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Guest Editorial: Marcie Timmerman, National Alliance on Mental Illness

Jails are the new mental health institutions. Across the country, people are being incarcerated for having a severe mental illness. If they had diabetes or cancer, would we be putting these people in jail for committing nonviolent crimes? More than likely, we’d insist they receive medical treatment instead of jail. That’s where the Mental Health Court model comes in. On October 9, 2014, Fayette County District Court will cut the ribbon on its first Mental Health Court.

Fayette County’s court results from the efforts of many individuals and organizations, calling themselves the Take Down the Wall: Decriminalization Committee, organized by NAMI Lexington. Law enforcement, treatment providers, and community service organizations are represented on this committee. It is part of a movement to close gaps in the mental health system, and to stop the “revolving door” of people from jail to the street and back again.

Not just anyone is right for Mental Health Court. Only those who are determined to have committed nonviolent misdemeanors as a direct result of severe mental illness will be eligible to participate. There are many potential referrers to the court, but the judge in charge has the final say on who will be accepted. A court coordinator will ensure participants have housing, medical benefits, and other necessary services. Doctors and therapists will work with the court to devise individual treatment plans. If the participant does not comply with the agreed-upon terms, they will be sent to jail on the original charge. If they do comply, they will be rewarded with lesser charges, or other special accommodations at the judge’s discretion.

Other mental health court programs have been successful in many ways, including reducing taxpayer costs and decreasing the number of times a person returns to jail. Voluntary participation greatly increases the likelihood of treatment compliance after discharge from the court program. The court itself can operate as a support system. Participants are seen in the same courtroom and can benefit from each other’s progress. A Kentucky Peer Specialist will also be assigned to the court; their role will be to mentor and assist from a “been there” perspective.

Participants in mental health court have severe, persistent mental illness. Many of them also have anasognosia- a brain condition which prevents them from realizing they have a mental illness- so they don’t seek out traditional outpatient treatment. The court’s effect on these individuals can be so profound it has picked up a name: “The Black Robe Effect”. Even though they don’t think they have a mental illness, many will adhere to treatment because a judge asks them to.

Some individuals who qualify for the court may choose not to take advantage of its benefit. The court itself, though, is a crucial piece to closing the gaps in the mental health treatment system. It is our hope that it serves as another stopper in the “revolving door” for our most seriously ill citizens.

About the Author:
Marcie Timmerman earned her Master of Health Administration degree from the University of Kentucky in 2012. She is currently working as the Communication Director for NAMI Lexington.




  1. Pingback: Meaningful Progress for Mental Health Courts | Steve Kay for Lexington - July 21, 2015

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