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Someone to turn to
By Ann Coppola, News Reporter
Published: 02/23/2009

Some one to turn2009feb20 They’re unfortunately referred to as the “frequent fliers” of the criminal justice system. Mentally ill offenders tend to have higher rates of recidivism than any other segment of the incarcerated population in the United States. Non-violent offenders suffering from mental illness in particular commonly cycle in and out of jails for repeated low-level offenses, caught in a pattern the criminal justice system has struggled to correct for decades.

“It’s the revolving door phenomenon,” says Fred Osher, Director of Health Systems and Services Policy for the Council of State Governments Justice Center. “What tends to happen is they’re arrested for a small misdemeanor, they spend time in jail, and are released without any particular linkage to treatment. Before long they’re arrested again, the charges accumulate, and they continue to face higher lengths of sentences.”

To freeze the revolving door, many communities have established programs to divert mentally ill offenders from jail or prison and into treatment, either in hospitals or under community supervision. Now, districts across the country are taking the next step by developing entire mental health courts to focus on those individuals who continue to fall through the cracks.

“Mental health courts have been one of the innovations at the courts level to address this population,” Osher says. “They have been present since the late 90’s but they’ve really taken off in the last several years.”

Similar to drug courts, mental health courts give select offenders the option of a judicially supervised treatment plan in lieu of incarceration. The courts typically employ a case management team of community supervision officers and mental health professionals. Mental health courts generally select low-level, non-violent offenses, although some of the more established courts now deal with felony charges.

The number of mental health courts in the United States has grown from only four in 1997 to more than 175 today, according to estimates from the Council of State Governments. Even with the multiplying trend, there is no national mental health court model. Most of the programs are only a couple of years old and are learning as they go.

“We’re finding that for our participants, quality of life and stabilization of life tends to be the incentive for them to say, ‘I’m going to try this,’” says Stephen Goss, presiding judge of Dougherty Superior Court in Albany, Georgia. Located in one of the poorest congressional districts in the country, Dougherty’s dual mental health and drug court targets people who cycle in and out of jail. Founded in 2002, the court currently has 40 individuals under its supervision on any given day.

“When we hit the 30 month mark we looked back at every case we had, and what we found was our participants prior to the program were averaging 108 days in our jail,” Goss says. “After getting in the mental health court that number dropped down to about 29 days. In addition, 41 percent had not been rearrested. We’ve had some setbacks, but to me if you can say ‘never arrested again’ that’s a great thing.”

Most of the defendants Goss and his team of probation officers and case workers see are already on probation. The court holds hearings to determine if the defendant is regularly taking any required medication and attending medical appointments. Defendants stay under the court’s supervision for an average of 18 to 24 months.

“A mental health court doesn’t cure all problems but at least people feel like they’ve got someone to turn to,” Goss says. “The folks at the jail can say, ‘Judge, we’ve got a guy who’s really off his medicine. He’s on suicide watch and we need to get him to the state hospital. Can you help us?’ And I can get the appropriate orders. Just having these mechanisms in place has been a real help.”

It’s not just the Dougherty sheriffs that are grateful; the appreciation for mental health courts from the corrections field has reached a national level.

“Where I talk to judges from other parts of country, virtually every place there is a mental health court up and running one of the biggest fans is the sheriff and the jail staff,” Goss adds. “They know they’ve become the de facto mental health treatment facility in a lot of communities. So many of the jails and prisons are just full of people suffering from mental illness and the jail staff does the best they can, but they’re just not set up to be mental health treatment providers.”

In Oklahoma, mentally ill offenders have become a burgeoning part of their incarcerated population.

“In my prison system we’ve seen a 300 percent increase in inmates coming into our system with mental health issues over the last ten years,”Oklahoma Department of Corrections Director Justin Jones says. “We’re in dire need of more safe cells, observation cells, and more mental health treatment services.”

Oklahoma developed its mental health courts within the past couple of years, and the early results have been promising. There are a handful of mental health courts across the state, including Tulsa, Oklahoma, and McCurtain counties. The Department of Corrections provides a case manager and community supervision officer for each participant.

“One of the reasons that we’re such advocates of mental health courts is without any doubt, the participants were definitely prison bound if not for the mental health court,” Jones explains. “The in-community treatment the courts provide for our non-violent, mentally ill offenders is much better than what we can provide in prison.”

There are 41 participants in the Oklahoma County mental health court and 27 in the Tulsa County program. Even though the labor-intensive programs serve small populations, Jones says the cost savings to the state are definitely worth it.

“It averages us about $2.50 a day to be involved with the mental health courts on my side,” he explains, “and in Oklahoma the average cost for a prison bed is 47 dollars a day. If you look at the funds being spent for community mental health treatment just in my agency alone, we estimate savings of about $100,000 a year for individuals in the program that haven’t recidivated. And that’s just for Oklahoma County.”

Aside from the cost savings, Jones sees the rise in mental health courts as an opportunity to make a dent in the growing national recidivism rate.

“I believe it has the potential to have a bigger impact on recidivism than possibly other specialty courts,” Jones adds, “and I think it’s because of the wrap-around services. Without proper medication and interventions these individuals certainly were going to be rearrested and incarcerated. It is truly a diversionary program.”

Even though mental health courts are relatively still in their infancy, the progress made so far is bringing hope to a lot of communities. From the sheriff to the taxpayer to the families of mentally ill individuals, it seems everyone has a stake in shutting down the revolving doors.

Related Resources:

Quick facts on jails and mental illness

More on the Council of State Government and mental health courts

Latest mental health research in corrections


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