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A Judge’s View On Youth Mental Health & The Justice System

Part of the Hiding in Plain Sight blog series

Written by Kee Dunning, author & psychotherapist providing crisis intervention

March 28, 2022 / Forbes

After 28 years of service, Judge Nan Waller became the presiding judge over the mental health court as well as managing the competency to stand trial docket in Multnomah County, Oregon. She is also co-chair of the Oregon Chief Justice’s Behavioral Health Advisory Council and is a member of the National Judicial Task Force, which examines the State court’s response to mental illness.

She wants to change the way things are done in the legal system. Instead of judging a book by its cover, she likes to ask herself first “what don’t I know about this person in front of me, [and] why?

“Everybody [has] a story,” said Judge Waller. “I love being a judge because I get to find out the stories. The other benefit is I get to work at the intersection of practice and policy. Practice needs to inform policy. You must understand how the policy is going to affect people.” Being the mental health and competency trial judge allows her this opportunity.

“I spent the first part of my career in juvenile court, and you really get to know people in that environment,” she reflected. “I approached each child in juvenile court as I would approach my own children, as a parent who cares and loves this child. I spoke to the kids as though I was speaking to my own children at the dinner table. I would ask them, what are your hopes? What are your dreams? What is your plan? As time progressed, I had more and more kids that would stare blankly at me when I asked that question. A profound moment happened when I asked a young man, what are your hopes? This child burst into tears and said I have no hopes. That said a lot to me about our court system and our society. I knew that policies sometimes worked well and would give the child a path out, but too often, our policies were barriers and thus took hope away.”

It is time for us to see a change in the court system. So how do we change policies?

“What seems like a good idea on paper can be a disaster in practice,” said Judge Waller. “In the early 20th century, we sent anyone with mental illness to an institution, out of sight, out of mind. That created a national stigma and mental illness.

Then new policies were issued in the 1980s and then we closed the large institutions, which was well-meaning and good-intentioned, but no one considered the big picture. There was nowhere for these individuals to go. If we closed the institutions, we needed to have community-based services for persons with mental illness, in order to be successful and live their best life possible, but the community services were not available. What then happened, was a shift of persons with mental illness to our jails, to the streets, living under bridges and along highways – hiding in plain sight. People didn’t want to see mental illness. This, coupled with the re-routing of individuals into the justice system, has further increased the stigma and discrimination associated with mental illness.

All people need a purpose, a place, and a sense of safety. It is our collective responsibility as a country to provide this for all people, but especially for those living with mental illness.”

She continued, “As a judge, I have the [rare] opportunity to engage with the person standing in front of me. I can see they have been beaten down. When I ask what they want and need, I discover that most people in mental health court have never been asked those questions. We need a paradigm shift in this country. We need to recognize the humanity in every person and we need to listen and see that individual as a fellow human being. I want to see this in all courts, not just mine.”

“Mental health courts are a younger form of the treatment court model. They include planning for wrap-around services. In mental health court, you need to be a little more vulnerable as a judge or court officer.

“The lack of access to appropriate behavioral health services and professionals has been a real challenge for us in mental health court,” she continued. “It can take months to get someone mental health services. In the meantime, what do you do for this person? How do you help them? First and foremost, we need to deflect people who do not belong in the criminal court system, to the community. Next, you have to be persistent and find the right people to help them. Sometimes that means people having to retell their story over and over to get the help they need, each time they have to re-tell their stories can take a toll. It can be hard to keep going, but you have to encourage people to keep going, to not give up!”

We need to give people hope, let them know they matter, and they are worth it.

“Exactly!” said Judge Waller. “I love what I am doing, getting to work with these people, and hearing their stories. But I know the people I work with need a whole community to help them keep going. At the end of mental health court, we are excited and clap, but I worry, will they have the help they need? Things may turn around quickly, but they may still be back in front of me again.”

She continued, “I worked on setting up a wraparound program when I was doing more juvenile work. I recognized that we had to look at everything in the child’s environment and consider the wholeness of their life. That was the only way to make effective change, we need to communicate with family, school, etc.”

Everyone can be a source for instigating this type of change. “We need a collective responsibility of caring. When my youngest child was in preschool, her school was in an area where there were a lot of homeless people and a lot of individuals who were mentally ill. When she got older, we did some volunteer work in the community. My daughter recognized after doing the work, that she would never look at people on the street the same way. She knew, even as a small child, we needed to be aware and be safe but we also needed to recognize the humanity in the individuals on the street. She knew that we shouldn’t look the other way and disregard the person. We should look them in the eye and say good morning recognizing that we see them as a person, as a fellow human being. We need to build a strong community-based support network. People need a purpose. There is also the collective responsibility to direct frustration toward the right solutions – not just out of sight, out of mind. We need to be the change we want to see.”

About the Author

ee Dunning, author & psychotherapist providing crisis intervention

Kee Dunning is a psychotherapist in private practice, adjunct faculty and author, writing on topics such as rural youth suicide risk assessment and intervention, cognitive behavioral therapy, teen dating abuse, bullying, and concepts in communication, anger and conflict management. For nearly two decades, Kee has provided crisis intervention for triage for homeless, trafficked, and at-risk youth and families and their support systems; and was Clinical Supervisor for Graduate Studies in Counseling at  Montana State University.

The “Hiding in Plain Sight” Blog is a series leading to the upcoming 2022 documentary Hiding in Plain Sight: Youth Mental Illnessproduced and directed by Ewers Brothers Productions, executive produced by Ken Burns, and presented by WETA, the PBS flagship station in our nation’s capital. 

Related Series & Films is a mental health resource, not a crisis or suicide response website. If you are in crisis, or experiencing thoughts of suicide, please text the Crisis Text Line (text HELLO to 741741), or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Both services are free and available 24 hours a day, seven days a week.