Friday, July 16, 2021

Obtaining services and treatment for mental illness continues to be a major challenge in the United States. The challenge compounds significantly when individuals suffering from serious mental illness (SMI) have a co-occurring substance use disorder (SUD). According to SAMHSA, of the 8.9 million young adults who reported having a mental illness in 2018, more than 2 in 5 went untreated and of the 5.1 million with an SUD, nearly 9 in 10 did not get treatment. And according to the National Institute of Mental Health, nearly one in five U.S. adults live with a mental illness, some 51.5 million in 2019, with 13.1 million adults suffering from an SMI.

For far too many individuals suffering from an SMI, SUD, or both, the justice system is the de facto entry point for obtaining treatment and services. There are many reasons for this, not the least of which is the criminalization of mental illness and the lack of alternative approaches to divert individuals from the courts and into treatment. Because the justice system plays such a major role in responding to SMI and SUD, the state courts of our nation play a vital role in leading change. State courts are most often the primary referral source for treatment, as individuals suffering from SMI or SUD get swept into the justice system. State courts are on the frontlines of the crisis.

Given our nation’s reliance on the justice system in responding to SMI and SUD, SAMHSA, the Conference of Chief Justices and the Conference of State Court Administrators (collectively, Conferences) have agreed to cooperate in their efforts to improve the state courts’ response to individuals suffering from mental illness and SUD. Building on the work of the highly successful National Judicial Opioid Task Force, the Conferences have established, with funding from the State Justice Institute (SJI), a national task force to examine the state courts and recommend systemic improvements in the justice system’s response to those with mental illness. Assistant Secretary of SAMHSA, Dr. Miriam Delphin-Rittmon notes, “I am so pleased that SAMHSA is part of this important Initiative which presents a unique opportunity for state and national behavioral health and justice leaders. The states’ chief justices are responsible for every aspect of the judicial system; the fact that for the next two years they will focus on issues of individuals with mental illness and substance use disorder and their interactions with the court system provides an opportunity for transformative work and collaboration between the justice and behavioral health leadership in every state.” Chief Justice Paul Reiber of Vermont, co-chair of the national task force, notes that “A partnership between the Conferences, SAMHSA’s national and regional experts and state behavioral health leaders is absolutely critical if we are going to make any progress in addressing the challenges SMI and SUD present to our justice system and therefore our nation.” And Chief Administrative Judge Lawrence Marks of New York, co-chair of the task force, notes “Our ability to align justice system responses and individual needs depends on state court leaders and behavioral health leaders at all levels understanding the breadth of challenges, identifying intersections between courts and behavioral health, and finding innovative solutions.”

Recognizing the critical role state courts play in responding to justice involved individuals suffering from an SMI or SUD, SAMHSA and the Conferences in conjunction with other state and national leaders are committed to working together in partnership to lead systemic change and promote systemic innovation. Recently, regional directors of each of SAMHSA’s ten regions and members of the executive committee of the national judicial mental health task force cooperated in a series of regional calls that brought together the chief justice, court administrator, and behavioral health director from every US state and territory. These calls both highlighted the common challenges that face courts and behavioral health leaders in every state and confirmed the need for a more effective partnership. They also demonstrate the importance of joint leadership in addressing the problem – chief justices, state court administrators, SAMHSA and regional and state behavioral health leaders working together to find solutions to a deep and pressing need. Only through such partnerships between the Conferences and national behavioral health leaders will the state courts be able to respond more effectively to those suffering from an SMI or SUD.