Georgia Behavioral Health Legislative Caucus. Mental Health Courts in Georgia Appalachian Circuit Superior Court (Pickens, Gilmer and Fannin Counties)

Georgia Behavioral Health Georgia Behavioral Health Legislative CaucusLegislative Caucus

Mental Health Courts in GeorgiaMental Health Courts in Georgia

Appalachian Circuit Superior Court (Pickens, Appalachian Circuit Superior Court (Pickens, Gilmer and Fannin Counties) Gilmer and Fannin Counties)

Athens-Clarke County Superior, State, Athens-Clarke County Superior, State, Municipal, Magistrate, and Probate CourtsMunicipal, Magistrate, and Probate Courts

Bibb County Superior CourtBibb County Superior Court Chatham County Superior and State CourtsChatham County Superior and State Courts Chatham County Juvenile CourtChatham County Juvenile Court DeKalb County Superior and Magistrate DeKalb County Superior and Magistrate

CourtsCourts Dougherty County Superior Court (National Dougherty County Superior Court (National

Learning Site)Learning Site)

Mental Health Courts in Georgia, cont.Mental Health Courts in Georgia, cont.

Fulton County Superior and State CourtsFulton County Superior and State Courts Hall County Superior Court with concurrent Hall County Superior Court with concurrent

misdemeanor jurisdictionmisdemeanor jurisdiction Henry County Superior, State, and Probate CourtsHenry County Superior, State, and Probate Courts Mitchell County State CourtMitchell County State Court Muscogee County Superior and State CourtsMuscogee County Superior and State Courts Piedmont Circuit Superior and State CourtsPiedmont Circuit Superior and State Courts Pickens County Superior, State, and Magistrate CourtsPickens County Superior, State, and Magistrate Courts

In Planning:In Planning: Augusta Circuit Superior CourtAugusta Circuit Superior Court

Over last 20 yearsOver last 20 years

State prison population has State prison population has increased 209%increased 209%

County jail population has County jail population has increased 134%increased 134%

State population has increased State population has increased 51%51%

Data on Extent of ProblemData on Extent of Problem

15% of county jail population are 15% of county jail population are persons with a serious mental illness; persons with a serious mental illness; 5% of state population5% of state population

66% - 75% have co-occurring drug 66% - 75% have co-occurring drug addictionaddiction

Out of 51, Georgia ranksOut of 51, Georgia ranks 35th in state hospital spending35th in state hospital spending 42nd in community spending42nd in community spending 45th for state agency mental health 45th for state agency mental health

spendingspending

Role of the CourtRole of the Court

Persons with untreated mental Persons with untreated mental illness often become trapped in illness often become trapped in a cycle in the criminal justice a cycle in the criminal justice system, clogging court dockets.system, clogging court dockets.

Most have committed Most have committed misdemeanor or non-violent, misdemeanor or non-violent, low-level felonies precipitated low-level felonies precipitated by their mental illness.by their mental illness.

Role of the CourtRole of the Court

Through civil commitment Through civil commitment cases, judges order persons to cases, judges order persons to involuntary inpatient or involuntary inpatient or outpatient treatment.outpatient treatment.

Courts balance individual Courts balance individual liberties with security concerns liberties with security concerns for community.for community.

Typical MHC Case FlowTypical MHC Case Flow Arrest and arraignmentArrest and arraignment Identification, screening, assessment and Identification, screening, assessment and

referralreferral Decisions re: eligibility and interest in Decisions re: eligibility and interest in

participation (defense counsel)participation (defense counsel) MH evaluation and preparation of MH evaluation and preparation of

treatment plantreatment plan Plea/contract: MHC participation (judge, Plea/contract: MHC participation (judge,

prosecutor, defendant and defense prosecutor, defendant and defense attorney all agree)attorney all agree)

Treatment and court monitoringTreatment and court monitoring Compliance: No jail/prison, reduced or Compliance: No jail/prison, reduced or

dismissed chargesdismissed charges Non-compliance: Jail/prison sentenceNon-compliance: Jail/prison sentence

Terms of Participation Terms of Participation Stage of proceedings (post plea, Stage of proceedings (post plea,

pre-sentence, post sentence, etc.)pre-sentence, post sentence, etc.) Length of treatment mandate Length of treatment mandate Requirements for graduation:Requirements for graduation:

Standardized goals, individually Standardized goals, individually appliedapplied

Graduation from court is not Graduation from court is not graduation from treatment/servicesgraduation from treatment/services

Lifelong treatment needs vs. time-Lifelong treatment needs vs. time-bound court processbound court process

Rewards/incentives for successful Rewards/incentives for successful completioncompletion

Sanctions for non-complianceSanctions for non-compliance

Informed ChoiceInformed Choice

Competence (regarding legal Competence (regarding legal proceedings and treatment)proceedings and treatment) Superior Courts in both Dougherty and Hall Superior Courts in both Dougherty and Hall

Counties have Specialized Competency Counties have Specialized Competency DocketsDockets

Decision to participate, MHC is voluntaryDecision to participate, MHC is voluntary Understanding the Criminal Justice and Understanding the Criminal Justice and

Mental Health consequences of Mental Health consequences of participation participation

Service GapsService Gaps

Lack of - Lack of - Comprehensive treatment in the communityComprehensive treatment in the community Care management/court diversion coordinatorsCare management/court diversion coordinators Appropriate medicationAppropriate medication Supportive and permanent housingSupportive and permanent housing Job training and supported employmentJob training and supported employment Early identification and diversion to appropriate Early identification and diversion to appropriate

carecare Communication, coordination and collaboration Communication, coordination and collaboration

among systemsamong systems Prevention effortsPrevention efforts

RecommendationsRecommendations Fully funded, comprehensive system of Fully funded, comprehensive system of

community-based services will reduce community-based services will reduce court case loadscourt case loads

Evidence-based treatmentEvidence-based treatment Active care management, including Active care management, including

diversion coordinatorsdiversion coordinators Access to quality medicationAccess to quality medication Access to medical careAccess to medical care Treatment for co-occurring addictive Treatment for co-occurring addictive

diseasesdiseases Consistent access to benefitsConsistent access to benefits

Mental Health Court Mental Health Court ResearchResearch

Mental Health Court research continues to Mental Health Court research continues to emergeemerge

The current research shows that MHC is a The current research shows that MHC is a cost effective alternative to incarceration, cost effective alternative to incarceration, improves psychosocial functioning of improves psychosocial functioning of participants, and positively impacts re-participants, and positively impacts re-arrests rates.arrests rates.

AcknowledgementsAcknowledgements

This presentation was adapted fromThis presentation was adapted from New York Center for Court Innovation, Carol Fisher, Director, New York Center for Court Innovation, Carol Fisher, Director,

Mental Health Court Programs Mental Health Court Programs TASC, Inc., Alicia M. Kusiak, Senior AdministratorTASC, Inc., Alicia M. Kusiak, Senior Administrator Chief Justice-led Task Force to Promote Criminal Chief Justice-led Task Force to Promote Criminal

Justice/Mental Health Collaboration,Justice/Mental Health Collaboration, Judge Stephen Goss, Judge Stephen Goss, Dougherty County Mental Health/Substance Abuse Court,Dougherty County Mental Health/Substance Abuse Court,Judge Winston Bethel, DeKalb County Mental Health Court, Judge Winston Bethel, DeKalb County Mental Health Court, Baldwin County Sheriff Bill MasseeBaldwin County Sheriff Bill Massee

Chief Justice-led Task Force to Promote Criminal Chief Justice-led Task Force to Promote Criminal Justice/Mental Health Collaboration, Chair Chief Justice Leah Justice/Mental Health Collaboration, Chair Chief Justice Leah Ward Sears, Co-Chair Judge John Allen, Chattahoochee Ward Sears, Co-Chair Judge John Allen, Chattahoochee Circuit Superior Court, and Co-Chair Judge Winston Bethel, Circuit Superior Court, and Co-Chair Judge Winston Bethel, DDeKalb County Magistrate CourteKalb County Magistrate Court