740 CHAPTER 16
Some legal scholars and mental health advocates argue that the right to refuse
treatment is at odds with outpatient commitment laws, whereby individuals can be
forced to take medication, be committed to an inpatient facility, or put in jail if they
don’t adhere to their outpatient treatment (Perlin, 2003). In fact, although some
individuals who receive outpatient commitment may be competent to refuse treat-
ment, the law may not allow them to refuse.Mental Health and Drug Courts
Federal, state, and local court dockets are fi lled with cases awaiting a hearing or
trial. In order to hasten the speed with which cases are resolved, municipalities have
instituted specialized courts, such as divorce courts, to address particular types of
problems. Two such special courts are particularly relevant to the mentally ill: drug
courts and mental health courts.
Drug courts were developed in Miami in 1989 for fi rst-time drug abusers—
those whose substance abuse was viewed as the underlying motivation for their
crime (Miethe, Lu, & Reese, 2000). Soon after arrest, these people were offered an
alternative to jail: They could attend a drug treatment program, submit to random
and frequent drug testing by urinalysis, and meet with the drug court judge regu-
larly. If they did not show up for a court hearing, a bench warrant would be issued
within hours and they could be sent to jail. The overall goal of drug courts is to help
defendants reintegrate into society.
Drug court programs do not simply aim to decrease substance abuse; they
recognize the complex nature of the factors that contribute to such abuse. Thus,
drug courts not only promote intensive treatment for drug abuse and relapse
prevention—they also encourage education and employment. In fact, participants
typically are asked to earn a GED (high school graduate equivalency diploma) and
to hold a steady job. Moreover, participants are required to develop a relationship
with a mentor in the community and to meet all their fi nancial obligations, such as
child support. Some drug court programs also require community service. Absti-
nence is assessed through frequent random drug testing, and during their time in
such a program, less than 10% of participants use drugs.
Relapse rates are between 4% and 20% for those entering a program and even
lower (less than 4%) for those who complete one. Many communities have ex-
tended drug court programs to include individuals who were previously jailed for
substance abuse–related crimes, with equivalent success (Drug Court Clearinghouse
and Technical Assistance Project, 1998).
The success of drug courts led to the development of mental health courts,
which began in Florida and now exist in most states, but not necessarily in mostDrug courts recognize that maintaining
abstinence can depend on a complex
interplay of factors, such as educational
opportunities and employment. John Sundlof/Alamy