Standards on Substance Use Disorders and Mental Health Conditions: Standard V. Indications of substance use disorders, mental health conditions or co-occurring disorders

Standards adopted by the Supreme Judicial Court, acting on the advice of the Working Group on Substance Use and Mental Health.

Table of Contents

Standard V

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. 

Commentary

Use of an illegal substance, or even inappropriate use of a legal substance, is not necessarily indicative of a substance use disorder. Examples of sources of information that may suggest a substance use disorder, mental health condition, or co-occurring disorder could be a factor in a case before the court include:

  1. A party’s self-identification as having a substance use disorder, mental health condition, or co-occurring disorder.
  2. The allegations before the court. In a criminal case, a statement that a criminal offense was committed while the defendant was suffering from a substance use disorder, mental health condition, or co-occurring disorder may appear in the information provided to the court, such as a police report or statement of facts, if available; information in the clerk's file; or allegations presented at a hearing on an application for a criminal complaint. In some civil cases, the complaint or subsequent pleadings filed with the court may allege a substance use disorder, a mental health condition, or a co-occurring disorder.
  3. The offense charged. Any criminal offense can involve substance use disorders, mental health conditions, or co-occurring disorders. However, substance use disorders and mental health conditions may appear with more frequency in connection with certain types of criminal charges, including but not limited to drug or alcohol related offenses, disorderly conduct, disturbing the peace, assault and battery, malicious destruction of property, arson, animal cruelty, leaving the scene of an accident, breaking and entering, larceny, prostitution, shoplifting, and trespassing.
  4. The person’s record of criminal history. In general, a party's Criminal Offender Record Information (CORI) or Court Activity Record Information (CARI) may reveal a history of charges or convictions that involve a substance use disorder, a mental health condition, or a co-occurring disorder, which may be apparent by the nature of the charge itself or the pattern of charges. 
  5. Abuse prevention and harassment prevention orders. An affidavit in support of an application for an abuse prevention order or a harassment prevention order may allege or reveal facts suggesting a substance use disorder, mental health condition, or co-occurring disorder.
  6. The behavior, demeanor, or physical appearance of a party before the court. Substance use disorders may be indicated if the party appears agitated, glassy-eyed, unkempt, or unsteady, or if the party smells of alcohol. Judges and other court personnel should be aware, however, that slurring of speech or tremors can also be symptoms of neurological or medical conditions. Mental health conditions may be indicated by a party’s behavior in the courtroom or courthouse, including but not limited to outbursts of anger, inability to follow instructions, anxiety, withdrawal, or the inability to interact appropriately with court personnel or participate in court proceedings.
  7. Third-party testimony.  A victim of a crime, a police officer, a family member, or others may provide information about a party’s substance use disorder, mental health condition, or co-occurring health disorder.
  8. Medical evidence.  Medical evidence provided to the court may include a diagnosis that an alleged incapacitated party suffers from a substance use disorder, mental health condition, or co-occurring disorder, particularly in guardianship and conservatorship cases involving requests for authorization to treat with antipsychotic medication.
  9. Welfare of children. Substance use disorders or mental health conditions may be present where parties have demonstrated issues with safely parenting their children, leading to supervised parenting time and therapeutic intervention, including involvement by the Department of Children and Families (DCF).

In cases where judges have authority to order treatment, they should consider using that authority consistent with Standard VI: Assessment and Treatment Matching and Standard VII: Court-Ordered Treatment.

Contact   for Standards on Substance Use Disorders and Mental Health Conditions: Standard V. Indications of substance use disorders, mental health conditions or co-occurring disorders

Date published: November 16, 2023
Last updated: November 16, 2023

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