Last month I had the privilege of giving two lectures on the above topic, which holds special meaning for me. My presentation centered on the idea that forming a partnership between attorneys and mental health therapists will help secure the best possible results for their mutual clients not just now, but in the long run as well.
First I spoke with a group of local therapists in Deerfield Beach, and the following week I went on to do a second presentation at the Florida Behavioral Health Conference in Orlando. The positive response I got from both lawyers and therapists was so overwhelming that I wanted to share the experience. Because there’s a lot of material to work with (each presentation went over an hour!) I’ve broken the lecture down into two separate blog posts. This first one is geared towards how therapists can help lawyers.
To me it’s always seemed crazy that the two sides were separated, with little communication between them, especially considering the number of defendants in the criminal justice system with either a mental illness or substance abuse disorder. Just look at these statistics by the Florida Bar:
- 17% of adults booked into jails have a serious mental illness
- 65% of adults in the US Corrections systems have a substance use disorder
- 72% of adults with serious mental illnesses in jail also have co-occurring substance use disorders
When a person is facing legal trouble and is also battling an addiction, or suffering from a mental illness, that person needs both legal protection and treatment. These are the two pillars that together ensure this person’s best chance at success.
Pillars hold up the same structure. And while each pillar provides its own separate support, it would still be very helpful if each pillar knew what the other was doing, and shared valuable information that could strengthen the support each side can offer.
In my lecture I identified four key areas in which therapists can best help attorneys for the better good of their mutual clients:
- Helping the lawyer better interact with his/her client
- Establishing trust with the judge and prosecutors
- Establishing a concrete treatment plan with goals consistent with the criminal justice system, that the judge can sign off on
Helping the Lawyer Better Interact with his/her Client
Attorneys are given absolutely no training on how to work with mentally ill or addicted clients. We don’t know how to recognize signs that a client is on the verge of relapse, and we don’t always know when to take comments that seem like passing thoughts seriously. Unfortunately I had a client who joked with me about killing himself, and then one week later actually did it. I felt awful, and that in some way I had failed him. I kept replaying the conversation over in my head trying to figure out if I had missed an important sign, or if there was anything I could have done differently to prevent it.
That’s one area where clinicians can really help attorneys. They can educate them on how to best interact with the client, signs to look for that indicate the person is about to relapse, and when to take threats or comments seriously. I’m sure in this instance it may have helped me.
The response from clinicians on this topic during my lecture was powerful. They couldn't believe lawyers were given no training on how to work with individuals suffering from addiction or mental illness. That’s when I had to explain that unfortunately this lack of education isn’t limited to lawyers.
Education & Establishing Trust with Prosecutors & Judges
Lack of education permeates other parts of the criminal justice system as well, including judges and prosecutors, who are taught punishment, not treatment. The role of the prosecutor’s office, and of the judge is to protect society. Their primary concern is “if I let this person go, will they hurt someone else?” Because of course, slapped across newspaper headlines and local new stations will be the names of the judges and prosecutors who let the person go that then committed another crime. They’re looking to protect their reputation, as much as the public.
In their training, neither judges nor prosecutors are educated on proper treatment plans for a defendant suffering from substance abuse or a mental illness. They don’t know what the best course of treatment is, and they don’t know why one form of treatment would work well in one case and not another. They’re unaware that certain types of interactions may cause stress, or severe difficulty for a particular defendant. Take the case of the Broward judge who screamed at a woman with breathing problems, and specifically told her she wasn’t there to talk about the defendant’s breathing problems. That defendant died shortly after her court appearance.
Therapists have the ability to fill in this gap in education by taking the time to explain to the court what the best form of treatment is for a defendant, which I discuss more in the next section. When a clinician takes a vested interest in a client’s case, it helps establish trust with the judge and prosecutors. They see a lot of the same therapists over and over, and are a bit jaded. So when you go the extra mile for your client, it will create trust that can make a significant difference in the outcome of your patient’s case.
Most attendees found it ludicrous that the people responsible for deciding what happens in their patients’ lives don’t have an adequate understanding of treatment, or any way of really determining what is best for the patient.
That’s why a thereapist’s input can be very powerful.
Establishing a Concrete Treatment Plan with Goals Consistent with the Criminal Justice System, that the Judge Can Sign Off On
Putting together a concrete treatment plan that a judge can sign off on could help sway judges away from punishment and more towards treatment. Now, many times I’ve worked with therapists who will put together a uniform looking letter indicating a defendant’s issue and proposed treatment plan. But when judges get tons of these letters that all look fairly standard, it makes them not put a whole lot of faith in the plan.
Details are key. Instead of writing a generic letter, do an entire psychosocial evaluation of your client. Provide details about their life, their family history, their diagnosis, etc. so that a judge has a comprehensive view of the person. It helps to personalize your patient so that Steve isn’t just a defendant, or a case number; but the judge has a chance to see him as an actual person. I understand that this type of evaluation is a lot more work, so don’t be afraid to charge for it. Showing up in court on behalf of your patient also goes a long way. When you are willing to advocate on behalf of your patient, the judge may be more willing to do so as well.
Also back your treatment plan up with statistics. Judges and lawyers love statistics, and any other evidence that proves something will work. So beyond stating how it will benefit the patient, state how successful the plan has been in the past, along with any studies that show its effectiveness.
It is somewhat unthinkable that there hasn’t been more of an attempt to bridge the gap between these clinicians and attorneys. I am committed to changing that, and plan on expanding my lecture series to other conferences, and to other parts of South Florida. I would love to see a collective effort where both sides have an understanding of where their respective roles could help not only their clients, but help improve the entire mental health/criminal justice system as well.
Look out for part two of this piece, which will be published in October. In part two I will discuss how lawyers can help clinicians.