SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation is committed to sharing information that elevates the voices of people with lived experience and taps into the expertise of practitioners in the field. This article is a unique blend of both strategies. Sarai Flores, Esq., is a returning eNewsletter contributor. She participated in a Q&A on her lived experience with trauma and justice system involvement and authored an article on advancing trauma responsiveness in the courtroom. The Honorable Michael Aloi is a prior participant in SAMHSA’s GAINS Center How Being Trauma Informed Improves Criminal Justice System Responses training. The following is an edited transcript of a conversation between the two about Judge Aloi’s approach towards those with a trauma history who end up on the other side of his bench, as written from Sarai’s perspective. Included in the article are Sarai’s thoughts about her conversation with Judge Aloi, as they relate to her own experience of incarceration. These asides are noted in italics.

As a practicing attorney, formerly incarcerated woman, mother, community member, and change agent, I sat down with the Honorable Michael John Aloi, U.S. Magistrate Judge, for the United States District Court for the Northern District of West Virginia (who also serves as a drug court judge) for a conversation about his journey to becoming trauma aware. In this interview, Judge Aloi explains why it is essential for judges, attorneys, and court staff to understand trauma. He shares how courts can use trauma-informed practices as a part of the healing process for participants who are experiencing substance use disorders, mental health issues, and poverty.

Creating a Trauma-Informed and Trauma-Responsive Court

In our interview, Judge Aloi discussed his views on building a trauma-informed court. Building a trauma-informed and trauma-responsive court means developing a universal assumption of trauma and understanding the effects of trauma on individuals and families. “I am not an adversarial person,” Judge Aloi stated while recognizing the justice system is inherently adversarial. He continued with a question, “So, how can we solve a problem with respect, with dignity? Forgiveness, reconciliation, and redemption? These are things that last,” he says.

Judge Aloi provides insight into where courts fall short and where they might improve. For example, he says, “The legal system tends to identify the surface problem. To be successful, we need to address and resolve the underlying issues. If you don’t address the underlying issues, you will never solve the problem.” In pondering the solution, Judge Aloi asks, “How do we create a process that addresses these underlying issues?” He recommends being trauma-informed, which to him includes providing appropriate resources to address underlying issues. According to Judge Aloi, “Every state needs comprehensive wraparound services to address the underlying issues and needs of people experiencing criminal legal issues.” Judge Aloi went on to explain, “This is how we should be responding to trauma. Trauma will not go away, but how we respond to the trauma can be productive. People need to feel safe and secure in their environment.”

The drug court collaborates with Jobs & Hope West Virginia to provide these much-needed resources. Jobs & Hope is West Virginia’s comprehensive response to the substance use disorder crisis. Governor Jim Justice and the West Virginia Legislature established the program. Through Jobs & Hope, participants can gain free access to medical, dental, substance use treatment; employment training; housing; driver’s license reinstatement; and non-violent criminal record expungement.

With the help of the US attorney’s office, public defenders, probation office and other court personnel, Judge Aloi has created a treatment court that begins to meet the needs of its participants in a holistic way. The Judge notes, “Without full cooperation from all parties involved, I wouldn’t be able to give the services that are needed to the drug court participants.” These services include a drug and alcohol evaluation, mental health evaluation, physical and dental care, employment assistance, housing, and cash assistance. The court provides wraparound services with a significant success rate for drug court participants.[1]

When I was prosecuted, the focus was on what I had done and if the case could be proven or not. There were no questions about what had happened in my life to bring me to a point where I believed that selling drugs was my only option. Many factors played into my ending up in front of the bench rather than behind it. During our conversation, Judge Aloi’s insight resonated with my experiences of mental illness, substance use, poverty, and trauma.

Considering Co-occurring Mental Health, Trauma, and Substance Use Disorders

Untreated mental health needs are highly correlated with justice involvement and incarceration.[2], [3], [4] The marginalization and stigmatization of mental illness is significant, and often these issues stem from untreated trauma, especially in women who have experienced sexual abuse, assault, or trafficking.[5], [6]

On this issue, Judge Aloi says, “My experience has been that most people charged with a drug crime are struggling with substance abuse or mental illness. My experience has also been that an indictment will not make that go away. If it would, these issues would have been solved a long time ago. Everyone I’ve seen in my courtroom who is struggling with substance use is also struggling with underlying mental health issues. Whether it’s anxiety, depression, or trauma, people aren’t going to recover without working at it; having a program and professionals to help.”

Judge Aloi acknowledged that courts and the adversarial nature of the criminal justice system could be challenging for people with mental or substance use disorders. “Just being in a courtroom is inherently traumatic. What is it like for a woman or even a young man who has been the victim of severe abuse to walk into a courtroom and have a correctional officer put handcuffs on them? What do we gain as a society by implementing practices in a traumatic environment? As a judge and an officer of the court, I believe I have an obligation to identify harmful practices, name them, and think of ways to mitigate further harm. Courts can perpetuate trauma, and there are many days it doesn’t feel like justice.”

As an impacted woman, I can personally attest that courtrooms, handcuffs, shackles, and the isolation that comes with imprisonment are retraumatizing. My story is not unique. I have 9 of the currently listed 13 adverse childhood experiences. When I was arrested and later convicted of criminal offenses, no resources were offered prior to my incarceration. I was not given a mental evaluation, even though I have suffered from post-traumatic stress disorder and Attention-deficit/hyperactivity disorder (ADHD) most of my life. I was not offered any physical evaluations or dental resources. I was also not offered housing, employment, or educational assistance prior to incarceration.

The drug court requires everyone to have a mental health evaluation. However, the Judge acknowledges “how hard it is to open up.” He says, “we’re Americans—how do we deal with 99 percent of our problems? We act like they’re not there, and we don’t talk about it.” It takes a lot of commitment and follow-up to access the trauma and make it safe to heal. In addition to mental health evaluations, the drug court provides educational resources to participants. Many people in the drug court program also obtain their General Educational Development (GED) as part of their participation and a certificate as a recovery coach.

Throughout my incarceration I was not given any psychiatric evaluations and continued to struggle with the effects of my untreated ADHD until recently. However, through my incarceration, I was introduced to cognitive behavioral therapy, alcohol and drug treatment, and later housing resources upon release. I first entered the criminal justice system in 1991 at the age of 13, I had no work skills. During my incarceration I was trained to weld and given typing lessons, this gave me hope that I might have enough skills upon release to find a real job.

Acknowledging Trauma and Poverty

People living in poverty often encounter multiple traumas. Judge Aloi acknowledged the need for the court system to understand historical, generational, and racial trauma. Further, people appearing in courts may have difficulty accessing the resources that may facilitate the successful negotiation of their traumatic experiences.[7] Judge Aloi adds, “Poverty is traumatic! When people need to wonder where they are going to live, what they are going to eat, and what they are going to wear, that is traumatic.”

Judge Aloi recognized that recovery could be a matter of resources. It costs close to $3,000 a month for a person to be incarcerated in the federal system. In contrast, he notes, “Give someone $1,000 a month, and we can take care of most of their needs.” One of the things he learned from the GAINS Center’s Trauma Training is that supporting recovery from trauma involves addressing our measures of stability. This includes taking care of mental health; having a place to live, a job, a sense of family; and having a safe, secure environment.

Because I have lived below the poverty line most of my life, this conclusion wasn’t new to me. As someone with a criminal record for possession and distribution of controlled substances, I still remember why I felt like I needed to do what I did as a young mother. Hearing his statement was a form of validation that my own actions didn’t occur in a vacuum. When I was out of jail, I was hustling, trying to stay alive. But, when I was locked up, I had my basic needs met (clothing, food, etc.), which allowed me space to work towards recovery. If we could provide access to resources outside of being involved in the justice system, we could create another pathway for people to access healing and recovery.

Fostering Our Sense of Connection

A trauma-informed criminal justice system will look different in various contexts. Judge Aloi has shown that by understanding and meeting the need of court participants, courts can respond in a way that creates a safe space for participants. His beliefs inform how he looks at people coming before his bench—he considers that each person is made in the image of God. So, he responds to them in a way that treats them as such. Judge Aloi suggests that it is “easy to have an adversarial justice system when we treat people appearing in court as other,” which disconnects us from their story and potential for recovery, “instead of as neighbors, as one of us.”

As a Native person, I believe that we’re all connected. When you look at a person, and you think negatively about them, telling yourself, “They’re a criminal,” you end up feeling bad. But when you look at a person and think about what they must have gone through and what experiences they must have missed out on, you sense more positive feelings, like compassion and hope. This is just one example of how we’re all connected—having a negative or a positive thought about someone else can affect our minds and bodies. This affirms my belief in the idea that we are all connected. Developing a greater sense of our connection includes serving people with a trauma-informed approach and helping people begin a path of recovery from their traumatic experiences from their first appearance in court and throughout their time of involvement in the criminal justice system.

About the Author

Sarai Cook Headshot

This interview and article are by formerly incarcerated attorney Sarai Flores. Ms. Flores continues to be directly impacted by many systems and cycles of oppression and poverty. Through these experiences, she has made it her life’s work to empower and encourage others by modeling the possibilities of overcoming cycles of oppression. Since graduating from law school in 2011, Ms. Flores has worked in community development and public service at the Tribal level with the Muscogee (Creek) Nation, national level with the U.S. Department of Energy, and internationally. Ms. Flores is the recipient of the National Center for Native American Economic Development 40-Under-40 award, the Muscogee Creek Nation’s professional of the year award, and the New Leadership Oregon outstanding alumni award. In addition to leading the National Trauma Awareness Initiative, Ms. Flores writes and speaks about the intersection between mass incarceration, disability law, civil rights law, and criminal justice system reform. She brings valuable first-hand insight into policy work, where many impacted people do not have a voice.


[1] Treatment Courts Work –

[2] More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of States (

[3] Criminalization of Mental Illness (

[4] Mental Health Problems of Prison and Jail Inmates (

[5] Jennifer V. Pemberton, and Tamra B. Loeb, “Impact of Sexual and Interpersonal Violence and Trauma on Women: Trauma-Informed Practice and Feminist Theory,” Journal of Feminist Family Therapy 32, no. 1–2 (April 2, 2020): 115–31,

[6] Atsushi Matsumoto, Claudia Santelices, C., and Alisa K. Lincoln, “Perceived Stigma, Discrimination and Mental Health among Women in Publicly Funded Substance Abuse Treatment,” Stigma and Health 6, no. 2 (2021): 151–162,

[7] Understanding the Impact of Trauma and Urban Poverty on Family Systems: Risks, Resilience, and Interventions (

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