The definition of mental illness can vary by state.  Florida defines mental health in their Mental Health Act:

"Mental illness" means an impairment of the mental or emotional processes that exercise conscious control of one's actions or of the ability to perceive or understand reality, which impairment substantially interferes with a person's ability to meet the ordinary demands of living, regardless of etiology. For the purposes of this part, the term does not include retardation or developmental disability as defined in chapter 393, intoxication, or conditions manifested only by antisocial behavior or substance abuse impairment.

The following organizations provide definitions of mental illness: the American Psychiatric Association, the Center for Psychiatric Rehabilitation at Boston University, the National Alliance for the Mentally Ill (NAMI), and the Knowledge Exchange Network (KEN) at the Center for Mental Health Services.

The first mental-health court was specially designed to address the complex issues affecting persons with serious and persistent mental illness or mental disability who enter the criminal justice system.  Mental-health courts generally handle misdemeanant cases involving mentally ill defendants.  The goals of the mental-health court are similar to those of the drug court--to divert mentally ill misdemeanor offenders from jail into treatment.  Therapeutic jurisprudence is applied as the court attempts to explore issues of choice, personal responsibility, and the relevance of a judicial course of treatment or punishment for any given criminal case.

Jail-diversion programs have goals similar to those of the mental-health court.  One such program initiated in 1998 in Santa Fe, New Mexico, offers low-risk adult offenders suffering from mental illness and substance abuse an alternative to jail. This voluntary program, run by the Santa Fe Police, is designed to reduce recidivism by giving the offender an opportunity to change the lifestyle that led to crime.

Because specialized mental-health courts are continually being planned and developed, and others are closing due to funding cuts, the exact number of mental-health courts is not known.  It is estimated that there are over 110 mental health courts currently.  Congress promoted the development of mental-health courts with the passage in 2000 of America's Law Enforcement and Mental Health Project Act, which instructed the attorney general to fund 100 demonstration projects. The resulting Mental Health Courts Grant Program, which relies on a flexible definition of what constitutes a mental-health court, provided grants to 23 courts in 2002 and will fund another 14 courts in 2003 (see Mental Health Consensus Project).

In 1996 Marion County, Indiana, started the Psychiatric Assertive Identification Referral/Response (PAIR) Program in Indianapolis, which many consider to be the nation’s first mental-health court. This initiative is a comprehensive pretrial, post-booking diversion system for mentally ill offenders. In 1997 Broward County (Ft. Lauderdale), Florida launched the first court to be formally called a specialized mental-health court.  In February of 2001, the first juvenile mental-health court opened in Santa Clara, California. 

In October 2000, Congress approved an annual appropriation of 10 million dollars through fiscal year 2004 to establish up to 100 mental-health-court programs.  The Bureau of Justice Assistance recently announced the selection of FY 2003 Mental Health Court Program grant recipients. Fourteen communities in 12 states received a combined $2 million in grant funding to implement projects that allow participants to voluntarily accept judicially supervised treatment plans in lieu of traditional criminal justice processing. For appropriations for these grant awards see: “Fiscal Year 2006 Mental Health Courts Awards.”

The Council of State Governments will serve as the technical assistance provider for the mental-health-court program. As technical-assistance provider, CSG will coordinate a meeting of all grantees and facilitate on-site and off-site technical assistance to the grantee courts.

Funding sources for other mental-health programs include the Substance and Mental Health Services Administration.

Table 35: "The Defense of Insanity: Standards and Procedures,” from David Rottman, et al., State Court Organization, 2004 (Washington, DC: Bureau of Justice Statistics, 2006) provides a 50-state look at standards and procedures of the insanity defense in pretrial, trial, and posttrial proceedings, including:

• Standard of proof
• Burden of proof
• Jury informed of verdict consequences
• Test for insanity
• Insanity verdict
• Mandatory or discretionary treatment
• Post-conviction authority
  

Carmen Cirincione and Charles Jacobs (1999) contacted officials in all 50 states and asked for the number of insanity acquittals statewide between the years 1970 and 1995.  They received data from 36 states.  Few states could provide information for the entire 25-year period, but the following results were obtained:

• The median number of insanity acquittals per state per year was 17.7.
• California and Florida had the highest annual averages (134 and 111, respectively); New Mexico (0.0) and South Dakota (0.1) had the lowest.
• Most of the acquittals were for felonies rather than misdemeanors.

Source:  Lawrence S. Wrightsman, Edie Greene, Michael T. Nietzel, and William H. Fortune, "Science of the Insanity Defense: How Successful Is It?” in Psychology and the Legal System, 5th ed.  (Belmont, CA: Wadsworth, 2002).