Eukaryon

Download PDF

If everyone who recognized your difficult days and knew when you were not your full self suddenly disappeared. It would leave anyone vulnerable. This reality, layered onto someone who is already struggling with their mental health, can create a space to be judged not based on the full story. That is not merely unfortunate; it is unfair and unjust. People can relate to the need for support, a community, and someone who truly sees them. The stigma against mental illness causes discrimination. And, our fear leads to the criminalization and ostracization of a person’s differences. Thus, leading someone to incarceration. 

Mass incarceration is a persistent and growing issue in the United States. Alongside this is the growing number of individuals living with untreated mental health conditions, visible and non-visible. These two crises are not parallel; they intersect. Mental Health Courts (MHC) provide a barrier to help filter out individuals who are entering incarceration and allocate potential resources that could prevent them from re-offending. Despite MHCs becoming a deterrent to imprisoned individuals with mental illnesses, many of those individuals are still not getting the help they need. Those with unaddressed psychological needs are often placed into the prison system not because of intrinsic criminality, but because of systemic neglect (Otto, 2020).

Background

In 1841, Dorothea Dix, while teaching in a Massachusetts jail, observed that a high number of inmates were not criminals, but people with mental illnesses (Dvoskin et al., 2020). Her observations led to her efforts to provide proper care to individuals who were struggling with mental illnesses and had been penalized for it. Most individuals at that time who were believed to have a mental illness were forced into psychiatric hospitalization or the jail system. About forty years later, Massachusetts enacted the first state law allowing voluntary admission (Dvoskin et al., 2020). Even more recent is the development of a Therapeutic Court: The Mental Health Court (MHC), first established in 1980 in Indiana. 

Figure 1. Illinois Cities with Mental Graph Programs as of 2020 (Otto, H. D.2020).

MHCs allow defendants to be seen in court as more than just a case, but as people struggling with mental illness. MHCs work specifically with defendants who have mental illnesses to balance specialized care and sentencing. MHCs serve as a useful tool to reduce recidivism, the likelihood of re-offence (Otto, 2020). When defendants are granted the court’s permission to choose treatment over traditional sentencing, they gain access to support that can help disrupt the cycle of incarceration.

Mental Health Courts are one of several types of Therapeutic Courts. Currently, Lake County has a Drug Court, Veteran Treatment and Assistance Court (VTAC), and MHCs. By having MHCs, they are able to focus on a small group of individuals with severe mental illnesses, from schizophrenia to severe bipolar disorder. Depending on the severity of the violation, whether felonies or misdemeanors, this court offers tailored interventions. MHCs utilize the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to define mental health disorders, symptoms, and criteria for the disorder (American Psychiatric Association, 2013).

When an individual is arrested, police are trained to recognize signs of mental health issues. They may not catch every individual; however, there is another filter, attorneys. Attorneys are informed by the Bar Association to assist in identifying clients who may benefit from MHC. Both police and attorneys play major roles in the first step: application.

Application

An individual with a pending case may apply to MHC with the understanding that they have a severe mental illness. The case is then screened by the MHC team, which includes two judges, two state attorneys, two probation officers, a case manager, and a psychologist/clinician. The psychologist conducts a screening to assess the severity of the illness and whether the individual is fit for programming. If their mental illness is deemed not to meet the criteria for the program, then they will be denied. This is because MHCs are small and need to be selective, as this process is long and intricate. However, this also highlights how individuals are excluded because of systems like the DSM-5, which may not capture the full experience of mental illness (American Psychiatric Association, 2013).

Furthermore, there is another choice to make. After assessment and confirmation, the case’s legality must also be considered. Felony or misdemeanor charges are reviewed in accordance with federal law: “The court shall impose a sentence sufficient, but not greater than necessary, to reflect the seriousness of the offense, to promote respect for the law, and to provide just punishment for the offense” (18 U.S. Code § 3553, n.d.). Individuals must serve their sentences and will not get an “easy way out.” Instead, they will have to work hard for their program and commit to treatment. 

Processing/Entering of the Program

If the case is not approved, it may be dismissed or reconsidered. If approved, the individual enters the program under the supervision of a probation officer. Mental Health Courts (MHCs) then develop a tailored treatment plan, which may include group or individual therapy, prescribed medication, and other supportive programming. 

Another form of treatment and programming offered through MHCs, as Frank Morelli, Manager of Probation in Lake County, explained in an interview, “Our adult probation department has several programs that are run by Probation Officers. Moral Reconation Therapy (MRT) for substance abuse and for domestic violence is part of that programming. It is equivalent to Intensive Outpatient Therapy for substance abuse”(F. Morelli, personal communication, August 24, 2025). MRT is a cognitive-behavioral treatment to enhance positive behavior, moral reasoning, and decision-making. Originally developed by Dr. Gregory Little and Dr. Kenneth Robinson to treat moral reasoning in offender populations and individuals with substance use issues (Correctional Counseling, Inc., n.d.).

For individuals with greater needs—such as lacking housing or experiencing severe mental illness—Lake County provides access to housing with on-site services. Lake County is unique in its commitment to ensuring participants have everything they need—from rides to appointments to medication pickups. The biggest thing about the court and the team at Lake County is that they care. Comparatively, MHCs are small but thorough; they only take a limited number of participants at a time to ensure proper care. Yet many more individuals need help. That is why, as we move into the next stages of our lives, we must reflect on where we can make an impact.

The Impact

When an individual enters the Lake County Court, they join a family that wants them to succeed. They are required to attend court every Monday, where Judge Bishop or Judge Novak checks in with them, starting by asking how they are doing and genuinely trying to build connections. Manager of Probation Frank Morelli makes it clear that this leaves the individual vulnerable during treatment and in court (F. Morelli, personal communication, August 24, 2025). Then, the judge reviews their treatment progress by holding them accountable or offering incentives. Incentives include $10 gift cards, increased privileges such as an extended curfew, or having their case called first in court (Judge Bishop, personal communication, August 24, 2025).

Once probation is completed, individuals are encouraged to stay in contact with the team. Major outcomes I observed during my time at MHC included individuals gaining employment and achieving mental health stability. Beyond those outcomes, I witnessed people reconnecting with family, continuing their education, and most importantly, finding a support system. This system allowed them to make their own choices. Like Dix, I saw individuals who were struggling with their mental health finally begin to move forward (Dvoskin et al., 2020).

Thus, Mental Health Courts create a foundation of care and respect; they remind us that there is room for both justice and compassion. By challenging the idea that punishment is the only response to unwanted behavior, they offer something more that allows an individual to reflect, grow, and adapt to new and uncomfortable challenges. As we move forward in our academic and professional lives, it is imperative to ask ourselves whether the systems we want to build and grow within criminalize individuals for being different or recognize their humanity. The work being done in Lake County is not just legal work; it is rooted in emotional and scientific understanding. It shows what can be the outcome when an individual has support, a community, and someone who truly sees them. And that is the kind of justice worth working towards.  

Note: Eukaryon is published by students at Lake Forest College, who are solely responsible for its content. This views expressed in Eukaryon do not necessarily reflect those of the College. Articles published within Eukaryon should not be cited in bibliographies. Material contained herein should be treated as personal communication and should be cited as such only within the consent of the author.

References

Dvoskin, J. A., Knoll, J. L., & Silva, M. (2020). A brief history of the criminalization of mental illness. *CNS Spectrums, 25*(5),1–13.[https://doi.org/10.1017/S1092852920000103]

Otto, H. D. (2020, October 26). *A review of literature on mental health court goals, effectiveness, and future implications.* Illinois Criminal Justice Information Authority. [https://icjia.illinois.gov/researchhub/articles/a-review-of-literature-on-mental-health-court-goals-effectiveness-and-future-implications]

American Psychiatric Association. (2013). *Diagnostic and statistical manual of mental disorders* (5th ed.). American Psychiatric Publishing, [https://www.psychiatryonline.org/dsm]

Legal Information Institute. (n.d.). *18 U.S. Code § 3553 - Imposition of a sentence.* Cornell Law School. [https://www.law.cornell.edu/uscode/text/18/3553]

Correctional Counseling, Inc. (n.d.). *History of MRT.*