Sunday, November 15, 2009

Worth Watching

There has to be a compromise in the middle between the dark ages when we locked up our mentally ill and the current system that treats with no mandatory follow up. This offers both sides an alternative, let's see where this goes. I like where it says incentives for compliance(or co-operation with the prescribed medical plan) and sanctions for non-compliance.

Thornton: A court for mental illnes

History will be made in Colorado's 18th Judicial District this week when Colorado's first districtwide adult Mental Health Court will convene to hear the case of "Robert," age 37.

Robert has bipolar disorder. He frequently goes off his medication, hasn't followed through with treatment plans, has attempted suicide, and has been hospitalized three times. He has several prior convictions for shoplifting, violating restraining orders and resisting arrest. Now he says he wants to figure out a better way to live, and has volunteered for the Mental Health Court.

The court is a specialized treatment court similar to others used in Colorado for drug users and teen offenders. It's designed to divert nonviolent felony offenders who have a serious mental illness such as bipolar disorder, schizophrenia or major depression, as well as those with a combination of mental illness and substance abuse. It is not open to those with violent behavior or to sex offenders.

Most of the people who'll come before the court have been repeatedly in and out of jail. They've been charged with minor offenses that result from their mental illness, things like being a public nuisance, drinking in public, and shoplifting. They're charged with a felony because of the cost of items they've stolen or damaged. Usually they have been off their medications because they can't afford them, and live in and out of shelters.

Defendants who volunteer for the court are assessed for eligibility by a team that includes the Mental Health Court magistrate, the coordinator of the court, a treatment professional, and representatives of the district attorney's and public defender's offices.

Each participant will have an intensive treatment plan, including case management and medications, and will be closely monitored by probation officers and mental health professionals. Treatment addresses the mental illness, recurring substance abuse and criminal thinking. There will be incentives for compliance, and sanctions for non-compliance that may include re-sentencing.

The need for such a court is compelling in both human and fiscal terms:

• Approximately 250,000 people with severe mental illness are in U.S. prisons and jails at any given time.

• It costs about $30,000 to keep a person in a Colorado prison for a year.

• More than 40 percent of inmates in Arapahoe and Douglas county jails need mental health services and 20 percent of those are seriously mentally ill.

• Over the last three years, Arapahoe County alone has spent $13.6 million on 574 inmates with a diagnosis of serious mental illness. It costs 38 percent more to detain a mentally ill inmate.

• While the average prisoner stays 20 days in a metro-area jail, prisoners who are mentally ill stay an average 110 to 120 days.

• The recidivism rate of mentally ill inmates is staggering, at more than 50 percent.

The process of establishing the 18th Judicial District Mental Health Court began in 2007. Funded initially by a $75,000 federal planning grant, the court is now set to begin operations with additional federal funding of $200,000.

The court expects to see 30 cases this first year. Scott Thoemke, CEO of Arapahoe/Douglas Mental Health Network, said the cases "should provide good data to show that the mental health court is less expensive than what Colorado is doing now" with the mentally ill.

Given the crisis in Colorado's budget, the staggering cost of the state's criminal justice system and the large numbers of people with mental illness in Colorado jails, taxpayers should be eager to support investment in additional mental health courts.