Mental health courts: Competence, responsibility, and proportionality

Abstract

Mental health courts (MHCs) function as a component in the criminal justice system designed to reduce recidivism by promoting effective treatment for offenders who commit offenses due to the effects of their mental illness. MHCs frequently require guilty pleas from mentally ill offenders, place those offenders on probation, and require as a condition of probation that those offenders participate in treatment intended to ameliorate the disorders that increase their propensity to commit crimes. MHCs are designed to promote the well-being of the mentally ill offenders by providing treatment that improves their clinical conditions in a manner that decreases risk of recidivism and punishment. Decreasing the risk of recidivism also promotes the well-being of society. Consider the following concerns. First, do MHCs actually decrease recidivism more effectively than available alternatives? Second, what are the alternatives and what considerations other than comparative rates of recidivism are relevant to identifying the most appropriate legal institution to apply in attempting to reduce recidivism among offenders with mental illness? If an offender presents a risk of harm to others due to mental illness, what justifies the state in applying the police power through civil commitment, through an MHC within the criminal justice system or through a defense of not guilty by reason of insanity followed by post-acquittal commitment? MHCs are often described as applying a framework grounded in Therapeutic Jurisprudence. That framework pursues the development of legal rules, procedures, and roles that promote the well-being of those involved in a manner that recognizes and protects other important values embodied in law. In order to advance this project, MHCs must decrease recidivism without causing disproportionate harm to the well-being of some participants or seriously undermining other important values embodied in the relevant law. Thus, justifying MHCs requires that we identify the full range of relevant values and examine the ways in which MHCs may advance or undermine them under various conditions.