The provision of mental health care services throughout most of North America, including Canada, has witnessed a steady decline, beginning with the deinstitutionalization movement in the latter half of the 20th century. As a result, a criminalization of mental illness has occurred. Accused with mental disorders languish in detention centres and correctional facilities, where they lack much-needed treatment.

Mental health courts are a response to this reality. In the typical American paradigm, some accused can avoid conviction and sentence through successful participation in a treatment program overseen by the mental health court team. These accused are diverted back into the civil mental health care system. The Canadian system has been much broader in focus. The primary objectives of the courts are to expeditiously assess and treat mentally disordered accused and to slow down the “revolving door.”

Mental health courts began as grassroots initiatives in the mid-1990s. One of the first known programs, the “Diversion of Mentally Disordered Accused,” was created in Toronto as part of the Crown Policy Manual in 1994. In addition to this program, a mental health court was created to deal with a broader range of issues. These specialty courts have been a success and now number in excess of one hundred in North America alone.

In writing this book, the authors have sought to assist two groups of professionals involved with these courts–mental health care service providers and the various criminal justice professionals.

Part I of this book is an overview of the historical and theoretical foundations underlying the mental health court movement. Part II offers a thorough description of a typical mental health court in operation. It describes the role of each mental health court team member and provides guidance to those seeking to establish a mental health court. Part III analyses the successes and failures of these courts and ends with a critical look at the long-term desirability of mental health courts.