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Last Modified on Sep 12, 2025
Mental health as a criminal defense explains current legal issues surrounding the criminal defense of mental health and the psychiatrically impaired. Cases that may arise can include anything from competency to be adjudicated, to pretrial diversion and mental health courts, to insanity defenses, or guilty but mentally ill (GBMI) in the states that have these defenses. Treatment and diversionary options have become an increasing focus.
By understanding the differences in how states deal with these issues, defendants and families can better understand their rights.
Hire a Mental Health Criminal Defense Lawyer
At the Law Offices of Nellie L. King, we bring extensive experience to cases where mental health intersects with criminal charges. Our team works with respected psychiatrists, psychologists, and medical professionals to present credible evidence that courts recognize.
We are known for compassionate, thorough advocacy that prioritizes both fairness and treatment. By staying informed on state-specific laws and programs, we provide clients with strategic defense options rooted in knowledge, credibility, and trusted professional relationships.
Competency to Stand Trial: How States Decide Readiness
Competency to Stand Trial prevents defendants from facing trial without the capacity to understand the charges and to assist with their defense. The principle is applied in every state, although the procedure may vary. Some states use local evaluators. Other states, like Michigan, have centralized forensic facilities.
Trial proceedings are stayed if a defendant is found incompetent. The court then orders treatment until competency can be restored. Defense attorneys ensure the process is carried out properly. The defendant’s rights are protected during evaluation, as the competency determination can result in their case either continuing or being suspended for treatment.
Insanity Defenses and Alternative Verdicts
The insanity defense involves a defendant’s state of mind at the time of the offense and whether the defendant knew the difference between right and wrong. States use different tests; some use the M’Naghten rule, while other states use a broader test that also considers a defendant’s capacity to conform their conduct to the requirements of the law.
The state of Michigan, in addition to a defendant’s ability to use an insanity defense, also has the option of a guilty but mentally ill verdict, which mandates treatment during the sentence while incarcerated.
Insanity defenses are used rarely in most states and are rarely successful. However, in the rare case where they are applicable, they remain an important defense. Defense attorneys present their clients’ cases in tandem with their experts to try to ensure the psychiatric truths of a defendant’s circumstances are not lost, and that a defendant has the opportunity for a verdict that takes their medical condition into account.
Mental Health Diversion Programs
Diversion programs permit eligible defendants who have received certain diagnoses to receive treatment instead of prosecution or incarceration. Programs are typically structured to provide a combination of counseling, medication management, and judicial oversight, with the possibility of dismissal or reduced charges upon successful completion.
Eligibility for diversion programs can vary by state, with some states limiting diversion to misdemeanor offenses, while others permit defendants charged with felonies to participate. A 2024 survey of California counties found that 44 of 52 counties (85 %) reported having a mental health diversion program in operation.
A defense lawyer can advocate for a client’s access to diversion, submit medical evidence, and assist in meeting program requirements. In addition to providing an opportunity for rehabilitation, diversion can minimize future justice system involvement for both defendants and the communities they live in.
The Growth of Mental Health Courts
Mental health courts offer court-supervised treatment plans. Mental health courts exist in many states, though they have different eligibility requirements and are structured differently. Large states may have more than one mental health court per county, while rural counties often have little to no access to mental health courts.
Research on mental health courts shows that graduates recidivate at a significantly lower rate. The U.S. Department of Justice found that those who participate in problem-solving courts are significantly less likely to recidivate than other similar defendants.
Defense attorneys are a vital part in making sure clients get admitted into mental health court and that they are compliant with the rules of the court. Mental health courts are just one example of the shift nationwide to treat, rather than incarcerate, people with mental illness.
Sentencing and Mental Health Considerations
Judges nationwide factor in mental health when sentencing, though the emphasis on psychiatric illness differs by jurisdiction. While some states require a psychiatric evaluation pre-sentencing in certain cases, others leave it to the discretion of the judge. Sentences may incorporate probation with mandatory treatment, residential treatment programs, or reduced sentencing if illness played a significant role in the crime.
Defense attorneys highlight treatment history and expert testimony to argue for a rehabilitative sentence. In cases involving conditions such as ADHD, presenting an ADHD Defense can also help demonstrate that behavioral symptoms contributed to the offense and that therapeutic interventions are more appropriate than punishment.
Bringing a defendant’s psychiatric conditions to the judge’s attention at sentencing is important to a just and fair outcome that holds defendants accountable and provides opportunities for healing and stability.
The Role of Expert Testimony in Mental Health Defense
Psychologists and psychiatrists are common experts in cases where defendants raise a mental health issue. Expert witnesses can often clarify how conditions and symptoms can affect a defendant’s conduct, decision-making, or culpability. Jurisdictions differ on how much weight to give to expert testimony.
Some states mandate that the defense have multiple evaluators for a sanity or mental health case. In other states, credibility determinations are generally left to the jury. An attorney inquires with known, credible professionals in the appropriate field, makes sure the expert’s testimony is presented in a way that is understandable, and cross-examines any prosecution experts.
In the absence of such testimony, a court may be oblivious to crucial medical facts. Powerful expert testimony at the appropriate stage can be one of the most effective levers in competency hearings, diversion petitions, insanity defenses, and sentencing.
Family and Community Support in Mental Health Cases
Courts may also look at whether a defendant has family or community support when mental health is presented as part of a defense. A strong support system will help a diversion request and could be a mitigating factor at sentencing. Some states may have programs that involve the family directly in the treatment process, which may require attending check-ins or proof of continued treatment.
The defense team partners with families to compile personal histories and obtain medical treatment documentation to showcase a complete image of the defendant. Showing that an individual has strong support in the community will assure the court that treatment outside of jail or prison is a possibility, which can minimize incarceration and recovery through resources outside of the justice system.
FAQs
What Does Mental Health as a Criminal Defense Mean?
Mental health as a criminal defense is a defense theory that argues for the consideration of mental health issues in explaining or mitigating alleged behavior. This may include the raising of a competency issue, an insanity defense, or other alternative defenses such as diversion or mental health court. The objective is not to excuse criminal behavior, but to work towards a fair consideration of illness in the outcome of the justice process.
Are Mental Health Defenses Recognized in Every State?
Every state has some system for recognizing mental health in criminal cases, but they vary widely in approach. Some states allow formal insanity defenses, some offer guilty but mentally ill verdicts, and many focus instead on treatment-focused courts or diversion. A defense attorney with state law experience can help clients see which options may apply when charges are pending in a particular jurisdiction.
How Common Are Mental Health Courts Nationwide?
Mental health courts have spread nationwide in the last two decades. Availability varies by county and jurisdiction size, but most states have at least one specialty court. These programs decrease recidivism and improve treatment involvement. A defense attorney can request admission to a mental health court, giving defendants access to rehabilitative options.
Can Mental Health Affect Sentencing Outcomes?
Defendant’s mental health can be a significant factor in sentencing. Judges may consider psychiatric reports, treatment history, and expert testimony before imposing penalties. Outcomes could include probation with mandated treatment, community-based programs, or reduced incarceration. A defense attorney knows to emphasize these factors, ensuring courts understand how illness influenced the case and why rehabilitation should be a focus, along with accountability.
What Role Do Families Play in Mental Health Criminal Cases?
Families play a significant role in mental health criminal cases by often providing crucial support during mental health criminal cases. They may share treatment history, encourage participation in court programs, or testify about the defendant’s condition. Courts may weigh this involvement when considering diversion or alternative sentencing. A defense lawyer coordinates with families to present a fuller, more compassionate picture of the defendant to the court.
Contact a Mental Health Criminal Defense Lawyer
The intersection of mental health and criminal law is a complex one, and it often comes down to the ways that each state addresses the issue. This can include everything from competency evaluations to diversion programs and even specialty courts. There are many avenues available to defendants that all balance a combination of fairness, accountability, and treatment.
At the Law Offices of Nellie L. King, we are committed to defending the rights of those whose psychiatric conditions play a role in their case. We work with experts, investigate all options, and advocate for solutions that put recovery and justice first. Hire a mental health criminal defense lawyer who can advocate with knowledge and compassion.
