Tipping the scales of justice: the role of forensic evaluations in the criminalization of mental illness.

An unprecedented number of individuals with mental illness are represented in the criminal justice system. The unending growth of mentally ill populations in the justice system has led to jails and court dockets being increasingly overwhelmed with cases involving mental illness, state hospitals devoting far more beds and resources to forensic cases, and people without a criminal commitment left waiting for mental health services as forensic cases are prioritized. Although a forensic mental health evaluation is only one component of this larger system, common problems with forensic mental health evaluations can exacerbate the criminalization of persons with mental illness in many ways. This article reviews the current literature regarding issues of quality, reliability, and validity of forensic mental health evaluations, discusses the broader impact of these issues, and offers potential solutions for the field.