By the Special Supreme Court Advisory Committee for Justice and Mental Health Planning
Across the country, problem-solving courts—often referred to as treatment courts—are recognized as evidence-based practices with a substantial and growing body of research demonstrating their effectiveness. These models have garnered strong bipartisan support and are grounded in principles that emphasize accountability, treatment engagement, and coordinated, multidisciplinary responses to justice-involved individuals with behavioral health needs.
In Illinois, Problem-Solving Courts (PSCs) have played a critical role for many years in improving outcomes for individuals involved in the justice system. State law provides a basic statutory framework for courts that choose to establish mental health, drug, and veterans courts.
To further strengthen fidelity to research-driven best practices, the Illinois Supreme Court has been a national leader in adopting formalized standards and a structured certification process for PSCs. Within Illinois’ decentralized court system, these standards and certification protocols are essential tools for promoting consistency across circuit courts, enhancing program integrity, and supporting ongoing quality assurance and continuous improvement.
Below, we will highlight core operational components and certification requirements for Illinois’ Mental Health Courts as set forth within Illinois Mental Health Court Treatment Act, 730 ILCS 168 and Illinois Problem-Solving Courts Standards.
Treatment courts provide participants with the opportunity to receive a wide array of services from a multidisciplinary team. Along with this intensive form of assistance, the participants are supervised closely to hold them accountable and be successful. Mental Health Courts (MHCs) are an important alternative within the criminal justice system to address what some have called a public mental health crisis. The following paragraphs highlight the importance of MHCs in Illinois, the continued resources these courts provide to those in the programs, and the goal of expanding MHCs across the state.
Mental Health Courts have been an available program to many justice-involved individuals in Illinois for more than 20 years. MHCs are focused on assisting individuals with mental health issues and/or co-occurring substance use issues connected with community-based treatment and social support, along with supervision. The goal is to facilitate appropriate treatment and social support in a way that engenders positive and lasting lifestyle changes for the individual with mental health issues so that incarceration is unnecessary.
MHCs can be traced back as early as 1997, when an administrative order was issued for a mental health-focused docket in Broward County, Florida. This type of specialized mental health docket grew from the success and large-scale adoption of the drug court model. In Illinois, the first mental health courts began in the early 2000s. To date, there are 31 certified MHCs operating across the state. All problem-solving courts in Illinois are certified by the Illinois Supreme Court, after a thorough application process. All PSCs are recertified every three years, utilizing a similar application process. Fidelity to the model and adherence to best practice standards are of the utmost importance when evaluating the effectiveness of any type of PSC.
MHCs are strongly rooted in treatment and helping the participant live a healthy lifestyle. Supervision of the participant, outlined in the court’s policies and procedures, holds the participant accountable to the community and themselves as they work to reach their goals. For instance, the phase structure may call for weekly meetings with probation for the first 30 or 60 days of the program. Probation officers working with MHC clients not only track compliance, but they work hand in hand with the clinical team to support the participant’s treatment and life goals. Frequent person-centered interactions enable probation to move beyond mere compliance officers and to become true partners in the participant’s change process.
MHCs in Illinois are voluntary, as expressed in the Illinois Mental Health Court Treatment Act, 730 ILCS 168. The statutory eligibility criteria found at 730 ILCS 168/20(a) provides in relevant part, “a defendant may be admitted into a mental health court program only upon the consent of the defendant and with the approval of the court.” After an initial screening to ensure the potential participant is statutorily eligible, the candidate is fully assessed by both probation and treatment for criminogenic risk and need. These assessments help the team evaluate whether the candidate is within the target population their MHC serves. The predominant target population of the Illinois MHCs is high risk and high need individuals.
Participants must show a willingness to participate in the program. No participant is forced to participate. Participants must be informed of the MHC framework and given an opportunity to ask questions about this justice alternative. Participants need to understand the legal consequences of successful, unsuccessful and/or neutral separation from the MHC. The court accepts a new participant only after knowing and voluntarily consent to participate is received.
Participants in MHCs develop individualized treatment plans based on their needs. Probation works with the participant to develop a case management plan as well. The treatment court team seeks to identify and remove barriers to treatment, often with the help of case management services. Significant time and attention are devoted to forming a treatment alliance where the participant is integral in setting specific, measurable, achievable, relevant, and time-bound goals.
All PSCs utilize a phase system for the participants to move through. Phase advancement occurs when the goals or benchmarks for that phase have been achieved. In this way, movement through the MHCs is dependent on participant performance. In the very early stages of any PSC, much emphasis is placed on participant’s honesty and attendance at court, probation, treatment appointments, etc. The MHC is an intensive form of probation. While in Phase 1, participants are generally attending court status hearings weekly (sometimes every other week depending on the location and size of the court), meeting with their probation officer once a week, attending treatment multiple times a week, and drug testing multiple times a week, if applicable, because of a co-occurring substance use disorder. Unfortunately, it is a stark reality that many people experiencing issues related to mental health also have accompanying substance use issues. Some MHCs have developed dual diagnosis treatment for those who are challenged by both mental health and substance use disorders.
Mental Health Courts, along with all PSCs in Illinois, seek to provide benefits to participants and the community. Participants have an opportunity for better legal outcomes. Some MHCs are true diversion programs where charges may be nolle prossed upon successful program completion. MHC programs are designed to allow participants to remain in the community, supported by a multidisciplinary team of justice and treatment professionals. This supportive, non-adversarial alternative helps participants access necessary treatment so that they can be able to realize their best selves.
MHC programs also benefit the community by reducing recidivism and saving taxpayer dollars. Regarding recidivism, All Rise (the National Treatment Court Association) reports that “treatment courts reduce recidivism by as much as 58%.”[1] MHCs encourage lasting change in their participants. Mental health and substance use disorders are manageable chronic conditions. When a participant can achieve sustained recovery from these disorders, they can contribute to the community. Incarceration, on the other hand, has not been successful producing the individual change necessary to achieve sustained recovery. As a result, those with mental health disorders may be returned to the community in the same, or in a potentially more fragile, condition than when they were detained. Traditional incarceration has not been an effective long-term solution to increase community safety.
A 2025 article published by the United States Courts reports, “In fiscal year 2024, detaining a person before trial and then incarcerating them post-conviction was roughly ten times more costly than supervising an individual in the community.”[2] We know that MHCs provide a more enhanced form of community supervision, with increased reporting and drug testing. This increased supervision requires investment. When communities commit resources through an MHC rather than relying on the traditional criminal sanction of incarceration, the evidence suggests overall cost-savings. Consider Georgia’s annual report wherein they find that “the average cost per participant in $3,407, resulting in an average savings of $19,664 per adult participant when comparing diversion savings to traditional incarceration costs.”[3] Cost savings vary, but Georgia is not alone in promoting the fiscal benefits of PSCs.
Perhaps even more important than cost savings is the benefit to the overall health of the community that MHCs can provide. MHC participants are encouraged to reach their full potential. For some, that may mean additional education, work readiness assessments and training, employment, or some combination. When participants build recovery capital in this way, they undoubtedly have a greater potential to contribute to the community as well as a greater sense of belonging and purpose.
What does the future of MHCs in Illinois look like? Mental health issues are a public health issue that affects all 102 Illinois counties. With 31 MHCs currently, we have room to expand. The county, and its stakeholders, must want to start a court of this type. Perhaps one of the first steps is to consider adding MHCs in counties with existing drug courts. These counties which are familiar with the drug court model may also recognize the benefit of addressing mental health issues through a similar model in their community.
PSC design is not cookie cutter. The statutory and best practices provide the legal framework, and the day-to-day operation of a PSC reflects the needs of the communities it serves. In some areas of the state, counties are joining forces for a drug court so that they can serve participants who reside in two different counties. The Eleventh Circuit has designed a veterans court that serves five counties. Creative solutions are waiting to be discovered.
Ongoing data collection is another hallmark of PSCs that is important to the success and expansion of MHCs in Illinois. There is a need for more robust and uniform data collection and reporting in Illinois. Ideally, Illinois data collection and reporting would allow us to consider Illinois MHCs against a nationwide data backdrop that would include information about graduation rates, participant demographics and recidivism. The data initiative in Illinois is continuing to improve and eventually will paint the full picture of the importance and effectiveness of the MHCs.
Increasing the visibility of existing MHCs is also important. MHCs operate in a public forum, making it fairly easy to watch court proceedings. Many MHC teams welcome visitors to their pre-court staffings so long as the requisite confidentiality agreements are executed. Staffings offer an opportunity to observe justice and treatment professionals working together toward the participant’s best interests. And perhaps some of the most impactful moments happen at MHC graduations. Graduations offer the opportunity to hear directly from participants about their experience in the MHC, their journey of change, and how they view their life and their future. The change in the graduates demonstrates the potential of MHCs to do justice.
The Special Supreme Court Advisory Committee for Justice and Mental Health Planning is charged with studying issues and matters related to mental illness and the justice system in order to make recommendations to the Illinois Supreme Court.