Mental health court programs in rural and nonaffluent jurisdictions

Criminal Justice Review

Volumn 33, Issue 3, 2008, Pages 405-413

  Goss, Stephen S ^a,b  

^a Superior Courts of Georgia   (United States)

^b NONE   (United States)

Author keywords

Mental health courts

Indexed keywords

EID: 49549123851     PISSN: 07340168     EISSN: 15563839     Source Type: Journal    
DOI: 10.1177/0734016808320327     Document Type: Note

References (34)

1. Gregory L. Acquaviva, Mental Health Courts: No Longer Experimental, 36 SETON HALL L. REV. 971, 977.
2. Stephen S. Goss, "Building a Community Based Mental Health Court Program", a note submitted to the National Association of State Judicial Educators, available at http://nasje.org/news/newsletter0704/resources02.htm (Fall 2007)
3. According to 2000 U.S. Census data, Albany, Georgia has a population of 76,939 persons. It is the only incorporated municipality in Dougherty County, Georgia, which has a total population of 96,065 persons. U.S. Census data from 2000 can be accessed on American Factfinder at the U.S. Web site: http://factfinder.census.gov/home/saff/main.html?_lang=en
4. Stephen Goss, Building Community Capacity to Deal with Offenders with Mental Health Issues in The Criminal Justice System (2003) (unpublished manuscript on file with the Rosalynn Carter Institute on Caregiving). It is important to identify community resources and program partners willing to work on these issues. Any group looking to start a mental health court needs to assess what level of programming the community will, and can, support. For example, some courts may prefer a diversion program because the judge does not want to be involved in supervision of offenders. Others may look at mental health issues training for jail nursing staff, first responders, and law enforcement to divert some of these public disturbance offenders to treatment. However, I stress to the judges and others looking at these programs that there comes a point where excessive planning can paralyze the effort. Although planning is needed and essential, there comes a point where a program needs to roll out and make adjustments as it moves forward.
5. Carol Fisher, Building Trust and Managing Risk, 11 Psychology Public Policy & Law 587, 588 (2005).
6. Subsequently, we instituted formal Crisis Intervention Team (CIT) training for first responders. CIT training was first instituted by the Memphis Police Department. On each shift, specially trained officers are available to come to a scene to interact with a mentally ill person. This is in an effort to prevent a volatile situation. This training program is being used across the country. CIT-Memphis Model is available at http://www.memphispolice.org/ crisis%20intervention.htm
7. L.C., by Zimring v. Olmstead, 1997 WL 148674 (N.D. Ga. 1997).
8. 42 USC §12131-12134.
9. 42 USC §12132; L.C. by Zimring v. Olmstead, 138 F. 3rd 893 (11th Cir. 1998).
10. L.C. by Zimring v. Olmstead, 138 F. 3d 893,902 (11th Cir. 1998).
11. Olmstead v. L.C. by Zimring, 527 U.S. 581, 603 (1999).
12. "For a substantial minority,... deinstitutionalization has been a psychiatric Titanic. Their lives are virtually devoid of dignity or integrity of body, mind and spirit. 'Self-determination' often means merely that the person has a choice of soup kitchens. 'The least restrictive setting' frequently turns out to be a cardboard box, jail cell, or a terror filled existence plagued by both real and imaginary enemies." Olmstead at 608 (Justice Kennedy concurrence).
13. Persons suffering from bipolar disorder will go through manic cycles. These are marked by feelings of invincibility, racing thoughts, and at times, inability to relax and sleep for days. We have seen a number of persons with bipolar disorder that have developed addiction issues. Some of these defendants begin binge drinking alcohol to reach a stupor to sleep. After a period of time, they develop a co-occurring alcohol abuse issue, which only exacerbates the complexity of the medical and legal problems. See, American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
14. As noted in Note 5, supra, Crisis Intervention Training for first responders is a step forward in dealing with these situations in the community.
15. The Criminal Justice System and Mentally Ill Offenders before the Senate Comm. on the Judiciary, 107 Cong. (2002) available at http://judiciary.senate. gov/hearing_search.cfm (hereinafter Hearings) (testimony of Gary Margolis, Police Chief, University of Vermont).
16. Supra, Note 3.
17. Hearings, supra Note 14 (statement of Hon. Patrick Leahy, United States Senator). It is noted that the Los Angeles County jail often holds more people with mental illness than any state hospital or mental health institution in this country. Rikers Island, the New York City jail facility, on many days treats more mentally ill persons than any mental health facility in the state of New York. (statement of Capt. John Caceci, Monroe County jail, Rochester, New York).
18. Hearings, supra Note 12 (testimony of Hon. Kenneth Mayfield, County Commissioner, Dallas County, Texas);
19. See also, Amy Watson, et al. (2001). Path to jail among mentally ill persons: Service needs and service characteristics, 31, 7 Psychiatric Annuals 421.
20. National Alliance for the Mentally Ill, Factsheet: The Criminalization of People With Mental Illness (2002), available at http://www.nami.org/Content/ ContentGroups/Policy/WhereWeStand/Convention_2002_ Fact_Sheets/ Criminalization_Fact_Sheet.htm
21. Supra, Note 3.
22. There are other community costs. This person goes to the local emergency room in a mentally decompensated state. Usually indigent, the treatment costs are absorbed by the local hospital authority indigent fund. Many times a local deputy sheriff has arrested the person and must sit for hours at the emergency room to wait to transport the inmate to the jail. For a rural county, this can seriously dilute the number of patrol officers during a shift, particularly at night. Other government costs include indigent legal defense and government aid to dependent children.
23. An excellent source of information for prospective court programs is the Council of State Governments, Criminal Justice /Mental Health Consensus Project Report (June 2002) available at http://consensusproject.org/the_report/.
24. See also, LeRoy Kondo, Advocacy of the Establishment of Mental Health Specialty Courts in the Provision of Therapeutic Justice for Mentally Ill Offenders, 28 Am. J. Crim. L 255 (2001).
25. Hon. Patrick Morris and coordinator Deborah Cima very graciously shared information and input in assisting the start of our program. See John S. Goldkamp & Cheryl Irons-Guynns, Crime & Justice Research Inst., U.S. Department of Justice, Emerging Judicial Strategies for the Mentally Ill in the Criminal Caseload (2000). In these early years of starting programs, many were instituted independent of knowledge developed in other programs.
26. The Learning Sites Initiative is an effort by the United States Bureau of Justice Assistance and the Council of State Governments to provide start-up mental health court programs with peer-to-peer assistance by linking them with established mental health court programs for guidance and advice. There are five mental 413health court programs serving as sites to provide information and hosting visits by other courts. These five programs are geographically diverse and are spread between metropolitan and rural programs. Our program in Albany, Georgia is one of the five courts selected. The other four sites are Bronx, New York; Akron, Ohio; Reno, Nevada; and Idaho Falls, Idaho. More information on these sites and other mental health court information and assistance can be found at http://consensusproject.org/mhcp.
27. Our court coordinator, Ms. Queen Hall, is a registered nurse and licensed professional counselor. She brought years of experience working with persons with mental illness and substance abuse issues in both in-patient and community based treatment settings.
28. Any judge or court officer seeking to start a mental health court program should meet the head of the community mental health service and the director of the area state hospital to get an understanding of the treatment options available in the area. For example, many states have Assertive Community Treatment (ACT) teams that work out of the state hospitals. These clinicians will go into the community, meet with the patients in their home setting, and monitor medications and treatment. Community based treatment options may include day treatment programs for substance abuse issues. Other resources such as housing alternatives, clothing, and shelter for the homeless might be developed through churches and charitable organizations.
29. As noted, being mentally ill is not against the law. This is a fundamental difference in a person addicted to illegal drugs and a person who is solely suffering from mental illness. The mental illness standing alone is not illegal. However, without proper treatment it many times leads to illegal behavior.
30. The program excludes sex offenders, defendants with firearms charges involving violence, and substantial drug dealing. On the latter exclusion, the facts are scrutinized. A crack cocaine user selling two rocks to buy one for personal use may be accepted. A dealer arrested with guns, digital scales, and cash will not be accepted.
31. Due to the relative youth of many mental health court programs, many draw inspiration and certain techniques from drug court programs. Nancy Wolff and Wendy Pogorzelski, Measuring the Effectiveness of Mental Health Courts, 11 Psychol. Pub. Pol'y & L. 539, 540 (2005).
32. Stephen S. Goss, "Defining a 'win' in a mental health court program," a paper submitted to the National Association of State Judicial Educators, available at http://nasje.org/news/newsletter0703/resources01.htm (March, 2007).
33. In this vertical study, 16 probationers were discharged from the postadjudication case management program. Nine of the 16 were discharged with successful results and seven discharged with unsuccessful results. Of the nine successful participants, seven had a primary diagnosis of mental health issues and two suffered primarily from substance abuse disorders. Of the seven unsuccessful participants, six had co-occurring disorders but continued to abuse drugs. Of the nine successful participants, they averaged 12.4 months in the program. Reviewing a corresponding 12.4 month period immediately prior to program entry, this group averaged 101 days in the county jail or an average of 8.2 days per month. Overall, these nine successful graduates decreased their jail stays from 8.2 days a month to 2.9 days per month. Of greatest significance is the fact that seven of these participants were not arrested at all during their 12.4 months in the program. Studying other active participants provided similar results.
34. The author recognizes and thanks Charmel Gaulden, Esquire for her editorial assistance with this article.