1.5 Hours / 1.5 CEs

On Demand | Self-Paced Professional Training

This on-demand professional training program on Continuity of Care and the Street-Jail-Hospital Revolving Door is presented by Michael Perlin, JD, and Heather Ellis Cucolo, JD, in partnership with the Mental Disability Law and Policy Associates (MDLPA).

There is a well-documented “shuttle process” by which individuals committed to psychiatric institutions (having been charged with minor “nuisance”-type criminal offenses) are often stabilized, returned to jail to await trial, and then returned to the hospital following relapse. This shuttling or cycling is bad for many reasons, not least of which is the way that it deprives the cohort of individuals at risk of any meaningful continuity of care. Continuity of care is crucial to reducing the rate of incarceration and institutionalization for persons with mental illness. Without this continuity, it is far less likely that any therapeutic intervention will have any long-lasting ameliorative effect.

This program shows that the current system – in addition to being utterly counter-productive (and in many ways, destructive) – also violates the constitutional right to treatment and the statutory right to non-discrimination as provided in domestic (the Americans with Disabilities Act) and international (the Convention on the Rights of Persons with Disabilities) human rights law. This also violates every precept of therapeutic jurisprudence; in this context, we argue that lawyers must integrate these teachings – focusing on the prerequisites of “voice, validation, and voluntariness” – in their representation of this population in the hopes that the current system can be ameliorated.

In conclusion, some solutions as to how continuity of care can be improved through mental health courts, programs that support diversion away from incarceration to treatment at an early process in a criminal proceeding, proper mental health screening, expanded access to mental health treatment, better re-entry services, and training for all persons interacting with someone with mental illness is offered.

Learning Objectives

Upon completion of this training, participants will be able to:

  • 1 Describe what is commonly referred to as the “shuttle process” and will see how this system is counterproductive both to the needs of the individuals involved and to society as a while
  • 2 Describe how the principles of therapeutic jurisprudence must be applied to ameliorate conditions under which the persons subject to this system are regularly treated
  • 3 Describe how the robust application of constitutional and statutory principles to the issues that arise in this context can help solve the current dilemmas faced by all
  • Intended Audience

    This training is intended for professionals who work with individuals with mental illness in legal or clinical settings, particularly within forensic mental health, criminal justice, or mental health law. It is designed for those who already have a foundational understanding of mental health issues in these contexts and are seeking advanced knowledge and skills relevant to their specialized roles. Participants are typically involved in supporting, representing, or adjudicating individuals with psychiatric disabilities.

    Examples of Relevant Professionals:

    • Mental health professionals (e.g., psychologists, psychiatrists, social workers, counselors) in forensic or legal settings
    • Attorneys and legal advocates representing individuals with psychiatric disabilities
    • Court personnel, especially those working in problem-solving or specialty courts
    • Clinicians in correctional facilities, psychiatric hospitals, or community mental health agencies
    • Professionals collaborating with or within forensic systems
  • Experience Level

    This training is appropriate for licensed and pre-licensed mental health professionals at various stages of experience with legal-psychiatric interface and continuity of care issues.

    • Beginner: Participants new to the intersection of mental health and criminal justice will gain foundational knowledge of the “shuttle process,” its impact on continuity of care, and relevant legal and ethical considerations.

    • Intermediate: Participants with some experience in forensic or correctional mental health will deepen their understanding of therapeutic jurisprudence, constitutional and statutory rights, and practical strategies for improving continuity of care for justice-involved individuals with mental illness.
  • Practice Setting

    Professionals practice at the law–mental health interface in secure clinical units, legal venues, and community-based systems, working in interdisciplinary, high-stakes environments. Their work centers on assessment, advocacy, and coordinated care for justice-involved individuals with psychiatric disabilities, ensuring continuity across jail–hospital–community transitions and adherence to constitutional, disability, and therapeutic jurisprudence principles.

    Examples of Practice Settings:

    • Forensic psychiatric hospitals and civil commitment units
    • Jail and prison behavioral health services, including reentry/discharge planning
    • Mental health, problem-solving, and specialty courts
    • Public defender, legal aid, and disability rights offices
    • Community mental health agencies and diversion programs
    • Probation, parole, and pretrial services collaborating on treatment plans
    • State mental health authorities and oversight/policy bodies

Training Instructors:

Michael L. Perlin, JD

Michael L. Perlin is Professor of Law Emeritus at New York Law School (NYLS), where he was director of NYLS’s Online Mental Disability Law Program and director of NYLS’s International Mental Disability Law Reform Project in its Justice Action Center. He is co-founder of Mental Disability Law and Policy Associates and is currently Adjunct Professor of Law, Emory University School of Law, and Instructor, Loyola University New Orleans, Department of Criminology and Justice

Heather Ellis Cucolo, JD

Heather Ellis Cucolo is a Distinguished Adjunct Professor of Law and the facilitator of the joint JD/MA program with John Jay College of Criminal Justice at New York Law School (NYLS). She is also an adjunct professor in the JM Program at Emory University School of Law and a Fellowship faculty member at Albert Einstein College of Medicine.

Training Outline

Key topics covered in this training include:

  • The current “shuttle process” and why it is so destructive for the population in question

  • How the lack of continuity of care ensures that purportedly-therapeutic interventions will not have any long-lasting positive effect

  • How the current process violates constitutional and statutory rights (both domestic and international)

  • How the application of therapeutic jurisprudence principles is the best solution for the problem at hand.

We are proud to partner with

Mental Disability Law and Policy Associates (MDLPA)

Mental Disability Law and Policy Associates   (MDLPA)

We are proud to partner with Mental Disability Law and Policy Associates, LLC for this training. MDLPA is a boutique educational training company that offers specialized mental disability law consulting, the creation or enhancement of distance learning programs, in-house or online courses, and day or weekend training seminars to reputable organizations, educational institutions, professional groups, and advocacy groups focused on providing advanced knowledge and skills to persons working with marginalized populations.

CE Sponsorship Information

Palo Alto University, Continuing & Professional Studies (CONCEPT) is approved by, recognized by, or maintains sponsorship provider status with the following boards and agencies. We maintain responsibility for all content in our CE/CPD programs. For more information, visit here. 

  1. American Psychological Association (APA): Approved sponsor of continuing education for psychologists.

  2. Association of Social Work Boards (ASWB): Approved continuing education provider (ACE program, Provider #1480), 11/22/2023–11/22/2026.

  3. Canadian Psychological Association (CPA): Approved to sponsor continuing education for psychologists.

  4. National Board for Certified Counselors (NBCC): Approved Continuing Education Provider (ACEP No. 7190).


Sponsorship Approval Statements

Palo Alto University, Continuing and Professional Studies (CONCEPT) is approved by the American Psychological Association to sponsor continuing education for psychologists. Palo Alto University, Continuing and Professional Studies (CONCEPT), is approved by the Canadian Psychological Association to offer continuing education for psychologists. Palo Alto University, Continuing and Professional Studies (CONCEPT) has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7190. Programs that do not qualify for NBCC credit are clearly identified. Palo Alto University, #1480, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Palo Alto University maintains responsibility for this course. ACE provider approval period 11/22/23-11/22/26. Social workers completing this course receive (clinical or social work ethics) continuing education credits. Continuing and Professional Studies, Palo Alto University, is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0103. Palo Alto University, Continuing and Professional Studies (CONCEPT) is solely responsible for all aspects of the programs. Palo Alto University, Continuing & Professional Studies (CONCEPT), is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0356. Palo Alto University, Continuing and Professional Studies, is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0073.