Glossary

Discrimination against, exclusion of, or devaluation of people with disabilities.

Potentially traumatic events that occur in childhood (0 to 17 years), such as experiencing violence, abuse, or neglect.

A type of defense requiring production of evidence by the defendant, rather than the state. Examples include the defenses of self-defense or insanity.

Another term for competence to stand trial. A person’s ability to work with (or “aid and assist”) their defense attorney is a key element of competence to proceed in a criminal case.

Substance use disorder that involves recurrent use of alcohol, despite significant impairment or problems associated with continued use.

A civil rights law that prohibits discrimination against people on the basis of disability.

A lack of awareness or insight into one’s own mental disorder diagnosis and related needs.

Medications that treat psychosis, a debilitating aspect of mental illness that impacts a person’s ability to distinguish what is real.

A category of disorders characterized by excessive and persistent fear and related disturbances in behavior. There are multiple types of anxiety disorders.

A set of guidelines for ensuring people in custody receive treatment that continues and is effective across transitions. The APIC framework includes four steps: Assessment, Planning, Identifying, and Coordinating treatment.

A community-based model of care where mental health services are provided in a person’s home or in a community location. ACT has the goal of keeping people with serious mental disorders in the community and trying to decrease hospital admittance.

A followup evaluation triggered by a screening that flags a potential problem or issue. An assessment is more in-depth than a screening, is performed by a mental health professional, and informs the facility about the services a person will need.

Facilities that were originally intended as a refuge for confinement and care of those with mental disorders and served in Europe and America as precursors to mental hospitals and psychiatric facilities.

A term used to include treatment of both mental health conditions and substance use disorders. Behavioral health providers may include psychologists, medical professionals, peers, therapists, social workers, and other medical and non-medical professionals who help manage and support behavioral health issues.

The legal standard of proof in criminal cases. Proof at this level includes overwhelming evidence that leaves no significant doubt in the minds of decision makers.

The amount or level of evidence required to prevail in a particular legal case. The burden of proof in a criminal case is “beyond a reasonable doubt,” and in most civil cases it is “by a preponderance of the evidence.”

A state of physical, emotional, and/or mental exhaustion where a worker is not experiencing satisfaction and fulfillment from their job.

Supporting clients by planning, coordinating and connecting them to services (health care, mental health care, substance use treatment, and social services) to address their needs and goals.

State certification for a professional who provides substance use counseling, also known as addiction counseling.

A court order requiring involuntary treatment, and sometimes confinement, for a person who has become unsafe due to a mental disorder.

Personal rights guaranteed and protected by the Constitution and federal laws enacted by Congress, such as the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990. Civil rights include protection from unlawful discrimination.

A federal law that allows the federal government to protect the civil rights of people who are in a facility such as a jail, prison, juvenile hall, or state hospital.

A legal standard of proof more demanding than the “preponderance of the evidence” standard, but less stringent than proof “beyond a reasonable doubt.” This standard is used in civil commitment cases, where serious liberty interests are at stake.

A mental disorder diagnosed in a person who also experiences (an)other mental disorder(s), most frequently referring to a mental disorder along with a substance use disorder.

A set of therapeutic techniques aimed at adjusting someone’s mental processes (e.g., thinking or perceiving) to promote behavior change.

Mental disorders that impact the ability to do things like think, problem-solve, or pay attention.

A hearing where a judge or hearings officer considers the evidence and decides whether it is sufficient to support a civil commitment.

A system of oversight outside of jail (probation) or after serving time in prison (post-prison or parole) where the supervised person has conditions to fulfill in order to remain in the community.

A 1963 act that was intended to provide federal funding to shift mental health care from institutional to community settings.

A state of physical and emotional depletion for a person in a helping profession, where caring for others in significant distress without opportunity to adequately recover leads to lack of compassion and empathy.

The ability of a criminal defendant to adequately participate in their own defense under the applicable legal standards.

An assessment that considers a person's mental capability in light of the legal standard for competence in their jurisdiction and then offers a professional opinion as to whether the person is legally competent.

Release of a person from an institutional setting (like a prison or hospital) into the community, often in a group setting, with requirements to abide by a set of rules and safeguards. If those conditions of release are violated, the person may be returned to confinement.

Ability to access uninterrupted health and mental health services during a setting transition.

Officer who has oversight of the prison and jail inmate populations and works to reduce or prevent any security risks.

Term used to describe commitments (involuntary treatment and/or confinement) by operation of law in the context of a criminal case. A commitment is not a conviction or a punishment.

Lawyer who defends people accused of crimes in criminal court, hired privately or by the government as a public defender.

Using the criminal justice system as a response to people who come to the attention of authorities primarily due to their mental disorders.

A person’s likelihood of criminally reoffending, assessed based on factors that directly relate to whether the person is likely to commit another crime (criminogenic risk factors).

A program aimed at training criminal justice professionals to safely and effectively respond to individuals experiencing mental health crises. CIT emphasizes de-escalation techniques and referrals to mental health and social services.

A network of community supports (including someone to call, people to respond, and a place to go) for people experiencing behavioral health crises. A functioning crisis response system avoids criminal justice involvement in response to crises.

A descriptor applied to behavioral health care that factors in and positively uses understanding of a person’s background and life experiences to provide them with care that meets their needs.

In policing, use of skills to slow events, decrease risk of physical confrontation, and increase opportunity for improvement of outcomes.

The dramatic downsizing and closure of large institutions, such as state hospitals, that housed people with mental disorders.

A legal standard of proof required in some civil rights cases involving the criminal justice system, meaning that an official was aware of substantial risk of harm but chose not to take action to avoid that harm.

Experience of becoming detached and emotionally distant, and losing empathy, that is associated with workplace burnout.

The ability and power to potentially fail that comes along with an opportunity for self-determination and growth.

Any condition or impairment of a person’s body or mind that makes it more difficult for that person to engage or participate in activities.

A broad push toward securing equal rights and opportunities for people who experience disabilities.

Categorical exclusion or unfair treatment based on a person’s status.

Where a person is identified at some point (early or late) in the criminal justice system and provided with a pathway out of that system.

The idea of guaranteed fair treatment within the legal system based on established procedures.

A formulation of the insanity defense eliminating criminal responsibility where a person’s wrong act was the “product” of a mental disorder.

The federal legal standard for competence to stand trial, requiring that an accused person must have a rational and factual understanding of the proceedings and an ability to reasonably consult with their lawyer about the case.

Amendment to the U.S. Constitution that prohibits cruel and unusual punishments, and regulates excessive fines and bail.

A medical procedure that involves passing small electric currents through a patient’s brain, creating changes in brain chemistry that have been highly effective in treating conditions such as severe depression.

A process allowing a doctor to order that a person be kept under medical supervision so their mental health can be assessed and stabilized. A hold can be a first step in involuntary commitment proceedings.

An American movement beginning the 1890s that encouraged practices such as forced sterilization to remove “unfavorable” characteristics in the gene pool. Eugenics became disfavored in the late 20th century.

Descriptor of a treatment, practice or intervention that is proven, via research, to be effective for achieving desired outcomes.

A defense asserted by a criminally accused person stating that the accused person has done something wrong but bears no criminal responsibility due to the circumstances of their action. Examples are duress (the person was forced to do something wrong) or insanity (the conduct was attributable to a mental disorder resulting in legal insanity).

A legal claim based on discrimination that alleges a failure to provide a disabled person with the accommodations that they need to be on equal footing with non-disabled people.

A legal claim intended to hold an agency or supervisors liable for their employees’ conduct by asserting that lack of training caused the employee to do the harmful act.

Amendment to the U.S. Constitution that creates numerous important rights. Among those rights is the right to receive “due process” of law in any proceeding that could deprive a person of life, liberty, or property.

A specialized psychologist who provides services within the legal system, such as completing psychological assessments and offering expert opinions on civil or criminal legal matters.

Relating to investigatory or court proceedings.

Amendment to the U.S. Constitution that governs the rights of citizens in the states. The due process clause of the Fourteenth Amendment is understood to guarantee fairness in proceedings in the criminal justice systems in the states, just as the Fifth Amendment due process clause requires fairness in the federal system.

A legal status defined by state laws indicating that a person is unable to safely care for themself or is likely to harm themself. Grave disability can be a basis for civil commitment in some states.

The terminology used in Oregon for a person who has successfully asserted the insanity defense and been excused from criminal responsibility. Other states use varying terms, often “not guilty by reason of insanity” or NGRI.

A law that prohibits health entities from sharing protected patient medical records without authorization.

Threat of harm that is immediate rather than in the future.

A strategy where providers from community-based organizations meet with individuals prior to their release from custody to begin service planning and establish continuity of care.

A law that established “special education” services for children who experience disabilities that impact their ability to learn and function in school. The IDEA requires that all students be provided with an appropriate and inclusive education.

A defense asserted by a criminally accused person stating that they should be excused from criminal responsibility for their conduct due to their state of legal insanity at the time of the conduct.

Confining people with disabilities or mental illness in facilities rather than supporting their integration into communities.

A window in time during a person’s interaction with the criminal justice system where that person might be provided an opportunity for diversion out of the system.

A formulation of the insanity defense eliminating criminal responsibility where a person’s mental disorder prevented them from controlling their behavior or compelled them to do the bad act.

A defense asserted by a criminally accused person stating that the accused person’s conduct was not wrong, or criminal, because their behavior was warranted, or justified, by the circumstances. An example is self-defense.

A law created by statute or a court decision that guides decisions and creates consistency in the legal system. For example, the legal standard of proof in criminal cases is “beyond a reasonable doubt,” and the legal standard for competency was established in the Dusky case.

Personal knowledge gained through direct, first-hand involvement. In the context of this text, lived experience refers to experience with mental disorders, including substance use disorders, and/or criminal justice system involvement.

A surgery where part of the brain is removed with a goal of managing or curing mental illness. Lobotomies were performed on patients up until the 1950s in America.

A formulation of the insanity defense eliminating criminal responsibility where a person, due to a mental disorder, did not know the difference between right and wrong in the context of their behavior.

A disability is perceived as attributable to a person’s impairment. This model contrasts with the social model of disability, which recognizes that the environment creates barriers—not the disability

Use of medication along with other therapies to treat substance use disorders. There are several medications that target alcohol use, as well as medications that treat opioid use disorder.

A medication-based approach for treating alcohol use disorders, reducing alcohol use, and sustaining recovery. The most common FDA-approved medications used to treat alcohol use disorders are acamprosate, disulfiram, and naltrexone.

A medication-based approach for treating opioid use disorders, preventing overdose, and sustaining recovery. The FDA has approved three medications for opioid use disorders: buprenorphine, methadone, and naltrexone.

A mental illness, substance use disorder, or disability that impacts a person’s cognitive, emotional, or behavioral functioning.

A professional providing treatment to someone with a mental disorder.

A diversion or “problem-solving” court that substitutes treatment and other interventions for traditional criminal punishments (jail or fines) for qualifying offenders.

Explaining a defendant’s conduct in a way that does not excuse but may soften judgment of the conduct, thereby providing a reason for a judge or jury to impose a reduced sentence. Facts in explanation might be considered mitigating factors or circumstances.

A team, often consisting of a mental health worker and a peer support provider, that responds to mental health crises in the community. Team members vary, and some operating under this name may include different types of professionals including law enforcement professionals.

An example criminal code developed by experts to provide states with standard language on which to base their statutes. Many states have adapted MPC language for use in their state codes.

A 19th century approach to treatment of those with mental disorders that specifically rejected the harsh treatments that had previously been common and instead fostered the idea that ill patients could become well if they were treated kindly.

Team of providers with members from different professions or specialities. ACT and mobile crisis teams, for example, are multidisciplinary.

A nationwide advocacy organization for people experiencing mental illness and their families.

Leading U.S. agency for research on mental health issues, founded in 1949 pursuant to the National Mental Health Act, as part of the National Institutes of Health (NIH). The NIH is composed of 27 research institutes and centers and is part of the U.S. Department of Health and Human Services.

A 1946 act that authorized research and care for mental health and significantly expanded America’s commitment to use science to understand and treat mental illness.

The idea that anyone can receive services at a provider, whether they walk in or are brought by a crisis team or law enforcement; and once there they will be assessed for whatever care they need at whatever level, large or small.

Diagnoses that, while potentially very impactful, do not make a person eligible for the insanity defense under state law, generally because they are diagnosed based on rule-breaking behaviors. Examples include sexual disorders, substance use disorders, and personality disorders.

In Oregon, the paperwork that triggers a court's involvement in a civil commitment. Each state, as well as the federal system, has developed its own procedures for initiating and completing civil commitments.

A nurse with an advanced degree and licensing to provide patient care, including diagnosis and prescription of medications, in a variety of settings.

A class of drugs that includes legal and illegal substances, such as heroin, fentanyl, and prescription pain relievers like oxycodone, morphine and others.

A substance use disorder involving opioid drugs, such as heroin, fentanyl, or prescription opioids (e.g., OxyContin).

In Oregon, a multidisciplinary oversight board charged with ensuring proper management and community safety with respect to all GEI patients. Each jurisdiction that allows the insanity defense has their own methods of overseeing this population.

A professional who generally assists lawyers with various administrative tasks, as well as legal tasks under supervision.

Officer who supervises people who have been released from prison to a period of supervision in the community, providing oversight and enforcement of release conditions, as well as resources to reduce risk of reoffense.

The use of trained healthcare workers to reduce barriers to care for individuals returning from criminal justice settings. Patient navigators help individuals navigate complex healthcare and social services systems to improve access to care and treatment.

People with lived experience, including with mental disorders and/or criminal justice system involvement, who have been successful in the recovery process and are trained to help others experiencing similar situations. Peers can have various titles: peer support workers, peer specialists, peer recovery coaches, peer advocates, or peer recovery support specialists.

An evaluation by mental health professionals to determine what, if any, mental disorder a person is experiencing and how that mental disorder is currently impacting the person facing commitment.

The legal standard of proof in civil cases. Evidence at this level makes something more likely than not to be true and may be characterized as “just enough” to tip the scales, or 51%.

Programs that allow a person to be supervised in the community while awaiting resolution of criminal charges.

Officer who supervises people allowed to leave or remain out of custody pending a criminal trial, ensuring supervisees follow court-imposed release conditions and appear at required proceedings.

Officer who supervises people convicted of crimes who are placed on community supervision, instead of or after a period of jail incarceration. Probation officers ensure that supervisees adhere to court-imposed conditions of release from custody.

Courts that attempt to support sustainable behavior changes (and avoid incarceration) by responding to offending conduct with treatment and other interventions. Examples are drug courts and mental health courts.

Lawyer who represents the government in criminal matters against people accused of crimes.

A mental disorder that causes disability, or limits one or more major life activities.

A nurse practitioner with special training and licensure to provide psychiatric care, including prescribing psychiatric medications (e.g. antipsychotic medications) as part of their patient-care role.

A physician who specializes in the diagnosis and treatment of mental disorders.

In Oregon, a specific procedure for initiating civil commitment proceedings that allows any two people acting together to initiate the commitment process.

Diagnoses that are permitted to form the basis for an insanity defense, assuming other requirements of the defense are met. This includes mood disorders, psychotic disorders, and trauma-related disorders, among others.

An adjustment or modification that meets the needs of the disabled person requesting it but does not place an excessive burden on the person providing the accommodation.

Return to criminal offending, as measured by re-offense, re-arrest, re-conviction, or re-incarceration.

Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.

The process of leaving jail or prison, from preparation and planning during incarceration through release into the community.

Targeted treatment provided to a criminally charged person who is incompetent, or unable to aid and assist in their defense. Treatment is intended to enable the person to constitutionally proceed with resolution of their criminal case.

Model of providing services that informs who receives services based on risk, what services are provided based on need, and how services are provided to maximize responsivity.

Patterns of school discipline that push students toward entry into the juvenile or adult justice systems. This is a particular risk and concern for students of color, disabled students, and students living in poverty.

A standardized set of questions designed to flag people who are at risk for a targeted problem, such as a mental or substance use disorder. A screening does not provide a diagnosis or guidance on the severity of any disorder; rather it informs that a person needs further assessment.

A phenomenon that occurs when service providers experience indirect, or secondary, trauma, yet experience symptoms similar to post-traumatic stress disorder, a condition associated with direct traumatic experiences.

A common name for the federal law 42 U.S.C. § 1983, originally enacted in 1871 and known as the Ku Klux Klan Act. Section 1983 allows individuals to bring lawsuits in federal court to address violation of their federal civil rights by state officials.

A federal law prohibiting discrimination against people with disabilities in certain federal government contexts.

Deliberate actions and behaviors to enhance mindfulness and well-being.

A tool for discussing and assessing various diversion options for people with mental disorders at progressive points, or intercepts, in the criminal justice system. The SIM may highlight options that are available or missing in a particular community or at a particular intercept point.

An understanding of disability as an aspect of a person’s identity rather than as a source of barriers, recognizing that environments present barriers for people who experience disability.

A professional who helps people manage problems in their lives. Work can involve an array of services, from advocacy to counseling to case management.

A form of discipline or separation used in incarceration where the person is also called isolation or administrative segregation, is where an incarcerated person is placed in a cell alone, with their human interactions strictly limited. Solitary confinement is generally used as a form of discipline for prison rule violations, or as a method to keep the isolated person or others safe.

Originally, state-funded institutions in the model of asylums intended to house people with mental disorders. Modern state hospitals are psychiatric facilities that provide care and treatment, usually on a short term basis.

Persistent and unfounded negative attitudes towards people with conditions such as mental disorders. Some people object to this term on the grounds that it may perpetuate negative ideas, and they prefer use of the terms “prejudice and discrimination” to describe societal attitudes and actions that reinforce negative stereotypes and policies.

An agency of the U.S. government that leads public health initiatives aimed at improving national mental health. SAMHSA offers extensive information and resources on mental disorders.

Treatment that helps a person manage and recover from a substance use disorder, typically including evidence-based therapies such as cognitive behavioral therapy and/or other therapeutic approaches, and increasingly including medication-based approaches. Substance use treatment represents a significant need in custodial environments.

Evidence-based intervention that provides job development and placement, job coaching and training, and problem-solving skills development to people with disabilities and behavioral health conditions.

Provision of health care, including mental health care, via means such as phone or video appointments, as well as electronic transfer of medical data.

A hypothesis suggesting that people in need of care during the deinstitutionalization movement were simply moved from one institution (hospitals) to another (prisons).

A system or action that realizes the widespread impact of trauma; recognizes its signs and symptoms; and responds by integrating this information into policy and practice, seeking to actively resist re-traumatization.

The federal agency that enforces laws of the United States.

The positive and empowering impact of experiencing others’ success in overcoming adversity.

When one’s worldview shifts after providing direct care to people who have experienced trauma.

A professional who provides direct services to victims of crime, often in community settings as a support person, or in the context of court cases to ensure access to victim’s rights, such as notification of hearings.

A transfer of care between support people or care providers (e.g. from correctional health to community-based services) that includes direct introductions, provision of required information, and if appropriate, transportation to the receiving service provider. Warm hand-offs are a technique to ensure continuity of care for people being released from custody.

A legal claim asserting that an arrest of a person is unlawful and unreasonable. In the disability context, wrongful arrest may involve an arrest based on disability-related conduct that is treated as illegal conduct.