The Mentally Ill: Legal Barriers to Getting Help

Law gavel depicting mentally Ill legal barriers

There is so much to say about the issue of gun violence and mental health. It’s hard to know where to begin.

Nikolas Cruz is the person who allegedly killed 17 students at Marjory Stoneman Douglas High School on Valentine’s Day 2018.

Cruz had outbursts of domestic violence for a long time before the shooting. Various people, including his mother, had called the police in an attempt to reign in his increasingly scary behavior. According to some reports, there were people who could see it coming, calling him a “school shooter in the making.”

The trouble is, until February 14th, he hadn’t done anything that could cause him to be involuntarily committed to a mental health facility. In addition, the episodes of violence leading up to the school shooting were all resolved without court intervention.

So, what do you do – what does a state do – for a person who is exhibiting scary behavior but who hasn’t done anything wrong… yet?

The Problem

This very pertinent question was brought up, in response to the Valentine’s Day shooting in an article in The Atlantic. This article discusses, among other things, why it may not have been as easy as getting Mr. Cruz into a mental health facility – especially in the State of Florida.

Despite domestic disturbances and the opinions of bystanders, the truth was that he hadn’t done anything even close to what he allegedly did on Valentine’s Day up to that point. He wasn’t going to commit himself, and he is 19, legally an adult – beyond his guardian’s ability to intervene.

Continuum of Care for the Mentally Ill

This is where the article talks about the need for many states to develop a continuum of care. The percentage of mentally ill people who are violent is very, very small.

According to one of the interviewees from the Atlantic article mentioned above, if you locked up every mentally ill person, you would only prevent a tiny percentage of violent crime.

In addition, many states – Michigan included – have come to see the necessity of handling those with mental illness who commit crimes differently.

There needs to be two separate avenues of treatment for criminals with mental illness and other criminals. The problem is police are often left to try to deal with mental health crises when a broken system isn’t equipped to take on more patients.

Here in Michigan, changes are underway. Two programs have been incorporated into law enforcement routine to help change the way mental illness is responded to. Mental health courts are one of those, and crisis intervention training is the other.

Mental Health Courts

Mental health courts are a collaborative effort between criminal justice and mental health fields. They involve judges, prosecutors, defense attorneys, and other court personnel.

They deal with nonviolent offenders who have been diagnosed with a mental illness or co-occurring mental health and substance abuse disorder. There are 150 of them in the state. And here’s what they do:

Continuing Judicial Supervision

Continuing judicial supervision includes periodic reviews over preliminarily qualified offenders with mental illness, mental retardation, or co-occurring mental illness, and substance abuse disorders who are charged with misdemeanors and/or nonviolent offenses.

The coordinated delivery of services, which includes:

  • Specialized training of criminal justice personnel to identify and address the unique needs of offenders who are mentally ill or intellectually disabled.
  • Voluntary outpatient or inpatient mental health treatment, in the least restrictive manner appropriate as determined by the court, that carries with it the possibility of dismissal of charges or reduced sentencing on successful completion of treatment. Centralized case management involving the consolidation of cases that involve mentally ill or mentally disabled defendants (including probation violations) and the coordination of all mental health treatment plans and social services, including life skills training, placement, health care, and relapse prevention for each participant who requires such services.
  • Continuing supervision of treatment plan compliance for a term not to exceed the maximum allowable sentence or probation for the charged or relevant offense and, to the extent practicable, continuity of psychiatric care at the end of the supervised period.

Crisis Intervention Training

This is a training program for law enforcement patrol officers – who can take part voluntarily – to deal with mental health crises and divert offenders away from the jail system. As policemen are often first-responders, this program can help officers recognize and appropriately deal with mental health crises.

Here is what a potential patient must exhibit in order to be committed to inpatient or outpatient psychiatric care in Michigan:

For inpatient treatment, a person must meet the following criteria:

  • Be a danger to self or others;
  • Be unable to attend to basic physical needs such as food, clothing, or shelter necessary to avoid serious harm in the near future; or
  • Thirdly, they must be unable to understand the need for treatment and continued behavior reasonably expected to result in significant physical harm to self/others

For outpatient care, a person must meet the following criteria:

  • Show an impaired understanding of the need for treatment makes voluntary participation in treatment unlikely;
  • Be noncompliant with recommended treatment necessary to prevent a relapse or harmful deterioration of condition. Additionally, they must demonstrate a history of noncompliance that includes two hospitalizations in past 36 months or acts/threats/attempts of violence to self/others in past 48 months


Contrary to popular belief, getting help for your loved one could be more difficult than you think. Michigan has adopted some helpful measures for those suffering from mental illness. However, more can be done. For more information, go to Treatment Advocacy Center.