues through long-term, judicially-led, interdisciplinary initiatives, and this issue demands a similar approach. The hearing will inform efforts to create a Judicial Commission on Mental Health that will be aimed at strengthening collaboration between systems and developing innovative solutions to nuanced problems.

Courts are in a unique position to help youth and adults move from illness to wellness, but for the promise of justice to be realized, we must take a closer look at how we see mental health and how we work together for meaningful improvement in the administration of justice for those affected by mental illness.

Nathan Hecht

Chief Justice, Texas Supreme Court

Sharon Keller

Presiding judge, Texas Court of Criminal Appeals

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