My loved one was arrested during a mental health crisis. How can I let the court know about their mental health history?

If your loved one who lives with a mental illness has become involved with the criminal justice system, you may wish to advocate for their mental health condition to be considered in the legal process.

One way to do this is by organizing a mitigation report, which is a comprehensive file of your loved one’s mental health medical records and any other important information about their mental health conditions and the impact of those conditions on their behavior and well-being.

We encourage you to organize this information quickly and give it to your loved one’s defense attorney as soon as possible. That way, the attorney understands that your loved one’s legal situation is related to a mental health condition they live with. They can explain your loved one's history to the judge, which may help them get a fairer outcome in court or be diverted to a treatment program rather than face criminal penalties like jail time or a criminal record.

It is OK to share one-way information with a defense attorney if they do not respond to your contact attempts. Consider all methods of contact possible to communicate this important information: phone call, fax, email, or a delivery of the report directly to the attorney’s office.

Steps For Writing a Mental Health History/Mitigation Report

Write your loved one’s full legal name and past legal names (if applicable) at the top of the document.
If your loved one has health insurance, list their insurance information including the type of insurance, the name of their insurance provider, and their insurance number and group number.
List your loved one’s primary care provider (PCP) name, address, and phone number.
List your loved one’s mental health diagnoses. Include the year of each diagnosis and the medical professional who made each diagnosis, if possible.
List your loved one’s current medications. List the dosage and purpose for each. Note any important instructions that come with the medications (e.g. regular blood testing, monthly injections, etc.)
List your loved one’s past medications. Include the purpose of the medication, dosage information, start dates, stop dates, side effects, and reasons for discontinuing, if known.
List important events from the past year in reverse chronological order, starting with the most recent event. List hospitalizations, treatment stays, arrests, incarcerations in jail or prison, periods of homelessness, and restraining orders. List the reason or precipitating event for each circumstance. Include dates and locations wherever possible. For example:
1. “Arrested for trespassing on 3/7/2023 in Anytown, PA. Was in search of shelter during a storm.”
2. “Hospitalized at Anytown Hospital from 1/13/23-1/16/23 after suicide attempt during a major depressive episode.”
List current mental health symptoms affecting your loved one’s well-being. Include descriptions and examples for each. For example:

“Hallucinations: Hears voices telling him he’s been chosen for God’s next mission.”
“Delusions: Believes her parents and siblings are planning to harm her. Has told mobile crisis workers that her mother threatened to end her in her sleep.”
“Mania: Two-to-three-week periods in which she sleeps only 1-2 hours per nights, gambles away large sums of money, and takes street drugs with strangers.”
“Impaired speech: Speaks quickly, yells abruptly, and says things that don’t make sense. Often scares friends and siblings by mentioning things related to death and world destruction.”

Write a short summary of your loved one’s history with mental illness. Explain specific symptoms that showed the onset of a mental health condition and describe any significant impairments they caused. For example:

“Started hallucinating at 21 years old while in college. Stopped eating and bathing, stopped going to classes, and got arrested for public indecency in 2015 because she believed there were microscopic bugs in her clothing. Successfully completed probation and participated in Coordinated Specialty Care treatment program for early psychosis. Lived in a partially supervised group housing facility, maintained employment, and continued with outpatient treatment for four years. Had another psychotic episode in 2020 and was involuntarily hospitalized. Has been in and out of the hospital and in and out of treatment and housing programs since. Has stayed out of trouble until most recent contact with law enforcement.”
“Got a concussion from high school football at 17 years old. Started having sudden bursts of rage and irritability, headaches, and difficulty sleeping. Dropped out of school and rarely came out of his room. Diagnosed with traumatic brain injury and depression until first manic episode 2 years later. Started writing on the walls, talking about being famous, and getting paranoid about family members and neighbors wanting to “take him down.” Diagnosed with Bipolar I Disorder. Lived at home with parents and sister until psychotic break and attempt to physically assault father at 20yo led to hospitalization. Entered residential treatment program in Anytown, NC. Discharged to community living facility in Anytown, NC. No awareness of bipolar condition and does not take medication consistently. Discharged from community living facility; has been unhoused since. Limited contact with family; has been reported missing three times.”

List any other details relevant to your loved one’s condition, functioning, or the help you hope for them to get. If they’ve had long periods of successful life functioning but are currently having a difficult time because of a mental health episode, be sure to note that. If their mental illness has caused severe impairments, they need help staying in treatment because they don’t recognize they’re ill, or there is other evidence they need the support of the mental healthcare system and not the criminal justice system to be well, be sure to note that.
You may also wish to include any documentation that provides a broader view of who your loved one is (e.g., community service, student records, character testimonies, etc.) or support they will have staying out of trouble if they are released (e.g., supportive home, a job, etc.).

For more information about working with your loved one to complete a full mental health history, you may wish to reference NAMI’s Navigating a Mental Health Crisis Guide. The guide includes a portable treatment record that you can download and fill out. The Treatment Advocacy Center has a fillable Mental Health History form that may be of help.

We hope this information will help you create a comprehensive mitigation report and advocate for your loved one’s mental health condition to be considered in the legal process. While the process may feel difficult, your care and advocacy are powerful and can make all the difference.

Hours of operation: Monday-Friday, 10 a.m. – 10 p.m. EST

Call: 800-950-NAMI (6264)

Text: 62640

Email: helpline@nami.org

Website: www.nami.org/help