Extending Mental Health Courts for Juveniles with Autism Spectrum Disorder in North Carolina: A Therapeutic Approach to Justice

As the dialogue surrounding juvenile justice evolves, it becomes increasingly clear that our legal system must adapt to recognize the unique needs of vulnerable populations, particularly those with mental health conditions. In North Carolina, the opportunity to extend mental health courts to juveniles with autism spectrum disorder (ASD) presents a compelling case for a more therapeutic approach to justice.

Understanding Autism Spectrum Disorder

Autism spectrum disorder is a neurodevelopmental condition that affects social interaction, communication, and behavior. The spectrum is broad; some individuals may require significant support, while others are highly independent. Many juveniles with ASD face challenges that can lead to misunderstandings in social situations and may result in behaviors that are misinterpreted as delinquent or criminal. For example, an individual with autism, not knowing how to respond appropriately to a police officer, may run when asked something as simple as their name. The officer may assume the individual is guilty of something and brought to the police station. Given that these behaviors often stem from their underlying conditions, addressing the root causes–rather than simply penalizing the actions–can lead to more constructive outcomes.

Mental Health Courts in North Carolina

Mental health courts have emerged as a progressive alternative to traditional court systems, particularly for individuals whose criminal behaviors are closely linked to mental health issues. These specialized courts focus on treatment and rehabilitation rather than punishment, aiming to reduce recidivism and improve mental health outcomes. After a statewide conference and training event, a Web-based survey was conducted with conference registrants, including judges, attorneys, and health care providers. Clear majorities of respondents agreed that their mental health courts were effective and useful. More than 80% of the respondents agreed with positive statements about their court’s improving clients’ chances or remaining in the community without another offense and moving toward long-term recovery. 

Eligibility for mental health court in North Carolina is based on a mental health diagnosis or history of treatment, with priority given to those with severe and persistent mental illness. However, autism is not considered a mental illness in North Carolina. Instead, it is considered a developmental disability. By extending these courts to include juveniles with ASD, North Carolina would help acknowledge the complexities of their behaviors and provide them with appropriate therapeutic interventions.

Therapeutic Consequences vs. Punitive Measures

The traditional punitive approach often fails to address the specific needs of juveniles with ASD. For instance, a teenager with autism may exhibit aggression or defiance not out of malice but as a response to overwhelming sensory stimuli or social misunderstanding. In such cases, punitive consequences can exacerbate feelings of isolation and anxiety, leading to a cycle of misbehavior and further entrenchment in the criminal justice system.

In contrast, mental health courts can facilitate access to specialized therapies, social skills training, and family support. By focusing on rehabilitation, these courts can help juveniles develop coping mechanisms and social skills, ultimately steering them away from future encounters with the law.

Legal and Ethical Considerations

Implementing mental health courts for juveniles with ASD in North Carolina would necessitate careful consideration of legal and ethical frameworks. It would be essential to ensure that the rights of these individuals are protected and that interventions are tailored to their specific needs. Multidisciplinary teams, including psychologists, social workers, and legal professionals, could play a critical role in developing individualized treatment plans that address both the mental health needs of the juveniles and the concerns of the community. 

These teams are already in use in mental health courts in North Carolina to refer individuals to programs based on their needs and to provide case management. The professionals on these teams work together to ensure that each participant in the court has a person-centered treatment plan, that regular status hearings are held to review the treatment plans, and to help them obtain housing and job skills training. These multidisciplinary teams would also play a critical role in implementing mental health courts for juveniles with ASD.

Addressing Stigma and Misunderstanding

Another vital aspect of extending mental health courts is the potential to reduce stigma associated with mental health and neurodevelopmental disorders. By acknowledging that ASD can influence behavior and that therapeutic approaches are preferable to punishment, the legal system can contribute to a broader societal understanding of these conditions. This shift could foster a more compassionate approach to all individuals with mental health challenges, paving the way for increased support and resources.

Conclusion

The potential to extend mental health courts to juveniles with autism spectrum disorder in North Carolina presents a unique opportunity to create a more just and equitable system. In addressing the underlying conditions that contribute to juvenile behavior, we can offer therapeutic alternatives that prioritize rehabilitation over punishment. In doing so, we not only support the individual needs of these young people, but we also foster a more understanding and inclusive society. As we consider reforms within our juvenile justice system, let us champion the idea that a therapeutic approach can lead to better outcomes for all.

Sarah Cha

Class of 2026, Staff Member