Lawmakers, Top Judges Push to Expand Mental Health Courts

Courts around the state have set up similar programs to allow people with mental illnesses and substance use disorders to enter treatment when facing certain criminal charges, typically in exchange for a guilty plea, as an alternative to jail or prison time. But they reach just a fraction of the people who might benefit from them.

“My path is not the norm, but it should be,” Bernardez said at the hearing, testifying in support of a bill called the Treatment Court Expansion Act, which would increase access to diversion programs across the state.

Currently, one in five people in New York City jails has a serious mental illness, according to city data. Very few have gotten support through diversion programs. In 2021, just over 0.3 percent of more than 34,000 people arrested in Kings County entered a mental health court program; in Tompkins County, just over 1 percent did, according to a report from the advocacy group National Alliance on Mental Illness.

At Rikers Island, thousands of people with psychiatric issues often encounter inadequate mental health treatment, and suicides and other deaths persist. County jails across the state are ill-equipped to care for incarcerated people with severe mental illnesses, sometimes transferring them to maximum security prisons while they’re legally innocent.

Unlike drug courts, mental health courts aren’t currently required by state law; individual courts have created them on an ad hoc basis. The proposed legislation would create statutory mental health courts across the state. The measure would make any New Yorker with a “qualifying diagnosis” — including most mental illnesses, developmental disorders, and substance use disorders — eligible for a diversion program. And it would allow people with misdemeanor or nonviolent felony charges to enter treatment immediately, without pleading guilty.

The bill was first introduced in the 2019–2020 session, but has never made it to the Senate or Assembly floor. Its latest version addresses some reservations from the judiciary. With support from the Court of Appeals Chief Judge Rowan Wilson and a growing number of Democratic state lawmakers, it may have a fighting chance in next year’s legislative session.

Proponents point to the significant cost savings achieved by diverting people from jail to drug treatment courts, as well as polling showing crime victims’ support for diversion programs. Studies have found that graduates of mental health court programs tend to show reduced recidivism, though evidence of lasting clinical success for participants is mixed.

Though the bill has gained broad support, its backers are gearing up for a parallel fight for more state investment on the treatment and provider side.

Expanding treatment courts would require only modest spending on additional judges or court staff, Wilson, the state’s highest-ranking judge, told lawmakers at the hearing. The far greater cost, he said, would be to bolster treatment services, especially in parts of the state without them.

“The way to make it a failure is to divert people and not have anywhere to send them,” Wilson said.

At the hearing, mental health and criminal justice reform advocates voiced strong support for the measure, but some echoed Wilson’s warning that it will require deep investments in mental health services to succeed.

“If you have more people able to access treatment courts, it could present a capacity issue on the behavioral health system,” said Nathan McLaughlin, who runs the New York state branch of the National Alliance on Mental Illness.

Zachary Katznelson, the executive director of the Independent Rikers Commission, backed the proposal but urged lawmakers to build a stronger pipeline for the clinicians, nurses, and social workers who will staff the treatment side of diversion programs.

“We don’t have enough staff to actually fill the vacancies that exist today in the existing services,” he said.

In 2023, Governor Kathy Hochul pledged to invest $1 billion in the state’s mental health care system. Since then, the state has expanded outpatient services, outreach teams, and psychiatric hospital bed capacity, but advocates told New York Focus earlier this year that the expansion has not kept up with demand for the programs. The behavioral health workforce is also stretched thin.