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June 11, 2014

A mental health court in DC – adversarial or inquisitorial?

To my shame, I have never visited a mental health court in England.  But I was hugely impressed by the one I saw this morning in Washington DC.  Having heard that services in USA were sparse, I’ve been surprised to hear of what sound like pretty good mental health services available, with good access to residential treatment for mental health and drug abuse problems.  Practically all those who attend the mental health court seem to have drug addiction as well as mental health problems.  The court is a diversionary court. If the offender completes the programme, their case is dismissed, unless it is a  felony (more serious) case, in which case the sentence is completing the programme.

Offenders were treated with infinite patience, with missed appointments for the most part tolerated, as long as there was some compliance.  Like the drug court I saw yesterday, it was not really adversarial.  Everyone, including the prosecutor, seemed to be working collaboratively to get offenders to access and turn up for treatment.  Did it need a court to do this?  Possibly not.  But this seemed a very humane way to deal with mental ill offenders, if they are to be processed by the criminal justice system.  Possibly more impressive was the meeting I observed afterwards, led by the mental health court judge – Ann Keary. Attended by representatives of all the main mental health services, of defence and prosecution, the meeting heard from practitioners who offered a group therapy programme focused on trauma.  Maybe English forensic therapists do trauma work, but dealing with trauma seems a more important part of sentences here (I also came across it at Red Hook community court).  The meeting also heard how providers of residential mental health services had started to accept offenders on methadone, and how all felt there was a gap in services for those with learning difficulties/disabilities. The judge led the discussion and agreed to put this gap in services on the agenda of a wider stakeholders meeting she was attending imminently.

The judge sat on the mental health court all week, and was an expert in offenders with mental health problems. She did or initiated research in her spare time on the outcomes of her court.  She wanted to do a piece of work on whether those who atended the mental health court remained engaged with mental health services after they graduated from the court programme.  Was her judicial independence compromised?  I think not.  Any offender who was chaarged with a new, serious crime, or who missed many appointments, was kindly ejected from the mental health court, back to the mainstream courts.