“The mental health movement started with those of us who noticed that we were able to see mental health issues with more clarity once people were clean from drugs,” says Melissa Knopp, Esq. Melissa is the Manager of the Specialized Dockets Section of the Supreme Court of Ohio. She has been working with drug court cases since 1995 for trial courts, drug court programs, and the jurisdictions that handle all mental health cases.
There had been attempts to procure mental health services within the drug court system before, but it became clear that drug courts were not equipped to address the complex nature of mental health issues. The courts realized the need for a separate mental health court docket, as mental health court issues require different sanctions.
Stigma was also a prevalent concern. Melissa says that other defendants would question why those drug court defendants facing both mental health and substance use issues sometimes did not go to jail, yet they did. This kind of stigmatization within the system provided additional reinforcement to the idea of creating a separate mental health docket. Melissa explains that people struggling with substance use issues face a different set of challenges than people struggling either with co-occurring disorders or with mental health issues.
The process for establishing mental health courts took time. There was early interest in 2000 and, in 2001, Melissa was designated as the Special Docket Program Manager. At this time, Justice Evelyn Stratton became very interested in mental health issues. She created an advisory committee and worked tirelessly to establish mental health courts. Melissa worked closely with her, and they partnered with the National Alliance on Mental Illness and colleagues from the criminal justice system. They presented a best practice called the Crisis Intervention Team (CIT), which showed police officers how to identify mental illness and to teach de-escalation skills through the use of role play.
The screening process for individuals to enter mental health court includes an assessment of both legal and clinical eligibility. To be legally eligible, the case must involve a probationary offense or be a diversion case, which depends on the type of crime. Diversion cases allow individuals who qualify to be diverted from jail to programs that support more specific mental health needs.
Clinical eligibility assessments take 10 to 14 days and must determine that a person has a severe mental illness; only individuals with Axis I diagnoses (as defined in the Diagnostic and Statistical Manual of Mental Disorders) qualify for mental health court. The individual must also be found competent to stand trial.
Once the reports are completed, the court treatment team and an outside advocacy group assess whether or not the person is appropriate for the program. The judge and defense council are informed as to the person’s eligibility for the specialized docket program. The mental health court’s diversion program then provides community supervision, community treatment, court hearings, and access to appropriate medications.
Mental health courts are critical to a system that has been placing people with untreated mental illnesses in jails, Melissa says. Jails were filling up in the 1980s after people were released from institutions, yet appropriate services were not available to them in the community. “Jails are not healthy places for people without mental illness,” says Melissa, “and they are definitely not healthy places for people who do live with mental illness.”
Diversion courts have also helped people to stay on their medications and have lowered hospital costs. “If the altruistic reasons won’t convince people of the benefits of mental health courts, then the financial reasons certainly hit home. This is the most intensive treatment we have, and the judges really like these programs because they are actually seeing people improving, and not just getting locked up,” says Melissa.
Melissa understands that it is difficult for case managers who have heavy caseloads to have one or two people who may require much of their time. She says mental health courts can help service providers save time and save lives.
“I talk to a lot of homeless service providers and case managers about our mental health courts, and I suggest that they speak to the judges and start a conversation with them if they are working with people who experience mental illness with criminal charges in their community,” she says. Many times, sanctions from the court can provide opportunities to prevent relapses because of the community and team approach. And engaging individuals with the court can assist providers to keep them out of the hospital and to foster more sustainable connections with the people they work with.
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