A Court of Refuge: Stories from the Bench of America's First Mental Health Court.

• Author: Zeiner, Carol L.
• Position: Book review

A Court of Refuge, Stories from the Bench of America's First Mental Health Court by Judge Ginger Lerner-Wren with Rebecca A. Eckland

This skillfully crafted book is a page turner. Judge Ginger Lerner-Wren and co-writer Rebecca A. Eckland weave a wealth of information into gripping stories of real participants (defendants) (names and details altered to protect confidentiality) in the first mental health court in the U.S., located in Broward County.

We are drawn into the lives of Roger, Rosemarie, Beatrice, Larry, Margaret, and others as they suffer loss of self to untreated mental illness. Many become homeless; many attempt to ease their emotional pain by self-medicating with street drugs, only to make matters worse. Now, they have been arrested for a misdemeanor brought on by failure to conform to "normal" conduct. For those with families, we feel the anguish of parents, siblings, and spouses who shoulder the burdens of caring for mentally ill relatives. Most have struggled, unsuccessfully, to access scarce community mental health services for their disabled loved one.

This court, born from the activism of Broward County citizens, demonstrates an alternative to the criminalization of mental illness. It aims to break the cycle that fills court dockets, packs jails, exacerbates suffering, and produces loss of future wellbeing. The cycle: people with untreated mental illness sometimes cannot conduct themselves according to accepted norms. They are arrested, typically in the beginning with low-level misdemeanors like nuisance or possession of drug paraphernalia. Many deteriorate in jail while awaiting trial, unable to pay even a small bond. A significant number cannot comprehend why they are there. Incarceration is particularly dehumanizing for the mentally ill, many of whom suffer illness because of prior trauma. Incarceration re-traumatizes and exacerbates their illnesses; they are targets of victimization in jail. If convicted, they can face more jail time. Corrections officers sometimes interpret behavioral manifestations of illness as intentional misconduct; ill inmates are subjected to further sanctions. Upon release, the person is worse off. The cycle continues, and can escalate because deepening illness can trigger worse behavior.

In traditional criminal justice, those convicted take responsibility for their actions by undergoing punishment. In Broward's mental health court, mentally ill participants who agree to participate take...