Placing court-ordered mental health conditions of pretrial release on those with mental illness must be accompanied by the ability to monitor compliance with those conditions.  The judge and the defense attorney should make clear to the defendant the consequences for violating release conditions.  The responses to condition violations should reflect the nature of the violation and should, unless the violations are severe, gradually escalate before imposition of the ultimate response - revocation of release.

It is important to have a written understanding regarding compliance and termination policies.  When a court orders a defendant to enroll in or maintain treatment, whether it be for a mental illness, or for drug or alcohol abuse, deference must be paid to the treating clinician regarding the status of the person in treatment.  Decompensation itself should not be considered a violation and the first response to noncompliance should be an attempt to adjust the treatment. Thus, the clinician or treatment program must assess the client's compliance with the order to participate in treatment on a case-by-case basis.  However, the treatment program should provide the court and the referring agency with written guidelines outlining its general policy for determining whether a client is in compliance and when it is time to both successfully and unsuccessfully terminate a client from treatment. 

When a violation of a pretrial release condition has been alleged, the court should hold a hearing looking into the circumstances of the alleged violation before taking action on the violation.  Such circumstances should include attempts by the defendant to comply; reasons cited for noncompliance; and the nature of the violation.  The court should consider that people with mental illness commonly experience relapses while in treatment, and that finding the most appropriate treatment is often a matter of trial and error for the treating clinician.  Before imposing punitive sanctions for noncompliance, the court should conclude that the defendant was capable of complying but chose not to.

Given the difficulties that defendants with mental illness may have in complying with conditions of pretrial release, it may be beneficial to have specially trained staff from pretrial release and diversion programs be responsible for supervising defendants with mental illness.

To protect the therapeutic/treatment relationship, mental health treatment programs should not report compliance and terminations directly to the court, but through the referring court entity - the pretrial services program or the pretrial diversion program.  In most cases, it would be sufficient to provide compliance information in summary form.  An exception would be if staff of the treatment program became aware of a specific threat that the client may pose.  In that instance, the professional guidelines of the clinician should dictate the most appropriate method of response.