"What Can I Do to Keep You Free?" Perspectives on Clinical Practice in the Criminal Legal System

Despite the glaring need for mental health care, relatively few court-involved people ever receive traditional therapeutic or intensive interventions. Most clinical engagements are instead limited to a course of brief mandated encounters.

The challenge for practitioners is making those encounters meaningful.

That challenge is considerable: practitioners and their clients are navigating systems that were never designed with treatment or support in mind.

With respect to the services we provide, we ask: “What can I do to keep you free?” We are also fellow travelers.

Practitioners often meet clients for the first time shortly after an arrest. Their clients may still be behind bars or have only recently been released, and practitioners may have precious few minutes to try to form a relationship and determine an appropriate plan. Particularly for people on pretrial supervision, neither clients nor practitioners will likely even know when a case is going to conclude.

There is little research or expert guidance that speaks to this reality. To fill this gap, the Center for Justice Innovation convened a national clinical roundtable, where a broad range of experts were asked to distill their professional wisdom and theories of change and apply them to practice in the criminal legal context.

While there were no easy answers, the discussion yielded a wealth of insights and actionable ideas. Among the themes covered: the merits of voluntary versus mandated treatment; the need for individualized approaches to engaging clients balanced against an administrative imperative to maximize the use of evidence-based practices; and working to make screening and assessment processes more efficient while also fostering engagement.