Serious Mental Illness and Alternatives to Detention: What a New York Forensic Opinion Can and Cannot Support

Stephan M. Carlson, MD, MBA, FAPA · Correctional Mental Health

A diversion proposal lives or dies on a single hinge: not whether the defendant has a serious mental illness, but whether a specific community plan would manage the specific risk that put him in custody. Reports that prove the diagnosis and stop there give the court a sympathetic story and no reason to act on it. What the court is actually being asked to decide When counsel proposes an alternative to detention for a defendant with serious mental illness, the court is weighing two things at once: the defendant's clinical condition and the community's safety if he is released to treatment instead of held. A psychiatric opinion that addresses only the first half answers half the question. The b

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