Judge develops Mental Health Court to address needs jails cannot meet
When the Honorable John Mitchell, District Court Judge in Kootenai County, Idaho, calls a defendant to approach the bench, the person comes forward to stand in front him in an informal setting. People in the room applaud.
|Judge John Mitchell presents awards to Mental Health Court programs.|
The judge asks: How have things gone for the past week? What issues have come up? Why didn’t the person show up at the probation office?
He also asks defendants if they tested positive for drugs, earned their G.E.D. (General Education Diploma) or are ready to move up to a new phase in their program.
When they are ready, they receive a certificate of achievement, and others in the courtroom give them a standing ovation.
This is Mental Health Court (MHC), a program that began in Kootenai County in 2004. Judge Mitchell was appointed to the district in 2001. In 2003, Marcy Black, a probation officer assigned to mental health cases, suggested he do special work with the mentally ill.
He knew that about half of the people he saw in the criminal justice system had mental illness.
“I realized I had to be more patient with them,” he said.
John and Marcy went to observe the original Mental Health Court program, created by Judge Brent Moss in Idaho Falls. They were impressed.
Six months later in September 2004, they began their program with five people. Now there are 47, and a waiting list. The MHC is budgeted for only 40 individuals. It can take a few extra people using money from drug forfeiture.
“Everyone in the program has a drug or alcohol problem plus a mental illness,” he said.
They have been charged with a low-level felony.
“Eight years ago, individuals wouldn’t be managed for mental illness,” John said. “Jails or prisons took them off their medications, then often gave them lithium. That was no solution. Our prison system is better now. There are 13 mental health courts of 44 districts in Idaho.
“Most people in court—more than 50 percent of men and most women—have suffered a significant trauma,” he said. “They’ve been sexually molested, physically abused, neglected or have seen someone close to them killed.”
A sentencing judge may give defendants a choice to enter the MHC program or may order them in—rare for a first offense. It takes a probation violation, coupled with mental illness.
There is usually a triggering event. Some defendants come from other counties, but must move to Kootenai County to enter the program. The program helps participants come clean and admit what they have done.
“Treatment providers with whom we work are good with this,” John said.
As the MHC reduces recidivism, it protects the community. It holds defendants accountable and helps them achieve long-term stability, become law-abiding citizens, and be successful family and community members. Continuation in the program is voluntary.
According to the MHC Participant Handbook, “The four-phase program consists of intensive supervision of clients by a mental health professional, frequent appearances before the judge, mandatory counseling, regular attendance at cognitive—self-awareness—change classes, and mental health substance abuse treatment and testing.”
When people complete one phase, they receive a certificate and move to the next, which is less strict. The full program can take as little as 14 months. Usually, it takes longer, depending on the participant’s progress.
“I appreciate options when dealing with addictions,” John said. “The first 90 days of the program focus on chemical dependency. The next six months focus on thinking errors, cognitive restructuring. Participants spend another year focusing on both.”
The MHC staff offers incentives when participants do well and sanctions when they backslide.
When they appear in MHC—at first weekly-—John encourages them: “You can do this!” and challenges: “Only you can do this.”
John also continually works to make the program clear to the defendants in court on a given day.
Speaking to everyone, he may say, “This program is about honesty. If you are honest about messing up, your sanction is less than if you lie. We are trying to change your conduct. You have made bad choices. Honesty helps with better choices. We expect accountability from you. We expect consistency in a good attitude from you—in court, in treatment and in the community.”
He believes the strength of the MHC is the 15-member team, a group that has changed little since it was established.
The team includes a public defender, the MHC clerk and coordinator, representatives from Health and Welfare and a private mental health treatment facility (ACES, Inc.), someone from felony probation, a prosecutor and the sheriff’s department.
A forensic peer support specialist, who has been to prison, can identify with participants. Some sit with the team from time to time. The team meets at 6:30 a.m., Thursdays, to review files of defendants to appear at 8 a.m. They review how well they have performed through the week and what incentives or sanctions would be good to offer.
Sometimes they decide a participant is not right for the program and vote to terminate his or her involvement. That person has to fulfill what their original sentence required. Often, the team puts a recalcitrant person on probation or sends them to jail for a day or two.
“We use jail sparingly,” John said. “Jails have no mental health programs.”
The team strives to keep participants in the program if possible.
“The watchword, the standard,” he said, “is whether they are making progress, even if ever so slight. If yes, we’ll stick with them. If no, we’ll still try for a while. At some point, they have to be humble. Until then, I don’t think they can change.
Motivating people to quit smoking doubles the chance they will stay clean and off drugs for the rest of their lives, he added.
Reflecting on early days of the program, John said one of the first people in the program wrote an essay. When she read it, the people in court clapped. She dissolved into tears, saying, “No one has ever clapped for me before.”
Others tell him, “I never had a judge shake my hand, show me respect or talk to me. You’re the first authority figure I’ve met who acts in a non-traditional way.”
One anti-social person evolved into someone who could lead support groups to help others.
Before they can leave the Mental Health Court, candidates must be clean and sober for five months, be employed if possible, have a sponsor, a place to stay and a high school diploma or GED, and pay all fines and fees.
John said MHC is cost-effective. It’s success rate is 80 percent, compared with 60 percent of people who go to prison without addressing mental illness.
Someone in prison costs Idaho about $25,000 for six months. Someone in the MHC program costs the state about $16,000 for a year and a half.
In 2012, the team began a Juvenile MHC with four participants. They cap participation at 15 people. There is no budget.
“I do this because I see results. I believe this is what God calls me to do. I can’t imagine not doing this. I see people do things they’ve never done before. I see people be Christ to others,” said John, who attends St. Thomas Catholic Church and occasionally St. Pius, the church in which he grew up.
At a retreat, he made a commitment to do something for others each week. A men’s accountability group he has attended for 14 years also helps him in this work.
“I care deeply about these people. I’m proud of how far some have come,” he said. “I love challenges. In formal court, I have control. Here, I don’t know what’s going to happen from second to second.”
The son of a lawyer in North Idaho, John attended the University of Idaho in Boise.
“As an undergraduate, I didn’t think about being a lawyer. After earning a master’s degree in law, I worked as a law clerk for three federal judges in Boise,” he said.
John worked with his father for 12 years until his father retired in 1996. He worked on his own for five years. In 2001, he applied for District Judge and was appointed to Kootenai County.
“There’s less stress, but I’m busy, working 60-hour weeks and volunteering 10 hours,” he said.
John is discerning about entering a four-year training to become a deacon: “I believe God has a plan for me. I don’t have a clear vision of it except in hindsight,” he said.
“I want a 100 percent success rate with the MHC program. As more people graduate, there will be an unknown ripple effect in the community,” he said.
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Copyright © February 2013 - The Fig Tree