Justice and Wellness: The Critical Role of Mental Health in Criminal Defense

In the public imagination, criminal cases and mental health often exist in separate compartments: crimes are broken down in terms of guilt or innocence, intent, and punishment; mental health is relegated to doctors, hospitals, and social services. But in real life, those silos frequently blur—many people charged with crimes also struggle with psychiatric illness, trauma, substance disorders, cognitive impairment, or other psychological challenges.

For criminal defense attorneys, ignoring that reality isn’t just unethical—it’s strategically unsound. A comprehensive defense must often engage with mental health issues: in assessing culpability, mitigating sentencing, challenging competency, or advocating for alternative resolution pathways (diversion, treatment courts, conditional release). Recognizing and treating mental health conditions is not a “soft” adjunct to criminal defense—it is essential to achieving justice, protecting clients’ rights, and promoting public safety.

Below are several dimensions of that intersection, and why integrating mental health considerations is critical.

Key Legal Doctrines & Considerations

Competency to Stand Trial

A defendant must be mentally competent to stand trial—that is, able to understand the proceedings, rationally consult with counsel, and assist in their own defense. When a mental illness or cognitive impairment impairs these capacities, the court may order a competency evaluation and delay proceedings until competency can be restored (often via medication or treatment).

When a client is unable to meaningfully participate in their defense, forcing the case forward would violate due process rights.

Mental Illness Defense

If a defendant can show that, at the time of committing the alleged act, they had a mental illness or cognitive impairment such that they could not understand the nature of their act or know it was wrong, that may rise to mental illness defense.

The mental health defense is an affirmative defense—so it must be raised by the defense and supported by sufficient evidence before the State is required to prove the defendant was criminally responsible despite the condition. Minnesota does not formally recognize a “diminished capacity” defense (i.e., that a mental illness weakens intent) in most criminal cases.

Sentencing Mitigation & Diversion

Even when a full mental illness defense is unavailable or unsuccessful, mental health evidence can play a powerful role at sentencing. A history of mental illness, trauma, substance use, or untreated psychiatric needs can be presented to argue for alternative, rehabilitative sentencing (e.g. probation conditioned on treatment, commitment to mental health services, or placement in a treatment-oriented facility). In many jurisdictions, mental health courts or diversion programs provide structured alternatives to incarceration when appropriate.

From a policy perspective, courts and jurisdictions increasingly recognize that for many defendants with mental illness, long-term public safety is better served by treatment rather than incarceration.

Why Treating Mental Health Matters (Beyond Legal Strategy)

Human dignity and fairness. Many individuals in the criminal system grapple with serious mental illness, developmental disorders, or histories of trauma. It would be unjust to treat them as though their minds worked like those of persons without such burdens. Recognizing these conditions respects dignity and ensures more equitable justice.

Better factual development. A mental health evaluation can provide insight into a client’s perception, memory, or decision-making frame at the time of an alleged offense. Expert testimony can help contextualize behaviors that might look incriminating when stripped of psychological context.

Reduced risk of recidivism. Addressing untreated psychiatric illness or trauma isn't just compassionate—it often reduces the likelihood of reoffending. Individuals who receive consistent mental health care are better equipped to stabilize, function in the community, and avoid future contact with the justice system.

Avoiding legal error. Failing to raise a competency issue or ignoring signs of serious mental illness can lead to reversible error on appeal. A vigilant defense must always assess whether mental health warrant inquiry.

Challenges & Ethical Tensions

Confidentiality vs. disclosure. If you want to rely on a mental illness or cognitive impairment defense, you may have to disclose medical records or expert reports that would otherwise remain private.

Client consent and autonomy. Sometimes clients resist psychiatric evaluation or treatment. Balancing a robust defense with respect for a client’s autonomy can be tricky—especially when involuntary treatment is at issue.

Restoration failures. Some clients may not regain competency despite treatment, which forces difficult decisions about dismissal, civil commitment, or other pathways.

Stigma and bias. Even among judges, jurors, or prosecutors, mental health issues carry stigma; expert and lay attitudes may distort or minimize the severity of a client’s condition. The defense must anticipate and counteract these biases.

Mental Health Resources & Systems in Minnesota

In Minnesota, the landscape of mental health services, legal frameworks, and resources offers certain avenues and limitations for clients who need psychiatric support in the context of criminal cases. Below is an overview of some key resources and institutional structures:

State Systems, Statutes & Institutions

Civil Commitment (Minn. Ch. 253B). Under Minnesota law, the state can involuntarily commit a person with mental illness who is unwilling to accept voluntary treatment and poses a danger to self or others or is unable to care for self.
Commitment Attorneys & Due Process Protections. In commitment proceedings, attorneys must be familiar with special rules governing rights, evidentiary procedures, and examinations.
Minnesota’s Mental Health Promotion Framework. The Minnesota Department of Health and Department of Human Services maintain webpages and efforts for mental well-being, prevention, and early intervention. Mental Health Promotion
Mobile Crisis Teams. Minnesota counties operate mobile crisis teams available 24/7 to respond to urgent mental health episodes, typically arriving within a short timeframe to provide in-person crisis interventions. Mobile Crisis Mental Health Services
State hospitals and regional treatment centers. Minnesota operates a few state psychiatric treatment facilities (such as the Anoka Metro Regional Treatment Center) for more intensive inpatient services.

Community, Nonprofit & Advocacy Resources

Suicide and Crisis Lifeline. Call 988 for free, confidential, 24-hour support. 988 Lifeline
Minnesota Crisis Text Line. Text “MN” to 741 741 for free, confidential, 24-hour support. Crisis Text Line
NAMI Minnesota. The Minnesota chapter of the National Alliance on Mental Illness offers educational resources, support groups, legal resource referrals, and advocacy. Minnesota NAMI
Mental Health Minnesota. A statewide organization offering community resource directories, advocacy, and information. Mental Health Minnesota
FastTracker Minnesota. This free search tool connects Minnesotans to mental health and substance use disorder care. FastTrackerMN
Behavioral Crisis Response in Minneapolis. The City of Minneapolis operates a 911-dispatched mental health alternative response program called Behavioral Crisis Response (BCR), which sends mental health professionals for crisis intervention and provides counseling, referrals and connections to support services. Minneapolis BCR
Walk-In Counseling Centers. Some counties maintain walk-in or drop-in counseling centers that are no-appointment, free, and anonymous. Walk-In Counseling Center

Recommendations for Defense Attorneys

Screen early and often. From the moment of intake, defense counsel should screen for signs of mental health or cognitive issues (psychiatric history, medications, hospitalizations, substance use, trauma).
Engage qualified experts. If mental health issues are present, retain forensic psychiatrists, psychologists, or neuropsychologists who can evaluate competency, criminal responsibility, or mitigation.
Coordinate treatment with defense strategy. Pursuing psychiatric care (medication stabilization, therapy) during the pendency of a case can strengthen one’s position, especially in restoration or mitigation pathways.
Negotiate creatively with prosecutors. In some cases, plea agreements can include conditions for mental health treatment, probation with treatment, or diversion into mental-health-specific pathways (if local programs exist).
Prepare the court and jury. Be ready to humanize the client’s mental health narrative—to help the factfinder understand that psychiatric disorders should not be seen as excuses but as meaningful context.
Advocate for system reform. Push for local mental health courts, increased capacity for treatment, better funding for community-based services, and closer coordination between criminal justice and behavioral health systems.

Conclusion

The overlap between mental health and criminal defense is not an optional addendum—it is often central to whether a client’s case is handled justly, humanely, and effectively. In Minnesota, defense practitioners have a patchwork of resources, statutory tools, and institutional pathways to lean on—but gaps and challenges remain.

By prioritizing mental health evaluation and treatment, defense attorneys help protect constitutional rights, reduce recidivism, and foster outcomes that serve both clients and communities. In a system too often dominated by punishment, embracing a more holistic, medically informed, and person-centered approach is not just better advocacy—it is a moral and professional imperative.