Standards on Substance Use Disorders and Mental Health Conditions: Principles

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

Courts should be aware of and be guided by the following principles in responding to behavioral health needs:

1. Substance use disorders and mental health conditions are complex and chronic conditions that affect brain function and behavior.
2. Substance use disorders and mental health conditions often co-occur.
3. Substance use disorders and mental health conditions are treatable. No single treatment is appropriate for everyone. Medications are an important element of treatment for many individuals.
4. Trauma is highly prevalent among court-involved people, and the impact of trauma is a contributing factor to both substance use disorders and mental health conditions.
5. Intervention at the earliest point possible improves outcomes for people with substance use disorders and mental health conditions.
6. Recovery from substance use disorders and mental health conditions is a process unique to each individual. Multiple pathways are necessary to meet individual needs.
7. Recurrence of use and/or symptoms is common. Recurrence presents an opportunity to reset treatment and recovery planning and goals.
8. Stigma is a significant reason why individuals do not seek treatment and support. Court responses must prioritize eliminating stigma.
9. Inequities and disparities exist in both the legal and behavioral health systems. Race, gender, sexual orientation, cultural and language needs, as well as economic status may be barriers to accessing effective care. Judges should be aware of individual and structural biases and should make efforts to eliminate them.  
10. Addressing equity issues requires an understanding of the root causes of outcome disparities within our society. All persons interacting with the court should be treated fairly, equitably, and impartially.
11. While courts and community partners have distinct roles, collaboration is vital in serving the court-involved population with substance use disorders and mental health conditions.