Mental Health Issues and Challenges in the Courts

Mental Health Issues and Challenges in the Courts 

Mental health is a significant issue in society today. It is even more concerning when it is related to its role within the criminal justice system. It is crucial to understand and recognize that some mental health issues can potentially affect the way an individual is handled or treated during the court process and within the criminal justice system. The problem lies in determining who is mentally ill and separating them from those individuals that try to use their issue as a defense for their actions. “There is irrefutable evidence internationally that mental illness is over-represented in the criminal justice system" (Daff & Thomas, 2014, p.1985). Additionally, "those with bipolar disorders have been found to be over three times more likely than those without a mental disorder to have had over four or more previous incarcerations" (Daff & Thomas, 2014, p.1986).

According to the text, Courts, when a defendant is suspected of being incompetent to stand trial, their attorney can file a pretrial motion for a determination of competency (Spohn, Hemmens, & McCann, 2019). If the motion is granted, the defendant will be evaluated by a psychologist or psychiatrist. For this to happen, there must be a reasonable cause to believe that the defendant is suffering from a "mental disease or defect" which makes him unable to understand the implications of the proceedings against him and that he be unable to help in his defense (Spohn, Hemmens, & McCann, 2019, p. 216). It is essential to mention that a defendant will not be unfit to plead simply because the individual has a mental disorder.

According to the article, Mental Disorder and the Criminal Justice System: A Review, the reason for the increasing number of mentally ill individuals in the criminal justice system is due to the closures of many state-run mental facilities (Freeman & Roesch, 1989). This essentially caused the release of these individuals into communities that either did not know how or did not care to deal with them. Since there are very few treatment centers set up to deal with the unique needs and issues efficiently, these people are faced with the reality of being homeless, and often become either victims or perpetrators of crime (Freeman & Roesch, 1989). The state is then tasked with the job of getting them off the street to protect citizens from these perceived dangerous people. To deal with these people, they are either locked up by incarceration or in a mental hospital.

The issue then becomes that “most civil commitment statutes now restricted involuntary commitment to those patients who are explicitly and imminently dangerous” (Freeman & Roesch, 1989, p.106). The results are that the most severely disturbed mentally ill individuals can no longer be removed from the community under civil law. This essentially creates a need to find a criminal solution, like arrest or incarceration, as a solution to the problem. Something important to note is that most mentally ill individuals are not violent, even though there is a common perception that they are. Also, they are often arrested for lower-level offenses.

Mental illness is a unique circumstance recognized in both common and statutory law. However, the designation of “mentally ill” means very different things within the legal and the health fields and is most evident at the pretrial and adjudication stages of the criminal process. Being designated mentally unfit to stand trial or insane are legal terms. Many of the people who are “diagnosed (or diagnosable) as mentally ill are legally fit, sane, and liable to being held criminally responsible” (Freeman & Roesch, 1989, p.108). The verdict of ‘not guilty by reason of insanity’ is often confused with the issue of fitness to plead. “‘Insanity’ is concerned with the mental state at the time of the offense while fitness to plead is related to the mental state of the individual at the time of the trial” (Dolan, 2004, p.S12). In reference to the law, to test insanity, it must be established that the accused had a 'defect of reason' due to a 'disease of the mind' which caused the individual not to be able to tell right from wrong. Those determined to be 'insane' are considered not responsible for their actions as determined by the law and, for that reason, are 'not guilty' (Dolan, 2004, p.S14). The insanity diagnosis requires evidence from at least two doctors. There are other individuals who are found to be fit to stand trial, who committed the criminal act, who may have been ‘insane’ at the time they committed the offense. When an individual is found to be 'not guilty by reason of insanity', the accused is not free to go, as they would be if they were found 'not guilty'. They are subject to options similar to those who are found unfit to plead (Dolan, 2004).

There are legal consequences that result from being designated unfit or insane. The outcome is that those individuals can then be placed involuntarily in a mental health facility until they become fit. For this reason, an attorney will be extremely cautious in deciding to have their client declared unfit. One study reported that this happens in fewer than one percent of felony trials and was successful in only one percent of those (Freeman & Roesch, 1989). There also seems to be tremendous controversy that accompanies the fitness and insanity issue as there are several different tests that are used to determine insanity. Data provided in a study by Gingell, indicate that nearly ten percent of inmates had a significant mental disorder, often schizophrenia, at the time they were being held while awaiting trial. The data also notes that very few of these individuals were provided a fitness hearing, and, of those people, none entered an insanity defense (Freeman & Roesch, 1989).

Furthermore, some jurisdictions have eliminated the insanity designation for "guilty but insane" or "guilty but not criminally responsible by reason of mental disorder" (Freeman & Roesch, 1989, p.109). This rule was established to authorize treatment for the mentally ill after a conviction; however, seventy-five percent of those defendants who are guilty but insane were incarcerated without any psychiatric treatment. Moreover, arguments against the guilty but mentally ill designation claim that it violates both actus rea (criminal act) and mens rea (criminal intent), which are both required to establish guilt (Freeman & Roesch, 1989). 

Under the Homicide Act 1957, an individual can enter a plea of diminished responsibility if they are charged with murder. This plea can potentially result in the reduction of a murder charge to a charge of manslaughter. There must be medical evidence to enter this as a defense (Dolan, 2004). Except for this example, having a mental illness does not affect liability for a crime. It holds that individuals suffering from mental illness are to be judged by the same criminal standards are everyone else. 

It seems that there is not enough opportunity and availability of psychological and psychiatric services for those inmates that need treatment. The condition to be released on parole requires that individuals receive their designated necessary treatment. Failure to provide adequate access to treatment with these facilities violates the Charter of Rights and Freedoms, which guarantees a person's right to liberties. Something interesting to note is that outside of the mental health system, an individual has the right to refuse treatment, and there is an obligation to obtain consent before providing any treatment, with few exceptions. This is flexible when it comes to involuntary mental patients. In the United States, incarcerated offenders have the right to refuse treatment (Freeman & Roesch, 1989). Any attempts to force treatment on the criminally incarcerated mentally ill generally receive resistance, with the exception of those individuals that are adequately troubled that they meet the standards for civil commitment.

Under the Mental Health Act of 1983, judges are given more power when dealing with criminally charged mentally ill offenders. According to Dolan (2004), a judge can send an accused individual to a hospital for assessment or treatment before trial. Also, the judge can order the detention of a mentally ill offender to a hospital after conviction. The Mental Health Act of 1983 also gives doctors and hospitals the authority to treat mental illness without an individual's consent, even in cases where they are capable of refusing treatment.

Mental health is a significant concern in most communities because of the lack of available resources and much-needed treatment facilities. It seems that mentally ill individuals also create a challenge for courts, detention facilities, and mental health providers. The law acknowledges mental illness only to determine fitness and insanity issues. There are many individuals with mental health issues that enter the system without proper designation or treatment. There are very few people in the criminal justice system who receive the official designation of being mentally ill, virtually ignoring the majority of the population of offenders with mental illnesses who are designated fit and sane. The issue that needs to be addressed is how to properly deal with those who enter the system with psychiatric conditions. This needs to be discussed at the community level to minimize the impact that these issues cause within the criminal justice system.

References

• Daff, E., & Thomas, S. (2014). Bipolar disorder and criminal offending: A data linkage study. Social Psychiatry and Psychiatric Epidemiology, 49(12), 1985-1991.
• Dolan, B. (2004). An introduction to law relevant to mentally disordered offenders. Criminal Behaviour and Mental Health, 14(2), S12-S18.
• Freeman, R., & Roesch, R. (1989). Mental Disorder and the Criminal Justice System: A Review. International Journal of Law and Psychiatry, 12(2-3), 105-115.
• Spohn, C., Hemmens, C., and McCann, W.S. (2019). Courts: A Text/Reader (3rd edition), Thousand Oaks, CA: Sage Publications Inc.