New Commitment Pathway for Offenders with Serious Mental illness: Expedited Diversion to Court-Ordered Treatment (EDCOT)

Over the last 50 years, as public hospital beds have diminished without offsetting increases in community services and supports, individuals with mental disorders have increasingly been arrested, jailed and punished. In many states, defendants thought to incompetent to stand trial wait months for assessment or treatment, only to eventually have their cases dismissed. About a quarter of arrestees have serious disorders and it has been estimated that more than 800,000 individuals with mental illness are under correctional control at any given time. “Decriminalizing mental illness” has become a standard plank in progressive proposals for overhaul of the “criminal legal system.” Professor Richard J. Bonnie will present and defend “Expedited Diversion to Court-Ordered Treatment” (EDCOT), a formal statutory diversion process for offenders with serious mental illness. As a civil commitment proceeding accompanied by dismissal of criminal charges, EDCOT would not entail a waiver of criminal trial rights and could be invoked even if the defendant lacks trial competence. EDCOT would also be available to authorize civil hospitalization of offenders who are not immediately able to function successfully in the community. These provisions, coupled with mandated compliance with outpatient treatment and judicial supervision, would enable diversion of many, perhaps most, offenders with serious mental disorders into a treatment system that could provide acute services, discharge planning, and problem-solving management in the community. Bonnie is Harrison Foundation Professor of Medicine and Law and director of the Institute of Law, Psychiatry and Public Policy at the University of Virginia. He has co-authored leading textbooks on criminal law and public health law and has devoted special attention during his career to public policies relating to mental health and substance abuse. His first book, “The Marijuana Conviction: A History of Marijuana Prohibition in the United States” (1974) was republished in 1999 as a “drug policy classic.” Bonnie has been involved in public service throughout his career. Among other positions, he has been associate director of the National Commission on Marihuana and Drug Abuse (1971‑73) and secretary of the first National Advisory Council on Drug Abuse (1976–80). He recently chaired a Commission on Mental Health Law Reform at the request of the chief justice of Virginia (2006–11) and is currently chairing an Expert Advisory Panel on Mental Health Reform for the Virginia General Assembly. Bonnie was elected to the National Academy of Medicine in 1991 and has chaired more than a dozen studies for the National Academies on subjects ranging from elder mistreatment to underage drinking, including the landmark report, “Ending the Tobacco Problem: A Blueprint for the Nation” (2007). In 2017, he chaired a study on policies needed to address the opioid epidemic in the United States and is now chairing a study on using knowledge about adolescent development to advance the well-being of all adolescents regardless of social background. Bonnie has ­served as an adviser to the American Psychiatric Association (APA) since 1979, received the APA’s Isaac Ray Award in 1998 for contributions to forensic psychiatry and special presidential commendations in 2003 and 2016 for service to American psychiatry. He has also served on three MacArthur Foundation research networks, including, most recently, Law and Neuroscience. He is also a consultant to the American Academy of Neurology’s Committee on Ethics, Law and Humanities. Bonnie received the University of Virginia’s highest honor, the Thomas Jefferson Award, in 200