Integrating the criminal justice system into mental health service delivery: the worcester diversion experience

Abstract

The substantial number of persons with mental illness encountered in many sectors of the criminal justice system has spurred actors from various agencies within that system to take actions aimed at reducing the growth of this population. These actions have included the development of specialty police units, jail diversion programs, and other mechanisms for channeling persons with mental illness out of the criminal justice system and into mental health treatment. The courts, too, have become involved in this effort with the recent development of the "mental health court," the latest of the "specialty" or "problem solving courts." These courts have not been without their critics, however, nor are they the only feasible approach to court-based diversion. This paper identifies and explores a range of options for structuring the relationship between criminal courts and local mental health systems. Beginning with a discussion of the rationale motivating the development of mental health courts, two alternatives to this specialty court model are discussed. One involves judges dealing with defendants having mental illness and substance abuse on a case-by-case basis. The other takes advantages of linkages that may already exist between most courts and the mental health providers who conduct their forensic assessments, expanding the role of these providers to serve as boundary spanners between courts and the components of local mental health systems. Regardless of the model adopted, however, appropriate linkages must exist between the courts and relevant providers. A case study is provided that demonstrates how the status of a locale's linkages can be evaluated and how the information derived from such evaluation can be used to improve the linkages between police, courts, and health and human services agencies.

Les Tribunaux de santé mentale : déjudiciarisation et jurisprudence thérapeutique

“…Alors qu'un tribunal régulier est animé d'un esprit de confrontation et de punition (Schneider et al, 2007), le TSM se présente plutôt comme un « agent thérapeu-tique » (Lerner-Wren, 2000) qui, à travers des échanges non conflictuels vise à trouver la meilleure solution menant au rétablissement éventuel du contrevenant (Grudzinskas et al, 2005 ;Poythress et al, 2002). Le juge n'est pas perçu comme une autorité détachée, mais plutôt comme un acteur qui noue une alliance avec le candidat (Poythress et al, 2002 ;Steadman et Naples, 2005).…”

“…Les équipes peuvent être composées de juges, d'avocats, de procureurs de la couronne, de médecins, psychologues, infirmiers, travailleurs sociaux, d'agents de liaison, criminologues, etc. (Grudzinskas et Clayfield, 2004 ;Grudzinskas et al, 2005 ;Schneider et al, 2007). Afin d'assurer la collaboration interdisciplinaire, il est essentiel que tous les intervenants se familiarisent avec le langage, les outils et les valeurs des uns et des autres et comprennent leur rôle distinct dans le processus judiciaire (Hartford, 2007 ;Schneider et al, 2007).…”

“…D'abord, les TSM constituent des phénomènes mouvants et non standardisés (Steadman et al, 2001). Non seulement les interventions varient-elles énormément d'un site à l'autre (Erickson et al, 2006 ;Grudzinskas et al, 2005) et d'un participant à l'autre (Goldkamp et Irons-Guynn, 2000), ces institutions sont aussi en constante évolution (Belenko, 2002 ;Cosden et al, 2003 ;Hoffman, 2002). Il est difficile de mesurer l'effet d'une seule intervention en raison des modifications internes (structure, procédures, personnel) et des changements contextuels (disponibilité des soins de santé, politiques, perceptions du public, etc.)…”

Facilitating knowledge exchange between health-care sectors, organisations and professions: a longitudinal mixed-methods study of boundary-spanning processes and their impact on health-care quality

“…57 Also included were two comparative case studies (one from the UK and the USA and one from the UK and South Africa). 82 Twenty-four studies (63.2%) used qualitative methods, 15,55,56,58,59,[61][62][63][64][66][67][68][69][70][75][76][77][78][79][80][81][82]87,91 of which 13 had a case study design 56,58,61,62,66,69,70,[75][76][77][78]79,82 and five were specifically ethnographic in their approach. [78][79][80][81][82] Nine studies used only quantitative research methods 60,65,[71][72][73]…”

“…Of the included studies, 17 were from the UK, 15,56,[61][62][63][64]68,70,[75][76][77]79,80,82,83,90,91 13 were from the USA, 55,[58][59][60]65,66,71,73,[84][85][86]88,89 four were from Canada, 69,72,78,81 one was from Australia, 74 one was from Ireland 67 and one was from Israel. 57 Also included were two comparative case studies (one from the UK and the USA and one from the UK and South Africa).…”