A Court of Mental Health

A Court Of Refuge: Stories From the Bench of America’s First Mental Health Court

It’s difficult for me to separate myself and critique this book outside of my attachment to and interest in its general concept, which is the development of a court of refuge for those who would otherwise become victims of what has come to be known as the “criminalization of mental illness.” A Florida judge, Ginger Lerner-Wren, observed many cases in her courtroom where she felt people were written off as hopeless and locked away in the prison system for an offense committed under the influence of a mental illness. Judge Lerner-Wren does an admirable job of weaving a few narrative threads together without creating confusion: the perceived need for the court after her witnessing many cases springing out of mental illness and its attendant circumstances of substance abuse, poverty, and homelessness; the court’s development and history from the lunch hour of her criminal division in the Broward Country, Florida courthouse to a multi-tiered national phenomenon; following the stories of a few of its earliest participants and tracking their progress and later success re-integrating into society; and the country’s overall treatment of mental illness and criminal justice, and how it has changed over the years.

Judge Lerner-Wren writes in an empathetic, clear, and straightforward style, without too much legalese and with the biggest focus being on the personal stories and how they reflect the mental health court’s mission. When she does use a term like “therapeutic jurisprudence,” she is always careful to define it and how it relates to the mission of the court. Overall, the book’s subtitle is an apt description of what it contains: “stories from the bench of America’s first mental health court.” 

I only recently learned about the existence of mental health courts, though there was a documentary about a S.O.B.E.R. court in the festival last year (S.O.B.E.R.: DWI Courts and the Transformation From Addiction to Recovery). These “problem-solving” courts offer a meaningful alternative for offenders with a mental illness or addiction who agree to a voluntary treatment program under court supervision. Both of these types of courts operate on the same basic premise: that by treating the underlying root causes of an addiction or mental illness and working to make the person whole, you can not only divert a lot of valuable members of society from jail, but you can also rehabilitate them. The argument is that problem-solving courts can actually save money and lives in the long run by reducing recidivism and re-introducing productive members into society, allowing us all to rise together. 

I loved how Judge Lerner-Wren shows that there are a lot of moving parts to a mental health court. She had a crisis team on call to immediately intervene during severe psychotic episodes and formed partnerships with various outpatient programs including group therapy and substance abuse therapy groups as well as housing and employment services for people with low income or people in rehabilitation. It’s a system that surely takes cooperation among the whole community but is likely to benefit all these social service organizations in the end. 

Judge Lerner-Wren doesn’t completely sugarcoat the court. While there are a few stories of former participants waving to her from bus windows or approaching her on the street excitedly telling her “Judge, I’m working now!” or “Judge, I went back to school!,” there are also some she sees who have returned to their drug habit or become panhandlers–demonstrating the court is not fail-safe, and participants must continue to do the work and maintain their progress outside a more monitored environment and program. 

I’m glad there are mental health courts in America (apparently over 400 now). What if so many people whose lives could be turned around ended up able to rehabilitate and re-enter society, rather than relapse? Prison isn’t rehabilitation. It’s a system of containment, punishment, and profit, and it often returns a person to society with a record that will lock them out of a fair share of housing and employment opportunities for the remainder of their lives, leaving them unable to contribute to society in any meaningful way. When I think of the many bright and talented individuals I’ve met in my own therapy programs who have made mistakes during psychotic episodes, I think that the intervention of a mental health court could potentially lead to so many lives being saved instead of so much wasted potential, the engagement of so many valuable social services instead of commissary fees, and a possible savings to society at large with less incarceration time and less recidivism. 

Adult Mental Health Treatment Court Locator | SAMHSA

Position Statement 53: Mental Health Courts | Mental Health America (mhanational.org) 

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