Ethical and Legal Issues 741
districts (Council of State Governments, 2005). Mental health courts seek to treat,
rather than incarcerate, mentally ill people who are charged with a misdemeanor.
Here are some common types of cases heard in mental health courts and the fea-
tures of such courts (Goldkamp & Irons-Guynn, 2000):
- The defendant’s mental illness seems to contribute to the alleged criminal
behavior.- The defendant’s behavior has raised concern for public safety.
- The specialized court is voluntary—the defendant must consent to be part of that
court rather than the usual court.- The mental health court tries not to send those who are mentally ill to prison.
Some mental health courts do not accept a defendant who has been violent.Other mental health courts will accept violent defendants but will put the defendants
in jail if they do not adhere to the plan for treatment (Redlich et al., 2005). Studies
report the same basic fi nding: When mentally ill people receive treatment, they are
subsequently less likely to become violent or to reoffend (McNiel & Binder, 2007;
Steadman et al., 1998).
Key Concepts and Facts About Treatment and the Legal System
- The Supreme Court has ruled that people who are civilly com-
mitted should be given the least restrictive alternative treatment
available—not simply confinement—while recognizing that
treatment might not necessarily be successful. In addition, civil
commitments may not be used solely to confi ne people against
their will indefi nitely. - Patients usually have a right to refuse treatment, such as medi-
cation. However, patients who have physically threatened other
people may be forced to take medication or receive other treat-
ment, as long as there has been a fair and adequate hearing of
the issues involved. In addition, the right to refuse treatment
may be overridden in certain circumstances, such as when a
patient does not have sufficient capacity to decide rationally
about particular treatments.- Defendants may be sent to drug courts if their drug use was the
underlying motivation for the crime; in drug court programs, de-
fendants are offered treatment for their substance abuse or de-
pendence, along with random drug testing and educational and
job training opportunities. Drug courts have been successful in
decreasing rates of relapse and reoffending. - Mental health courts can mandate treatment for mentally ill de-
fendants; such programs have been found to decrease violence
and repeat offending.
The Wheels of Justice:
Follow-up on Andrew Goldstein
The jury that heard Andrew Goldstein’s case was deadlocked—some jurors voted
to convict and some voted him not guilty by reason of insanity. The deadlocked
jury meant that another trial was necessary. This time, with Goldstein’s permis-
sion, his lawyers took him off his medication several weeks before he was to testify
so that jurors could see the extent of his mental illness. However, his mental state
at the time of trial could not be used to determine his mental status at the time he
committed the crime. This strategy was very controversial, and the judge allowed
it, provided that Goldstein be asked daily whether he wanted to receive medication
and that he be given medication forcibly if he appeared to become not competent
to stand trial (Rohde, 2000). Goldstein hit his social worker within several weeks
of stopping his medication, which meant that he resumed taking it and did not take
the stand. The jury found Goldstein guilty, although they acknowledged that he was
mentally ill. They decided that he knew what he was doing when he threw Kendra
Webdale onto the tracks, and that he knew it was wrong.
[The witness] Ms. Lorenzino testifi ed that Mr. Goldstein did not simply push Ms. Web-
dale, but that he picked her up bodily and threw her in front of the train. In interviews,