Court Review: Volume 43, Issue 4 – Mental Illness and the Courts: Some Reflections on Judges as Innovators

Issues raised by the influx of defendants with serious mental illnesses are some of the most important that criminal judges confront. Because of the volume of defendants with mental illnesses, the impact goes beyond that of the individual case and extends to jails, police and sheriff departments, the treatment system, and ultimately to the role of the judge. This article suggests some of the ways in which communities have attempted to respond to these issues, and highlights the fact that judges have become significant leaders as well as innovators in such efforts. Not every judge will decide to adopt one or more of these roles, but regardless, it is likely that the issues that mental illness creates for the criminal justice system will exist far into the future

Court Review: Volume 40, Issue 3-4 - Problem-Solving Supervision: Specialty Probation for Individuals with Mental Illnesses

One of the most important developments in American law over the last decade has been the exponential growth of problem-solving courts. Such courts achieve efficiencies by consolidating certain types of cases before specially designated judges. Additionally, in many instances, problem-solving courts adopt a therapeutic focus by attempting to achieve outcomes (e.g., obtaining treatment for a defendant) that go beyond the traditional goals of the judicial system. A recent commentary in this journal noted that “problem-solving courts generally focus on the underlying chronic behaviors of criminal defendants.” These courts include, but are not limited to drug courts, mental health courts, domestic violence courts, and teen smoking cessation courts. Perhaps the first prototypical problem-solving court was the juvenile court. Today, problem-solving courts exist in many countries throughout the world

Who will Pay for Involuntary Civil Commitment Under Capitated Managed Care? An Emerging Dilemma

Explores conflicts that may arise between managed care providers and payers in the context of civil commitment, where concerns over the potential risk presented by the individual who has been committed may run counter to payment decisions limiting reimbursement for care. Six strategies that providers can use to address these issues are discussed. They include avoiding negotiations with payers over individual patients\u27 care by ensuring that contracts with payers address civil commitment issues, identifying and creating services and social supports to reduce the necessity for commitment, adopting formal risk assessment protocols, researching the use of civil commitment and coercion in managed care settings, ensuring that incentives do not exist in states\u27 Medicaid managed care programs to use civil commitment to shift costs, and discussing with treatment staff the growing encroachment of financial considerations into treatment decisions