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Co-Occurring Disorders Court Focuses On Justice For High Risk Defendants

The Staff of the Co-Occuring Disorders Court

The State of Maine is one of few states in the nation to implement a problem-solving court that specifically targets adult criminal defendants with serious and persistent mental illness and co-occurring substance abuse disorders.  Maine's only Co-Occurring Disorders Court (CODC) constitutes that “last turn” in the revolving door of multiple prior incarcerations, psychiatric admissions, and treatment for substance abuse. 

Regardless of the setting, outcomes for individuals with co-occurring disorders involved with the criminal justice system are poor.  These individuals are among the most difficult to diagnose and treat and typically have greater challenges with housing, employment, family instability, and medication management, among others issues.  Consequently, they are significantly more likely than other offenders to relapse and to engage in new criminal conduct.[1] Traditional adjudication, supervision, and treatment alone are not effective with this population.  The costs of law enforcement intervention, incarceration, failed treatment, family fragmentation, and further victimization is unacceptable.  Innovative solutions such as the CODC have been effective and have reduced these costs.

The CODC, based at the Kennebec County Superior Courthouse, combines close judicial monitoring, specialized assessment and treatment services, wraparound case management services, incentives and sanctions depending on participation, and frequent and random drug and alcohol testing.  The Court team consists of presiding Justice Nancy Mills, District Attorney Evert Fowle, ADA Deborah Bertos, Assistant Court Clerk Roxanne DiMarco, and representatives from Crisis & Counseling and other treatment providers, the case management services provider, Adult Community Corrections, the State Forensic Service, and the Administrative Office of the Courts.  Because of the complex needs of these clients, the CODC collaborates closely with other social service, substance abuse, medical, dental, and mental health service providers at the local and state level. 

The court also serves as a catalyst for needed system changes and encourages accountability on the part of all service providers involved with its clients.  It has become well known throughout the State of Maine as a resource for high risk and high need nonviolent offenders.  The court's guiding principles are notable and reflect recognition of the particular needs of its target population:  first, CODC clients are respected and valued for their investment in making necessary changes in their lives; second, clients’ access to help is not restricted to the typical business day and week, which means that case managers and other team members are customarily available at all hours for assistance; and third, the service delivery system is expected to be responsive to the legitimate needs of CODC clients and the Court is persistent in motivating the system to respond appropriately.

To date, the CODC has admitted 70 individuals and currently maintains a full caseload of 30 clients. All have been diagnosed as dependent or addicted to drugs and alcohol and as having significant mental health disorders and symptoms as defined by the Diagnostic and Statistical Manual-IV-Text Revised (DSM-IV-TR).[2]The primary drugs of choice include prescription narcotics, heroin, cocaine, alcohol, and marijuana.  The CODC accepts individuals with a wide range of serious criminal offenses although public safety is prioritized.

Many clients have undergone a significant positive transformation during their participation in the Court. They are connected with medical, dental, substance abuse, and mental health treatment and are assisted in finding safe and affordable housing as well as employment, education, or meaningful community service.  They pay their fines, restitution, child support, and taxes.  In many instances, they are reconnected with estranged family members and children. 

In the most recent evaluation of the CODC, the overall graduation rate compared very favorably with other problem-solving courts nationally, especially given the challenges and complexities of CODC clients.  The overwhelming majority of clients reported daily use of substances prior to admission to the Court yet, once admitted, drug testing has resulted in an extremely low rate of positives.  Many test negative throughout their stay in the Court.  CODC participants are less likely to be convicted of a new crime than a comparison group of offenders referred but not admitted to the court and graduates are the least likely to commit a new crime.  If reconvicted, CODC participants are less likely to have committed a felony than the comparison group.[3]

For more information, please read :

ADULT DRUG TREATMENT COURT - Report To The Joint Standing Committee On The Judiciary 125th Legislature January 15, 2011 (PDF 9 pages)


1. Hornby Zeller Associates, Inc. (2010).  Evaluation of Maine’s Co-Occurring Disorders Court: Interim Report.  Prepared for the Maine Judicial Branch.

2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.

3. Hornby Zeller Associates, Inc. (2010).  Evaluation of Maine’s Co-Occurring Disorders Court: Interim Report.