Seattle Mental Health Court puts treatment before jail

Rising number of mentally ill inmates prompts some states to reexaminehow to handle special defendants.

By , Special to The Christian Science Monitor

Around here, Stanley Stevenson's death is a symbol of what can go wrong when those diagnosed with severe mental illness slip through the cracks of America's legal and mental-health systems.

Mr. Stevenson, a retired Seattle firefighter, was murdered more than two years ago by a man with a history of mental-health hospitalizations. The man committed the murder 11 days after his release from jail on a misdemeanor - despite warnings from a state mental hospital that he posed a threat to the community and should be committed.

But Stevenson's death was more than just a symbol of dysfunction between the criminal-justice and state mental-health systems. It became the impetus behind the Mental Health Court, a two-year pilot program aimed at bridging the gap between these two systems.

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"[We are] dealing with a difficult population of defendants, but our successes have been tremendous," says Judge James Cayce, who heads the King County program. "The Mental Health Court has made a difference for those people who have cycled aimlessly through the system - through courts, jails, and mental hospitals - for years."

The court's innovative approach - prison time is the exception, not the rule - is gaining ground as the nation struggles to cope with rising numbers of mentally ill inmates.

Washington State is considering expanding the court to other counties, and Ohio, Oregon, and Utah are looking into it as well. Last month, Sen. Mike DeWine (R) of Ohio said he will introduce legislation to fund 125 pilot mental-health courts across the US in the next five years. In the House, Rep. Ted Strickland (D) of Ohio will introduce similar legislation.

The moves come against a stark statistical backdrop:

*Some 283,800 mentally ill men and women - roughly 16 percent of all state and county inmates - live behind bars. These inmates spend an average of 15 months longer in prisons than other inmates, often because of disciplinary problems.

*Forty state mental hospitals have been closed this decade, and 60,000 people are squeezed into the ones that remain.

*In New York, there are 5,800 public psychiatric beds, down from 10,000 in 1994. Meanwhile, the city faces a class-action lawsuit for releasing mentally-ill inmates without follow-up care.

Since its start-up in February, King County's Mental Health Court (MHC) has seen more than 150 misdemeanor defendants. Not one of those has subsequently been arrested for a violent crime. A few have been re-arrested on misdemeanor offenses and then sent to jail. But 84 percent have avoided jail sentences completely.

In addition to Judge Cayce, the court is staffed with a prosecutor and defender, treatment liaison, and several probation officers who have significantly reduced caseloads in order to provide greater supervision and follow-up.

Unlike other courts, the MHC has a single contact person to simplify the process for the mentally ill, participation is voluntary, and defendants cannot be forced to take medication.

Those having their cases reviewed or considered for dismissal in court today seem receptive to Cayce's compassionate and calm approach.

"Keep up the good work," the judge encourages a quiet, nervous Russian immigrant through a court translator. The man, who is diligently attending all of his required probationary meetings, smiles briefly in gratitude.

King County's MHC - as well as a similar court in Anchorage, Alaska - is modeled after a Broward County, Fla., program, begun in June 1997.

Judge Ginger Lerner-Wren heads the part-time Mental Health Court in Fort Lauderdale, and says the court has handled more than 1,200 nonviolent offenders in the past two years.

It has recently received funding from the state Legislature to study recidivism rates and the potential for similar programs throughout Florida.

Because of a significant lack of services for the mentally ill in her county, says Judge Lerner-Wren, many individuals who are "on the streets in a psychiatrically destabilized condition" are arrested for a variety of misdemeanor crimes. It's at that point many are referred to the MHC.

As in Seattle, offenders in Broward County who agree to abide by the terms of the court are usually diverted away from jail sentences into treatment programs.

"This way," says Lerner-Wren, "they do not end up languishing and deteriorating in jail."

(c) Copyright 1999. The Christian Science Publishing Society

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