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The Alliance Position Paper on Mental Health Courts

Mental Patients Liberation Alliance based in New York State was one of the founding sponsor groups of the MindFreedom International "Support Coalition." Here is their official position on mental health courts, which are special separate courts for people diagnosed with psychiatric disorders who have been accused of committing crimes.


MENTAL PATIENTS LIBERATION ALLIANCE

MENTAL HEALTH COURTS


POSITION


The Mental Patients Liberation Alliance (THE ALLIANCE) opposes the formation of mental health courts to divert people from criminal incarceration by coercing them into mental health services and mandating treatment compliance. Such programs dispel criminal responsibility, are constitutionally unjust, prejudicial and discriminatory.


CRIMINAL JUSTICE SYSTEM


Mental health courts are created through local initiatives. There is no standardized model to follow. This is largely due to the difficulty affronted communities when attempting to answer the historical human question of mens rea, or how responsible are people regarding their personal behavior. THE ALLIANCE holds true that a person found guilty of a crime by a jury of our peers is responsible for the breaking of societal laws and is in debt to the victim(s) and to society. A person found guilty of a crime is fully responsible for the effects of that crime. Using lack of capacity as a reason for leniency dilutes the function of the legal system. In so doing, the criminal is stripped of his/her ability to accept full responsibility and the ability to accomplish full restitution for the crime.

The level of capacity to control one's behavior is an influential factor only to be considered at sentencing and not to be weighed during the fact finding of a criminal trial. After a careful look to the restitution to the victim(s) or group effected by the crime, creative sentencing can humanely address factors that would lead to the reduction of risk of the crime being repeated.


MENTAL HEALTH SYSTEM


At least one of every ten people appearing in the criminal court are receiving or have already received treatment by the mental health system. In some areas, the ration is much higher, and the numbers are increasing. Mandating treatment and mandating more treatment has not been proven to be effective in reducing these numbers. Until the mental health system successfully addresses the expressed needs of people with innovative and flexible approaches to create a more humane localized service delivery system, the revolving door between the criminal justice system and the mental health system will remain.

The closing of large state insane asylums and the release of the people who were inmates of those institutions prompted the Community Mental Health Act of 1972. This paved the way for local communities to provide people with requested mental health support services, either through county services or by the county's subcontracting services. However, these initiatives were not adequately funded, and the people to be effected by them were not part of the development process.

Failing to simply ask, "How can we help you?", allowed traditional institutionalized psychiatric segregation and control practices to weave their way into the fabric of community mental health services. This treatment has produced severe dependency on professionals for life's answers deprives people of the opportunity for capacity, as well as, the responsibility for their own lives. The process usurps self-reliance and prolongs incapacitation. In effect, the current mental health system increases incapacity rather than assisting people to become more responsible for their actions and their own lives, evidenced by the annual increase in numbers of adults and children labeled mentally ill, and the lack of people leaving or graduating from mental health services.


MENTAL HEALTH COURTS


The United States Congress sanctioned demonstration programs in 2000 for mental health courts (P.L.105-515) to address the criminalization of people labeled with mental illness. Segregating people by "illness" with the judicial system, mandating treatment and punishing failure, serves to perpetuate the criminalization of people so labeled. A separate pseudo-system of justice only serves to propagate perceived iniquities.

The general premise of mental health courts is to obtain more treatment for people with psychiatric diagnoses who have committed a crime and thereby, reduce recidivism within the criminal justice system. In actuality, however, mental health courts accomplish little more than prevent jail time for offenses and ensconce people into the mental health system. A candidate's eligibility generally requires a confirmed diagnosis of a mental illness, and the crime must be related to such. The alternative presented by courts is that the person either receive criminal punishment for the crime by way of probation, fine, and/or jail time, or adhere to a service plan that includes mental health treatment with the court ordering sanctions for failure to comply.

The tax burden is increased each year by prison expansion and psychiatric health care costs. Few people are seen as rehabilitated through the prison and fewer still transition from the mental health system. Prison populations increase annually, as do the numbers of people receiving mental health treatments.


RECOMMENDATIONS


The criminal justice system needs to remain a system based on law and not become a treatment referral system. Segueing people from one system to the next is a simplistic, ineffectual response to complex concerns.

Legislative changes must occur. The language of statutes affecting people describes as "the mentally ill" perpetuates discrimination of people so labeled by the mental health system and allows for a compromise of their civil rights by the justice system meant to protect such rights.

The mental health system must effectively assist people struggling with life issues, who are distraught from crisis, and/or are seeking help to deal with emotional issues, with services that meet the persons self-determined, self-defined goals and without imposing labels of "illness" which are followed with prescribed theories and algorithms that are played out because of economic interests. The fundamentals of one person helping another, beginning with a response to the expressed interest of their clientele, would be an adequate start.

Community service package that mandate compliance with mental heath treatment programs should be unbundled to prohibit discrimination and allow for responsive services without force or the threat of force.

Collaborative community efforts to help people seeking assistance must effectively address the expressed holistic needs of individuals. The lack of fair housing, employment opportunities, and the need for social reform can not be understated or ignored. Innovative solutions to resolve existing social concerns must be initiated and funded. Such efforts would help alleviate the strains of the criminal justice system and the mental health system.


CONCLUSION


Punishing and/or treating people through either or both systems without addressing the problems at the core is not the solution. Rather, it perpetuates and exacerbates the problems.

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Amy Smith, psychiatric survivor, organizer and artist

From her home in Colorado, Amy Smith provides leadership for the movement to change the mental health system in a variety of ways, from events to art work for the Occupy American Psychiatric Association peaceful protests by MindFreedom International. Amy is a psychiatric survivor, who has been psych drug-free since 2008. She is the former director of Colorado’s statewide consumer organization, and the creator of RISE University, an education program designed to illuminate the experience of labeled individuals and their families.
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