Mental health court a ‘safe zone’ of help

Assistance program for those in criminal justice system not feeling pinch, official says

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MENTAL HEALTH CARE CRUNCH: A TWO-DAY SERIES

Related coverage

Sunday: Mental health services under increased pressure

Key points:

o Those dealing with mental health crises find care options are limited.

o Local agencies respond: Southwest Behavioral Health plans to add services; free clinic explores adding services for the uninsured.

Did you know?

More than 320 people have graduated from Clark County's mental health court.

MENTAL HEALTH CARE CRUNCH: A TWO-DAY SERIES

Related coverage

Sunday: Mental health services under increased pressure

Key points:

o Those dealing with mental health crises find care options are limited.

o Local agencies respond: Southwest Behavioral Health plans to add services; free clinic explores adding services for the uninsured.

Did you know?

More than 320 people have graduated from Clark County’s mental health court.

Tracey Anne Green walks 9 miles round-trip to make her Clark County Mental Health Court appearances.

“That’s my meditating time,” Green said Wednesday following a five-minute check-in with a judge.

Green, 53, has been diagnosed with post-traumatic stress disorder, anxiety and depression. She doesn’t travel by bus from her Hazel Dell mobile home to the Clark County Courthouse in downtown Vancouver because she’s uncomfortable in confined spaces with strangers, a result of being sexually assaulted. She had a clean record until a few years ago, when she was arrested, on separate occasions, for driving under the influence and attempting to steal clothes from a Wal-Mart.

The sudden spiral of offenses triggered a referral to mental health court.

For the first time in her life, she was evaluated and began receiving treatment.

“I just kept thinking that was a part of life,” she said Wednesday, referring to panic attacks she’d been experiencing.

She’s on track to graduate Oct. 22 from the 16-month mental health court program. On Wednesday, she was praised by District Court Judge John Hagensen for staying on track despite challenges such as the retirement of her therapist. Hagensen asked Green how it was going with a new therapist. She said it was fine, and she thanked Hagensen and the court staff for their support.

“You’re the one who has done it all,” Hagensen told her. “Hopefully, you take some pride in that.”

Before she started out on her walk home, Green expressed gratitude for the program.

“This is like a safe zone,” she said, adding that the 16-month commitment has helped her stay clean and settle into a routine with therapy and taking medication.

“It’s not just, ‘Hey, wham, bam,’ and they push you out the door,” she said.

Court resources

Modeled after drug courts through which nonviolent addicts receive substance abuse treatment, mental health courts attempt to reduce the number of mentally ill defendants cycling through the criminal justice system for minor, nonviolent offenses.

While the number of people eligible for mental health services through Southwest Washington Behavioral Health Regional Support Network has grown by more than 30,000 since the Medicaid program expanded this year, the extra pressure on the already stressed system won’t affect mental health court, said Shane Wolf, District Court’s therapeutic speciality courts coordinator. The network works with the program to make sure clients are able to receive treatment from providers such as Columbia River Mental Health, Community Services Northwest and Lifeline Connections.

The court has a capacity of 50 clients. That limit is driven by court resources, not community resources, said Wolf, whose $58,848 annual salary comes from revenues from a one-tenth of one percent sales tax increase Clark County approved in 2006 to help pay for drug and mental health treatment.

Nationwide, there are three times more seriously mentally ill people in jails and prisons than in hospitals, according to a 2010 study by the National Sheriff’s Association and the Treatment Advocacy Center. The study also found that in 1955 there was one psychiatric bed for every 300 Americans, and by 2005 there was one psychiatric bed for every 3,000 Americans.

In Washington, 10 of 39 counties have mental health courts, according to the Administrative Office of the Courts.

All of the programs are voluntary.

Following King County’s lead, Clark County started a program in 2000. Early findings were encouraging. A 2003 report by Portland State University’s Regional Research Institute for Human Services included a study of 119 Clark County defendants. In the six months before signing up for mental health court, the 119 defendants had been booked into jail a total of 288 times.

After six months in the court program and meeting regularly with a judge, fewer than one-third of the participants had been re-arrested.

More than 320 people have graduated from Clark County’s mental health court.

Even among those who fail to complete the program, re-offense rates are lower than among defendants who don’t participate at all.

To qualify, there must be a nexus between the mental health diagnosis and the crime, Wolf said. Defendants plead guilty and pay a $100 court fee.

If they graduate, the conviction stays on their records, but their probation ends and they don’t have to pay $2,400 in probation fees.

Since 2009, the most recent year detailed statistics are available, recidivism rates ranged from 14 percent for graduates to 28 percent for people who were kicked out of the program, Wolf said.

Recidivism rates vary by type of crime and offender, but can be as high as 70 percent for defendants who don’t receive any type of treatment, said Clark County District Court Judge Vernon Schreiber, citing a study from the Substance Abuse and Mental Health Services Administration.

The next step

Green first received treatment through the criminal justice system, but most mental health court participants have been diagnosed before they are ever arrested, Wolf said. Many report not staying on medication, particularly anti-pyschotic drugs, because they don’t like the side effects such as drowsiness. Or they start feeling better and believe they can stop taking medication.

Dustin S. Richardson, 23, who graduated from court Wednesday, had been avoiding treatment for behavioral disorders for as long as he can remember. Diagnosed with attention deficit hyperactivity disorder, he was on an individualized education program throughout school. He was referred to mental health court after he was arrested for trespassing; his mother, who has custody of his daughter, called 911 after he refused to leave her property.

On Wednesday, Hagensen congratulated Richardson for making therapy a priority.

“The whole program is designed to give people some tools to get back on their feet,” the judge said.

Richardson has a full-time job and a place to live. The next step, he said, will be trying to get his daughter back.

Richardson told the other mental health court participants that his motivation to sign up for the court was to avoid jail, but eventually he came to terms with the fact that he needs to stay on his medication and in counseling.

“That’s 20 years in the making,” he said.