Public Defense Services for Defendants with Mental Health Needs: Results from Mixed-Methods Research

Purpose:  Untreated mental illness is at the root of criminal justice system involvement for many people. Courts use a range of strategies to divert defendants with mental health disorders (MHD) to treatment, as an alternative to incarceration.  Indigent Defense Attorneys are defendants’ primary advocates and play a strategic role in diversion-to-treatment strategies.  

There is a dearth of social science research addressing the challenges that attorneys face when representing defendants with MHD.This presentation will discuss the results of a mixed-methods study of indigent defense services for people with mental health needs that was funded by the National Institute of Justice.

Method: The study team conducted semi-structured interviews with defendants and their defenders from a one-year cohort of individuals arraigned in NY (Bronx and Monroe Counties  n = 200 defendants, 157 defenders).  The team analyzed administrative data from the local jails, Department of Health and Mental Hygiene, and the courts.  Data collection was completed in February 2015.  Data was used to answer the following questions: What is the relationship between type of representation, the nature of a defendant’s Mental Health Disorder (MHD) and case outcomes? What are the specific challenges faced by defenders when representing clients with MHD? How do they negotiate these challenges? What are the needs and priorities of defendants with MHD? How satisfied are they with representation and case outcomes? How much do the different models of indigent defense cost?

Implications: The incarceration of people with mental health disorders represents a significant public health crisis. Evidence-based diversion strategies that address untreated mental health symptoms are essential to supporting positive outcomes.