Violence, quality of life and child neglect incidents will persist — despite our state and local governments spending millions on crime prevention and child protection initiatives — until Minnesota courts provide effective health-focused responses. Photo illustration by Getty Images.
National, state and local data show that our crime and child safety problems are driven largely by addiction and mental illness. The National Institute on Drug Abuse estimates that 65% percent of the United States prison population has an active substance use disorder. And while another 20% did not meet the official criteria for an SUD, they were under the influence of drugs or alcohol at the time of their crime.
Unfortunately, our criminal justice system, which isn’t currently well positioned to deal with these problems, plays a pivotal role in interacting with many of these challenged citizens.
Misdemeanor, juvenile, housing, child protection, mental health and family court judges all are in daily contact with this population.
Most of these cases — except in treatment courts — are processed through Minnesota’s justice system with little regard for the behavioral health, trauma and addiction status of the respondents.
Violence, quality of life and child neglect incidents will persist — despite our state and local governments spending millions on crime prevention and child protection initiatives — until Minnesota courts provide effective health-focused responses.
As it is, we have a revolving door in and out of our jails and prisons instead of actual treatment of these Minnesotans’ addiction and co-occurring behavioral health issues.
With the looming budget deficit ahead, we should turn to proven policy strategies and creative adjustments to spending and services.
For example, medication assisted treatment is proving effective in addressing our homeless and justice-impacted populations. We must use these types of evidence-based strategies that we know lead to better outcomes for these populations. We must also move beyond “silo” delivery systems to coordinate agency and local government efforts, including the judiciary, to ensure the best treatment options for these Minnesotans and their families.
In many states, judicial leaders now recognize the pervasive impact of addiction and mental illness throughout the justice system and view these interactions as opportunities to offer help.
The Massachusetts Supreme Court, for example, issued comprehensive new standards for courts in 2023 to address substance use disorders and mental health conditions, beginning with this overall charge:
These standards apply to criminal, commitment, delinquency, juvenile, probate, family and housing courts and prescribe detailed processes for courts to follow to make this order a reality. One key point of the directive is to be “trauma aware” as to the presenting conditions, too often overlooked as a significant driver and impairment to stable recovery.
Among their new standards, No. 5 says “Judges and court personnel should look for indications of substance use disorders mental health conditions and co-occurring disorders that may be a factor related to a case before the court.”
Because many judges and prosecutors don’t consider or even acknowledge these disorders, standard No. 5 specifies nine sources of information including self-identification; allegations before the court; behavior/demeanor of the person; third party testimony; abuse orders; and welfare of the children.
Note the inclusion of court personnel — not just judges — so the admonition is system wide.
Per standard No. 6, as soon as a clerk, judge or probation officer believes one of these disorders is a factor in a case, referral is to a qualified clinician for diagnostic assessment to assist in determining which form of evidence-based treatment will be most appropriate and effective. Again, this standard is necessary because many participants are not properly assessed nor referred to evidence-based treatment such as Suboxone for opioid dependence. This is a nice way of saying the standard court directive to “attend AA and abstain from drugs and alcohol” is ineffective.
Standard No. 7 is a real innovator because it identifies six opportunities or intercepts to intervene in criminal cases to provide treatment: community services, law enforcement, initial detention and court hearing, jails/courts, reentry, community corrections.
Although just two intercepts involve the court, the admonition to judges is to be aware of this model to help identify local resources and gaps in service and increase connections to treatment and recovery support services. This expansive role for judges contradicts long-standing practice in Minnesota limiting their role to deciding cases.
Standard No. 2 dictates that ”courthouses should serve as information and navigation centers, since substance use disorders, mental health conditions and co-occurring disorders are factors in cases in many court departments.”
The court, service centers, and law libraries are to be centers for information on substance use, mental disorders and trauma, and sources for treatment and recovery support.
The phrase “navigation center” implies assistance in finding resources — a big step forward in terms of helping people sort through options and funding sources. Just this directive alone would be a sea change in culture — acknowledging the elephant in the room in most justice-involved cases.
By the way: As the Economist reported in 2024, Boston is emerging as the safest big city in America.
Crime is driven by addiction
The late Tom Johnson, who served as Hennepin County attorney for a dozen years, surveyed the jail 20 years ago and found 90% of the inmates were there due to addiction — they were either high or seeking money for drugs. We joined together to increase the tax on alcohol to fund services, hoping to end the revolving door of jail, drug seeking, jail, etc.
No luck then or to date.
With the new chief justice settling in after a year, I am hoping the Minnesota Supreme Court will adopt standards similar to Massachusetts’s 20+ pages.
It’s long past time to take action to implement a comprehensive, cooperative approach in all branches of government to address our crime and addiction crisis, which are one and the same.