Judges rarely have access to sufficient or timely information about the defendant's mental illness and often are unfamiliar with local mental health service providers so they feel uncomfortable with sentencing options focused on treatment instead of jail.

When someone with mental illness is arrested, they often lose access to their medication and the supports that help to stabilize their mental health. This can affect their behavior and impair their judgment in the courtroom. As a consequence of their disability, people with mental illness are often low income, and they are typically represented by a court appointed attorney they do not know and might not trust.

Prosecutors are responsible for protecting the public, particularly when the defendant is charged with a serious offense. But they often recognize that cycling people through jail for low-level crimes does little to improve public safety.

Court-appointed defense attorneys have an enormous case load that makes it difficult to investigate their client's mental health history. The attorney might also feel they have a responsibility to encourage their client to plead guilty to a low-level offence with a minimal sentence rather than agree to a much longer term of supervised treatment

Concerned about repeat offenders with mental illness clogging court dockets and hampering efficiency, the court administrator may also be concerned that new approaches will require more staff work.