Judges and Psychiatrists Discuss Mental Health Treatment in the Judicial System

Speaking at the institute, from left, Leifman, Osher, and former Ohio Supreme Court Justice Evelyn Stratton, J.D.

It is common knowledge that the judicial system sees a disproportionate number of mentally ill persons and that jails are crowded with inmates needing mental health services. The problem has many aspects, including the economic burden it places on the corrections systems within the United States and the ineffectiveness of common criminal penalties and sentences in circumstances where medication, therapy and support services are needed.

Fortunately, change may come. At the recent APA Institute on Psychiatric Services, in Philadelphia, fifty leading judges and psychiatrists from across the country met to begin developing strategies to improve outcomes for individuals with mental health needs in the criminal justice system.

As part of an ongoing collaboration, the Judicial-Psychiatric Leadership Forum was convened by the Judges’ Leadership Initiative for Criminal Justice and Behavioral Health and the Psychiatric Leadership Group for Criminal Justice and was coordinated by the American Psychiatric Foundation and the Council of State Governments Justice Center.

According to Miami-Dade County Judge Steve Leifman, cochair of the Judges Leadership Initiative:

“The progress made at this forum is an important step forward in addressing the needs of people with mental illnesses who become entangled in the criminal justice system. The cost of incarcerating rather than treating people with mental illness both in financial and human terms is exorbitant and unnecessary.”

Psychiatrist Fred Osher, M.D., director of the Center for Health Systems and Services Policy for the Council of State Governments Justice Center, added:

“It is critical that psychiatrists engage judges in a dialogue to identify effective strategies that result in improved public health and safety outcomes. It is a shared set of concerns that require a shared vision and collaboration to have the largest impact.”

An estimated 17% of people admitted to jail have serious mental disorders—more than three times the rate in the general population, and nearly 70% of adults in jails and prisons have a substance use disorder. For more information on this topic, see the Psychiatric News articles “Combined Effort Needed to Prevent Incarceration of Mentally Ill People” and “Judges Get Help Handling Mentally Ill Defendants.”

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