Pittsburgh’s ‘nurturing’ mental health court actually punishes the mentally ill, report says

Despite its stuffed Star Wars characters and posters displaying inspirational quotes, Allegheny County’s mental health court is a coercive and somewhat baffling place that demeans its participants and threatens them with incarceration, according to a new report by the Abolitionist Law Center (ALC), a Pennsylvania-based civil rights law firm.

The Pittsburgh-based court opened in 2001 to ostensibly connect people with mental illness to community-based services and keep them out of jail. Strict criteria govern who can participate in the Mental Health Court (MHC). They must have already received a diagnosis, been charged with a non-violent offense, and pleaded guilty. Before entering MHC, many participants spend weeks in the notoriously deadly Allegheny County Jail. The report states that one person was locked up for close to a year.

“It is the purpose and passion of the Mental Health Court to help individuals accept, understand, and embrace their mental health conditions and, when needed, help them overcome addiction so that they can live better, more stable, productive, and fulfilling lives,” the court’s website states. “We do this by creating a safe, supportive, and nurturing community where participants can begin their journey forward. It is our purpose and passion to enable individuals with mental health conditions to thrive in all aspects of their lives.”

But the ALC says its report shows that, despite political rhetoric that mental health courts are a more humane alternative to the carceral system, many remain, at best, problematic and often feed people back into the criminal legal system. In Allegheny County’s case, ALC says the court and its single judge, Beth Lazzara, routinely upend Pittsburgh-area residents’ lives with impunity.

To compile the report, ALC court watchers observed more than 150 unique participants from Mar. 8, 2021, to Oct. 3, 2022. The law firm says MHC participants are denied needed services and punished for their mental illness.

“[Mental Health Court] starts with arrest and revolves around the threat of the ACJ [Allegheny County Jail,” reads the report. “It surveils and punishes participants for their struggles with mental and behavioral health. It forcefully deprives people of their freedom of movement and medical autonomy.”

The Appeal has contacted Lazzara and will update the story with her response.

Despite the potentially severe consequences facing MHC participants, the report says defense attorneys are present at fewer than half of the hearings. Prosecutors are absent more than half the time. Typically, the only attendees are the judge, the defendant, the probation officer, and someone from the county’s Justice Related Services program, which is supposed to help people with mental illness who are involved in the legal system.

While many fees are mandated by state law, judges have some discretion over which costs to impose. ALC found that among the cases court watchers observed, dozens of people had to pay restitution to their victims—which, in some cases, were corporations. One person had to pay $48 to Rite Aid. Another had to pay more than $3,700 in “Insurance Company Restitution.” Participants were also charged for offender supervision, probation/parole admission, booking center fees, substance abuse education, and other items.

The Fifth Judicial Circuit of Pennsylvania refers to the MHC as a “problem-solving court,” which is designed to monitor “a participant’s progress and compliance in the program while offering positive encouragement and incentives, as well as imposing appropriate sanctions when necessary.” But Court watchers reported that Judge Lazzara imposes arbitrary rules that can jeopardize a person’s employment, housing, and mental health, including orders to stay away from their family members. Refusal to follow the court’s orders can result in incarceration.

The report says that, in one case, the judge said she entered a no-contact order against a participant’s family because “they’re your enablers: mom, dad, and your sister.” In another, she refused to allow a father to go home and care for his mother, who had recently had a stroke.

Court watchers also say Lazzara has implemented an awards system that demeans participants. While the precise criteria are unclear, doing well in her court earns participants “hope,” “courage,” “patience,” and “strength” bracelets, as well as “Han Solo turn-it-around” and “Yoda do-or-do-not” certificates. ALC says Lazzara, a former personal injury attorney who has been the MHC judge since 2012, has no publicly available credentials in mental health treatment.

“Lazzara’s MHC Courtroom can seem more humane than others, but it is both infantilizing and dangerous, oriented around the threat of jail,” reads the report.

Court watchers say they observed Lazzara routinely humiliate participants. She allegedly told one person she could send him to jail that day and he’d lose his housing, according to the report. She also allegedly said that her black robe gives her “the right to speak, and he needs to be silent,” according to a court reporter.

In another case, a seven-months pregnant mother of two sobbed and begged for another chance, according to the report. The judge told her that she wasn’t trustworthy and that the woman was “sentencing that child [the fetus] to a lifetime of misery.” A year later, the mother was kicked out of MHC and incarcerated for several months.

ALC recommends numerous changes to the court, including abolishing the requirement that people plead guilty and adding a peer support navigator to advocate for participants.

“The Mental Health Court is set up with one person as the problem and authority figures as the problem solvers,” the report says. “This only serves to maintain the culture of ableism that criminalizes disability in the first place.”