How Do Courts Deal With Mental Health Issues? The tabloids went wild when pop star Britney Spears was taken into custody and ferried to a Los Angeles psychiatric ward. Judge Lynn Toler joins us to explore what happens when the courts try to intervene in cases involving mental illness.
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How Do Courts Deal With Mental Health Issues?

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How Do Courts Deal With Mental Health Issues?

How Do Courts Deal With Mental Health Issues?

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The tabloids went wild when pop star Britney Spears was taken into custody and ferried to a Los Angeles psychiatric ward. In the meantime, her father was gaining the reigns over her estate.

It's a high-profile example of the kinds of mental health cases that can end up in the justice system. Here at NEWS AND NOTES, we've been looking at mental health issues as part of a month-long series. Today our contributor, Judge Lynn Toler, is with us to explore what happens when the courts try to intervene in cases involving mental illness. Welcome, Judge Toler.

Judge LYNN TOLER ("Divorce Court"): Thank you so much. It's good to be here.

CHIDEYA: So you know, in your time on the bench, you've seen your share of mental health-related cases. What's one of the most important lessons you've learned about what a judge's role or what the court's role is in that process?

Judge TOLER: I think the most important lesson I learned that the court in and of itself, the way it is structured, is not the place for these problems to be, that the court system has a very few things at its disposal. They have jail time, they have probation, they have fines.

Mental health issues are ongoing and systematic, and they deal on multiple levels - the ability of the person to live, to make money, have a place to go, to maintain medication and medical services - and the court has very little ability, especially on the criminal side, to deal effectively with people who have mental illness who happen as a result of that mental illness to break the law.

CHIDEYA: Now, we all know about divorce courts and small claims courts, but there's also apparently mental health courts? Explain what that is and what those courts do.

Judge TOLER: A mental health court is something new. They have sprung up like other what we call problem-solving courts have done to face systemic social problems that end up in the judicial system and have no other place to go.

A mental health court is a place where if a defendant or someone who has committed usually a non-violent crime comes into court, usually has an ongoing problem with the justice system, and there is a system in place where he gets an opportunity to go into a mental health court. There, they deal with the problem.

The judge is educated, the prosecutor, the probation department, and they have systems in place to allow this person to get the mental health assistance that they need instead of dealing it with so much as a criminal problem and keep the criminal thing over their head in order to allow them some kind of course of methods, but to deal with treatment and housing and all the other things that will allow this person not to re-offend.

CHIDEYA: Is this for relatively minor or non-violent offenses, or does this run the gamut?

Judge TOLER: Typically it's for non-violent offenses, people who stay in trouble for trespassing or they're homeless or disorderly conduct or just out in the street and they sit down and cause a traffic jam; I mean, the things that you would see in a municipal court which is not a felony because - and these people re-offend on a continuous basis, and there is no system or anything to hold them up so they won't get into trouble.

CHIDEYA: Now, in the case of someone like Britney Spears, she did not break the law before she was taken into custody for health reasons. If this is not a case where - you know, if you have a relative, for example, who seems to be on the verge, and you want to have them involuntarily committed - that is, against their will - what's that process like? And talk, if you can, about the legal side but also maybe the emotional side of what people have to do if they really believe that someone they love is in danger of hurting themselves.

Judge TOLER: Well, that's a very interesting question. The difficulty with that is oftentimes that these people will need medication, or they'll need some kind of support that the family cannot give. If the family is unable to do that, you can petition a court for conservatorship or guardianship. It depends. It's different in different states.

What you have to do is present sufficient evidence and have that person evaluated and a determination made that this person not only is mentally ill, because mental illness in and of itself is not enough to have you controlled by another entity, but so mentally ill and effectively disordered that you cannot - that you are gravely disabled, cannot provide for yourself, or that you are an immediate danger to yourself or to someone else.

Then a hearing is held, and you go through that process, and a conservatorship will - can be had. That doesn't mean a person goes into the institution. That just means that a person can have another person control their money, their functioning, their living, their housing decisions.

CHIDEYA: From an emotional side, though, what if you're that parent, that sister, that brother who says, look, I'm going to try to take control of my loved one's life, and you know that that person is going to fight you all the way? What kind of advice on that level would you give to someone who is trying to make that kind of decision?

Judge TOLER: I would say that you have to, just like any parent whose child fights them all the way on the decisions to go to school, to eat vegetables instead of candy, you have to have the final purpose in mind at all times. And it's difficult, it is hard, but you have to have a sense of resolve about it and understand intrinsically you are doing the right thing for that person, not for your own convenience, not because you want it, but because that person will be better off if you do so.

CHIDEYA: Let's dig a little bit into a specific law. There was a 1975 Supreme Court case, O'Connor versus Donaldson, and it set a precedent in mental health law. Tell us a little bit about that one.

Judge TOLER: Okay. In previous times, in the '50 - the '40s, '50s and '60s, there was a lot more people held in mental institutions and it was easier to do. And in the Donaldson case, this gentleman's father had gone to the court and said, listen, my son is delusional and he needs to be in institutionalized care.

They put him in institutionalized care, where he languished for 15 years, despite his continuous efforts to get out. The law at the time allowed custodial care of somebody who was found mentally ill and not much more. And in the Donaldson case, they said, look, mental illness in and of itself is not enough. What you have to have is that they have to have some danger, they have to be getting treatment, and it has to be shown that some less restrictive method of helping to monitor or let this person live is available and to allow this person - you just can't say someone's mentally ill, confine them, and keep them confined, because constitutionally everyone has a right to life, liberty, and if you're mentally ill, you don't lose that right.

CHIDEYA: Just quickly, how are prisons equipped to deal with people who are struggling with mental illness? I mean, are - if you do end up in jail and you do need treatment, are you likely to get it?

Judge TOLER: It depends on where you are. If you are in a small jail somewhere - it used to be in my courtroom, I would be happy to have a person on a state charge instead of a city charge because I could put them in a county jail. In my county jail, in Cuyahoga County, they had a whole floor dedicated to psychiatric patients.

They had psychiatrists on call, they had access to medication and ability to control that population or to deal with that population. If you are in a smaller place, you may not have that and you do not have that access, and there's more warehousing and restrictive methods going on because they don't have any other way to deal with them.

So really it depends on where you are, what kind of law that you've violated in order to determine how well the institution where you are is able to deal with whatever difficulty you have.

CHIDEYA: Well, Judge Lynn Toler, it's always great to have you on. Thanks so much.

Judge TOLER: Always good to be here.

CHIDEYA: Judge Lynn Toler presides on the television program "Divorce Court." She's also the author of "My Mother's Rules: A Practical Guide to Becoming an Emotional Genius." And she joined us from station KJZZ in Tempe, Arizona.

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