Saturday, October 31, 2009

Harris County judges vote next week on creating new mental health court

An editorial in the Houston Chronicle supporting creation of a Harris County mental health court mentions that on Wednesday, November 4:
[Harris County] criminal district court judges will vote whether to approve a detailed plan for a new “mental-health court,” a program that promises to cut crime, take a humane stance toward mental illness and save taxpayer money all at the same time. If the judges vote yes — and if Harris County commissioners then budget money for the program — the court could begin operation June 1.

The plan, created by 184th State District Court Judge Jan Krocker, a Republican, and more than a hundred mental-health stakeholders, would work like this: If charged with a non-violent felony, someone diagnosed with a significant cognitive impairment or mental illness (schizophrenia, bipolar disorder, post-traumatic stress disorder and the like) would quickly be offered a choice: regular court or mental-health court. Defendants not competent to make the choice aren't eligible; those defendants are either sent to a state hospital or medicated in hopes that they become competent to stand trial.

Staffed by a judge, lawyers and caseworkers trained to deal with mental illness, mental-health court would be far less adversarial than regular courts. Both the prosecution and defense would agree that the goal is for the defendant to successfully complete the treatment plan prescribed by the court's psychiatrist, including mental-health treatment and anything else, such as drug-abuse counseling, health care or job training, deemed necessary to straighten out the defendant's tangled life. Court social workers would help find housing and health care.

And the court's judge would monitor the defendant's progress — meeting with him or her every week, if necessary — and could punish failures to comply with jail time.
Travis County's mental health court appears to be having success, so hopefully the new one in Harris will, too. The biggest barrier to expansion in Houston, says the Chronicle, may be a lack of community based treatment resources:
The Harris County proposal suggests starting small in 2010, sending 26 percent of a narrowly defined group of eligible defendants — about 200 a year — to the new mental-health court. More than that, notes the planning team, would overwhelm the already strained patchwork of social services that provide support for Texas' mentally ill. The court, after all, has to be able to refer its defendants somewhere for help.
Stronger probation methods and problem solving courts seem tailor-made for so-called "frequent flier" defendants who are likely to wind up on the mental health docket, but only if community-based services are adequately supported. Some have been incarcerated dozens of times, so it's not like jailing them is keeping the public from interacting with them. But their past interactions with the jail, as the county's largest mental health provider, nobody ever helped them how to control the underlying illness under supervised conditions where they're held accountable for things like staying on their meds and keeping a job. Instead, probationers were left on their own to sink or swim.

The shortage of services isn't just a problem in H-Town. The public health system has gotten so used to treating mental illness in county jails that community-based resources have atrophied, even though they're cheaper and in most instances more effective. Simply creating a new court docket won't help in the long run if the service shortage isn't addressed, but perhaps the court can also be an effective advocate to communicate with the commissioners court what resources are needed to manage this large subpopulation of offenders that soaks up a vastly disproportionate share of criminal justice resources.

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