Evolving Role of the Criminal Justice System with Mental Health Offenders

Health Affairs is requesting abstracts for its theme issue on behavioral health, which will present work pertaining to policies involved in the delivery of mental health and substance abuse services. 15 to 20 peer review articles will be published in June 2016


This paper will discuss the evolution of the criminal justice system to better deal with mentally ill offenders. Current practices are forcing mental health counselors to work with jails, police officers, probation officers, and the courts.  Police and corrections officers have had to adjust their procedures and practices to better interact with mental health offenders which was previously seen as a mental hospital function.  Mental health courts require mental health counselors to evaluate and present recommendations on the best course with a mentally ill offender. This presents patient confidentiality issues while law enforcement is presenting a case for punishment. 

The mental health counseling and criminal justice system was developed through different avenues. Mental health counseling focused on the treatment of the patient. Law enforcement, jails and the courts concentrated on control and punishment of the offender regardless of the mental status. However, with the shift of mental health policy, better cooperation and treatment of the offender is required by both the mental health community and criminal justice. 

The evolution of the criminal justice system began with Dorothea Dix, a Sunday school teacher who walked into a basement in the 1800’s to find naked individuals chained to a wall. The belief was a person with mental illness actually converted to a primal state not requiring clothes. In Memphis, TN a mentally ill offender was killed by police officers. This resulted in a combined effort by police, mental health counselors and local hospitals in a better approach to deal with these offenders. Crisis Intervention Teams are used to intervene on the streets with mentally ill offenders in crisis.

While some large jails maintained mental health units, many smaller jails and Department of Corrections (DOC) prisons did not provide adequate resources.  Bradley vs Haley (1992) involved the severe lack of adequate mental health care, lack of mental health training for corrections officer and other issues in Alabama DOC.  Crisis Intervention Teams and mental health training was later developed in many jails.

 Many criminal courts realized the current system was not adequate to effectively deal with the needs of the mentally ill offender. The mental health court was seen as a cooperative effort between the need for punishment and treatment. This required a higher level of cooperation from law enforcement, jails and mental health counselors.

In-service and college curriculum on mental health had to developed and provided to all aspects of the criminal justice system and mental health providers to better work together in these situations.  In most Crisis Intervention Training sessions, users of the mental health services discusses their experiences with criminal justice (law enforcement, jails , courts) on how it could be improved.  It has become important the different aspects/approaches/ viewpoints on the mentally ill offender come together to effectively and safely deal with the situation. 


Publication Type: 
Journal Article
Ray Bynum
Debbie Ferguson
Dan Phillips
Year of Publication: 
Journal, Book, Magazine or Other Publication Title: 
Health Affairs