Mental Health Courts
Abolish Prisons

Mental health courts (MHCs) are specialized programs designed to address the legal issues and treatment needs of individuals with mental health disabilities and substance use disorders. Their policies vary by state, but they frequently focus on handling individuals with “severe persistent mental illness” and/or “chronic homelessness.” In theory, these courts aim to divert individuals away from traditional criminal courts and incarceration, recognizing that their involvement with the justice system may be linked to their mental health or substance use.

According to The Abolitionist Law Center:

“The MHC is a plea-dependent court that subjects people to most traditional carceral processes and leaves them with a permanent record. MHC revolves around the threat and reality of jail and directly criminalizes the behavioral health problems of its participants, punishing drug use, relapse, and what it perceives as aggression.”

MHCs are a common attempt at prison reform, but they come under scrutiny for perpetuating, not reforming, systems that rely on coercive measures and fail to address the root causes of mental health issues. While government officials may try to sell MHCs as a compassionate alternative to traditional criminal courts, they still operate within a carceral framework that fundamentally relies on punishment and control, rather than centering the needs of the disabled youth and adults that disproportionately find themselves subject to these measures.

In the words of the Society for Psychotherapy, “Many popular mental health prison reforms attempt to make a carceral system more therapeutic, but the most therapeutic reforms necessitate reducing the scope of the system itself.” 

MHCs are characterized by a lack of agency and autonomy given to individuals with mental health disabilities. They often employ isolation tactics as a method of control, including:
1. Court-Ordered Treatment Programs: MHCs often mandate individuals to participate in treatment programs, which may require them to adhere to strict rules and regulations which can include medications and therapy, without adequately involving the disabled individuals in the decision-making process.

2. Restrictive Conditions: As part of their involvement with MHCs, individuals may be subjected to restrictive conditions such as house arrest or electronic monitoring. These measures limit their freedom of movement and social interactions, contributing to feelings of isolation and disconnection.

3. Limited Access to Support Networks: Participation in MHC programs may restrict individuals’ access to their support networks, including family, friends, and community resources. This isolation can exacerbate feelings of loneliness, which in turn, can exacerbate mental health symptoms.

4. Emotional and Psychological Isolation: The coercive nature of MHCs, where individuals may feel compelled to comply with treatment under the threat of legal consequences, can lead to feelings of emotional and psychological isolation. This sense of being controlled and monitored can erode trust and hinder therapeutic progress.

5. Stigmatization: MHCs tend to operate within a medical model that pathologizes and stigmatizes mental health issues, contributing to societal narratives that frame mental health as a criminal justice concern rather than a public health issue. This perspective further marginalizes by perpetuating the idea that they are inherently dangerous or in need of control, and justifying force and coercion in mental health treatment.  This approach also presumes mental health is an inherent crisis that should be addressed outside of a community rather than within community, further isolating those with psychiatric disabilities.

The National Center for Mental Health Recovery suggests that we should work to eliminate force and coercion, and develop instead a compassionate, consumer-driven system because “research clearly shows that forcing patients to take medication is not supported by clinical evidence.”

Their statement goes on:

“Coercive interventions are routinely traumatizing to the individuals they purport to help and make people fearful of seeking treatment. Involuntary interventions are a poor substitute for building recovery-focused, culturally attuned, community-based mental health and social support services. There is an alternative to force and coercion: the fostering of trusting and stable relationships while emphasizing choice in treatment plans.

A growing evidence base validates the efficacy of “peer-directed services” – services directed by individuals who themselves have psychiatric diagnoses. Peer support workers can often help persons whom traditional services cannot reach; they can also train non-consumers on how to reach those experiencing extreme emotional distress or “psychosis.”

Person-centered crisis plans (also known as psychiatric advance directives) can also avoid force. Such plans are written documents in which individuals express their treatment preferences in the event that they experience an emotional crisis. An individual can also identify someone to act as a health care agent who can make sure his or her wishes are respected.

The goal of treatment should be recovery of a full role in society, not mere maintenance of “symptom-free” behavior.”
In order to create transformative, just policies, it is imperative to prioritize healing and support over punishment, and rely on community solutions and rehabilitative, person-centered methods, not isolation and imprisonment, as the primary tools for maintaining a safe society (Source). Crip Justice believes we should involve disabled individuals impacted by court-ordered treatment and MHCs in the development of these policies. Their lived experiences and perspectives should be central to decision-making processes, ensuring that any interventions are rooted in the principles of autonomy, dignity, and self-determination.