Book Review: A Court of Refuge

I finished reading A Court of Refuge, Stories from the Bench of America’s First Mental Health Court, by Judge Ginger Lerner-Wren, with a resounding YES! These past few weeks I have been learning about therapeutic courts for a variety of situations and find that the humanity and authenticity of such courts is compelling.  Judge Lerner-Wren’s compassionate voice tells the stories of some of the most vulnerable people in our society who need help not punishment.

I found myself thinking about my college years and sitting in court as a nursing student in 1977 for the commitment hearing of a man suffering from delusions as they weighed whether or not he was a danger to himself or others. I remember the frustration of his family as they realized that he would not be helped that day by the court even though he was clearly in a mental health crisis and unable to admit himself for mental health care.  After working a semester in a state mental hospital as their clients were being discharged to community based mental health services, I began to recognize the gait of the mentally ill homeless on the streets of Chicago.

The end result of this transition that began in 1965 is that 559,000 beds in state hospitals decreased to only 69,000 by 1995.  Homeless and prison populations soared and studies show that more than 10% of those incarcerated are known to suffer from severe mental illness such as schizophrenia, bipolar disorder or major depression. Prisons did not improve the plight of the mentally ill; instead they traumatize men and women who need treatment in a therapeutic setting.  The author carefully weaves into her story the policies and statistics that reveal her communities investment in restoring lives in a court of refuge.  One astonishing statistic is that an estimated 85% of incarcerated women have experienced sexual or physical abuse as a child or adolescent.  According to SAMSHA, "trauma informed criminal justice responses can help avoid re-traumatizing individuals. This increases safety for all, decreases the chance of an individual returning to criminal behavior, and supports the recovery of justice-involved women and men with serious mental illness.”

I will end with this quote “…mental health courts provide valuable lessons and insights into recovery and the power of community, human connections, and ways to leverage social networks and alliances to provide supports to fill gaps.  These bold efforts, however, also highlight the need for our nation’s policy makers to “turn the page” of centuries of stigma and discrimination and advance mental health reforms from a public health perspective.”