Court-Appointed Mental Health Treatment Referrals: Navigating Mental Health in the Justice System

August 19, 2025

Authored by: Louise Hartnett, B.A.

Edited by: Emma Loker, B.S

When courts recognize that certain criminal offenses are linked to underlying mental health conditions, they may order someone to engage in mental health treatment. This may be alongside (or instead of) other more traditional types of sentencing.

When this happens, these are known as “court-appointed mental health treatment referrals,” and can be confusing for someone in the justice system. However, court-ordered counseling referrals can be necessary and life-changing interventions for people who have struggled with their mental health.

There are a few aspects to navigating mental health treatment from court orders, from understanding the process and your obligations, to what treatment will involve. A mental health professional can guide you or a loved one through this process. This page can also help clarify what court-appointed mental health referrals are by discussing:

What court-ordered referrals are and who’s most likely to receive one
How courts refer clients to mental health treatment
Tips for navigating the process
Types of court-ordered mental health treatments

What Is a Court-Ordered Mental Health Referral?

A court-ordered mental health referral is a legal order that requires someone to participate in a particular mental health service. Often, it’s a non-negotiable part of someone’s sentencing or probation. A judge issuing an order might believe it will help reduce the risk of reoffending by addressing the root cause. The order may also require someone to have regular check-ins with the court to monitor the progress of their treatment.

Despite the justice system being distressing for many, court-ordered therapy has many benefits. Many ordered to participate in therapy may have never received support for their mental health. Therefore, ultimately, addressing emotional needs and challenges that contributed to offending behaviors can only be a good thing in the long run.

Not only does the person likely receive a lighter sentence, but therapy could improve their quality of life, work, and relationships. As a result, they may be less likely to engage in repeat offences.

What Is a Mental Health Evaluation?

Some judges will order mental health evaluations alongside treatment. These are assessments conducted by mental health professionals that can diagnose conditions, measure the severity of symptoms, and recommend appropriate treatments.¹

Mental health evaluation for court-ordered clients typically involves interviews, tests, and observations to gain an understanding of someone’s psychological state. For example, clinicians may inquire about the person’s behavior, mood, thoughts, perceptions, and their own insight into their mental health to make deductions.¹

Who Receives a Court-Appointed Mental Health Referral?

The people who are issued these types of orders usually have committed some sort of minor offense, but they also have an underlying mental health condition that contributed to it. For example:

Someone with bipolar disorder may be arrested for disorderly conduct (such as fighting). In this case, a judge might order them to participate in counseling with medication management.
Someone arrested for robbery may have done so because of impaired judgment due to depression. As a result, their court order may require them to attend therapy for managing their symptoms and impulsivity.

Court-ordered mental health referrals such as these typically apply to people who have committed relatively minor crimes. However, in cases of more serious criminal offenses, people may be detained in mental health treatment facilities.²

Is Court-Ordered Therapy Less Effective?

Many assume that court-ordered therapy would be less effective, as people may feel they’ve been coerced into it. So, it may be surprising to learn that this is actually not the case. Research finds that people who are ordered to have therapy by courts don’t have lower satisfaction rates. In fact, if the therapeutic relationship between them and mental health professionals is positive, they’re likely to have good treatment outcomes.³

How Does the Justice System Handle Mental Health?

There are several different pathways for people with mental health conditions in the justice system. The pathway may depend on the offense and the person’s mental health history, but some options include:

Mental Health Courts

Mental health courts are an alternative to the traditional criminal justice approach. Almost every state has a mental health court, with at least 450 across America.⁵ These courts aim to:

Reduce the likelihood of someone reoffending
Improve the quality of life for people with mental health conditions
Reduce jail, court, and case processing costs
Increase awareness among communities, practitioners, and policymakers about the experiences of people who have mental health conditions

These courts do so through a collaboration between mental health professionals and the criminal justice system.

However, they differ from regular courts in that participation is voluntary. If someone decides they don’t want to take part, they’ll be sentenced by a traditional court instead. Even so, they may still be ordered by that court to participate in other mental health programs.

Drug Courts

Drug courts can be found in every US state and are effective and specialist local-level courts. They typically divert non-violent offenders to supervised substance abuse programs to help prevent them from reoffending. Additionally, drug courts manage cases comprehensively with drug testing, job training, education, and housing support, as well as mental health referrals.⁴

Diversion Programs

Diversion programs are typically for first-time offenders of relatively low-level crimes. These programs aim to keep people out of jail and, ultimately, totally out of the criminal justice system.

People who end up in a diversion program may have committed offenses like petty theft, drug possession, or assault that didn’t lead to serious injury. Their sentencing may require them to perform community service as well as attend counseling. Diversion programs are favored over trials as they’re often cheaper and more effective at preventing people from reoffending.

Mental Health Referrals

Aside from the alternatives mentioned, the traditional court system also has pathways for offenders with mental health conditions. As established, traditional courts can issue mental health referrals to help manage these conditions, which we’ll explore in more detail next.

How Do Court-Appointed Mental Health Referrals Work?

Referrals for mental health by judges typically follow the same set of steps. The following is an explanation of what you can expect if you or a loved one has received a court-appointed mental health referral:

The court order is issued: The judge’s decision will be informed by any party that gives evidence suggesting the person has difficulties with their mental health. For instance, legal counsel or probation officers.
A mental health evaluation is conducted: As mentioned previously, these evaluations can help determine someone’s psychological state and inform any mental health diagnoses. The professional who performs the evaluation will be chosen by the court.
Findings are reported: The chosen professional will report their findings to the court and make suggestions for the person’s treatment. They’ll also comment on their competency to understand and participate in legal proceedings.
Treatment begins: Any ordered treatment will begin, whether it’s medication, therapy, or rehabilitation programs.
Regular check-ins are conducted: The person will be expected to comply with their court order. This may include regularly reporting to the court for check-ins, or their treatment provider will give updates themselves. Any non-compliance may result in fines and further legal consequences.

Legal mental health referrals to treatment programs may feel arduous and restrictive, but they’re ultimately for the right cause. Next, we’ll explore how you can handle this process to get the best outcomes.

Tips for Handling Court-Appointed Referrals

Court-appointed mental health treatment referrals may feel stressful and restrictive of your freedom. However, as mentioned, research demonstrates that you’re likely to have a positive outcome despite your treatment being non-negotiable.³

To help you with this experience, the following is some advice for getting the best outcomes out of this process:

Communicate with the court: Be honest about your circumstances if you’re worried they’ll make it difficult for you to engage in treatment. It might be possible for adjustments to be made.
Be meticulous with your obligations: This means knowing exactly where you’re expected to be, how often, who you report to, and any deadlines.
Rely on other kinds of support: If you can, lean on any friends or family members who can help you stay motivated and listen to what you’re going through. This way, you’ll be supported in as many directions as possible.
Be present during your treatment: Actively participating in your treatment can benefit your well-being long term, whether you gain insights into your condition or gain new coping skills. Plus, your dedication to the process may be reported back to the court and help your proceedings.
Keep your own records: Note down the appointments you’ve attended, and any milestones or feedback. This can help to demonstrate your compliance with the court at a later date.

Though the court-appointed referral process may not be pleasant, there is light at the end of the tunnel. If you engage honestly and hold yourself accountable, you’ll be more likely to have a good experience of treatment and “graduate” from any program.

Types of Court-Appointed Mental Health Care

There are many types of mental health care, offering different approaches and specialisms for various needs. For instance, therapy programs meeting court requirements may include:

Anger management classes: These may be appropriate for people who have been aggressive or violent, for example, becoming rageful during a dispute. These classes typically help people control their anger, resolve conflicts, increase emotional awareness, and communicate more effectively.
Court-mandated therapy programs: These may be prescribed to people with a wide range of mental health conditions. They typically involve one-to-one sessions that explore the person’s condition and life history. For example, the therapy may be trauma-informed or focus on cognitive-behavioral (CBT) techniques.
Group therapy: This may be assigned for people who need to address issues around anger or general poor mental health. These groups provide people with peer support, which can be tremendously helpful in understanding and changing behavior.
Inpatient programs for court-referred clients: These programs provide 24-hour care, therapy, and medication management. Residential treatment options like these are often from court referrals for people with more severe symptoms. For instance, in the case of someone posing a risk to themselves or others, or if someone has been deemed incompetent to participate in legal proceedings.
Court-ordered family therapy programs: These are typically ordered if family conflict has contributed to the offense. They might also be considered if the court feels that improved dynamics at home could significantly support someone’s recovery. For example, a teenager who’s gotten into legal difficulties from fighting may benefit from therapy with their parents to improve their communication and understanding of each other.

As may be clear based on these options, depending on the offense, mental health condition, and family life, court-ordered mental health treatment will vary.

Mission Connection: Get Support for Court-Appointed Referrals

Mental health services for court-ordered individuals typically focus on the underlying causes of the initial offense. If you’ve received a court-appointed referral, during your treatment, you may gain insights into your mental health condition or life history that you wish to explore further.

At Mission Connection, we offer a range of therapies and understand the importance of personalized care. After a court-appointed referral, you may wish to explore the right treatment options for your needs and recovery. Our team is here to discuss the best fit for you with compassion and understanding. Get in touch to discuss our services and get further support for your condition.

References

Voss, R. M., & Das, J. M. (2024). Mental status examination. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546682/
DeAngelis, T. (2022). Standing tall: A new stage for incompetency cases. Monitor on Psychology, 54(4). American Psychological Association. https://leg.colorado.gov/sites/default/files/images/neil_g_2022_apa_monitor_standing_tall_-_a_new_stage_for_incompetency_cases.pdf
Hachtel, H., Vogel, T., & Huber, C. G. (2019). Mandated treatment and its impact on therapeutic process and outcome factors. Frontiers in Psychiatry, 10, 219. https://doi.org/10.3389/fpsyt.2019.00219
Office of National Drug Control Policy. (n.d.). Drug courts. The White House. https://obamawhitehouse.archives.gov/ondcp/ondcp-fact-sheets/drug-courts-smart-approach-to-criminal-justice
Alternative courts not a catch-all fix for mental illness crisis. (n.d.). Law360. https://www.law360.com/articles/1356267/alternative-courts-not-a-catch-all-fix-for-mental-illness-crisis