New Mental Health Court in Harris County

The Houston Chronicle reports that Harris County judges have voted to get in line with the growing number of mental health courts nationwide ("Harris Judges Vote for Felony Mental Health Court," January 8, 2009).

According to the Criminal Justice/Mental Health Consensus Project, "Mental health courts (MHCs) are specialized dockets that link defendants with mental illnesses to court-supervised, community-based treatment in lieu of traditional case processing." In The Essential Elements of a Mental Health Court, the authors note that "Mental health courts are a recent and rapidly expanding phenomenon. In the late 1990s only a few such courts were accepting cases. Since then, more than 150 others have been established, and dozens more are being planned." Other mental health courts in Texas have been established in Smith, Bexar, El Paso, Tarrant, and Dallas Counties.

Here's the full article:

Harris County's criminal district judges voted Wednesday to designate a full-time felony mental health court, which will likely focus on defendants diagnosed with schizophrenia, bipolar disorder and severe depression.

State District Judge Jan Krocker will preside over the court, the first of its kind in Harris County. A start date has not been determined. Funding is still needed, she said. She did not give an estimate, saying details must still be finalized.

About 30 percent of the defendants who come through Harris County's criminal courts have a mental illness, Krocker said. She expects many of those defendants also will need treatment for substance abuse.

"It is a tragedy both for society and the defendant when mentally ill offenders go through the system without treatment," Krocker said Wednesday. "The mental health court can rewrite some very sad stories so there are great endings."

Mental Health Association of Greater Houston President and CEO Betsy Schwartz lauded the move, noting that mental health courts have been in place for years in other parts of the country and have proved successful.

She said she hopes that the court will prevent some offenders from "recycling" through the system.

"Individuals with serious mental illness can be matched with case management and services in the mental health court and the judge will know them as a person, have a relationship with them," Schwartz said.

The new court might also help some veterans suffering from post-traumatic stress disorder when they return to Houston from Iraq, Krocker said.

"We need to be prepared for the possibility that (some) may be mentally ill and homeless and may end up in the criminal justice system," Krocker said.

Harris County District Attorney Pat Lykos, who recently took office, applauded the judges' decision. Lykos emphasized mental health treatment as a theme in her election campaign last year.

"I think this is a major initiative," Lykos said Wednesday. "The criminal justice system is the last institution available to deal with these individuals. It's the institution of last resort. This is a moral issue. It's a dollars and cents issue."

Krocker plans for mentally ill defendants to be assigned to her court immediately after they are charged with a criminal offense if they have previously been diagnosed with a mental illness in the criminal justice system through the Mental Health and Mental Retardation Authority of Harris County.

Krocker also proposed that mentally ill defendants could be transferred to her court from another felony court if the judge, prosecutor and defense attorney involved in the case agree.

More than 7,700 defendants received psychotropic medications in Harris County in 2007, Krocker said. The Harris County Jail is the county's largest psychiatric hospital.

The court designation is one step in helping the mentally ill, Schwartz said, adding that other components must be in place.

"It can only be as good as the community support services that are available," Schwartz said.
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Earlier posts on mental health courts are available here and here. More information is available from the Consensus Project.

Possible New Mental Health Court in Smith County

The Tyler Morning Telegraph reports that Smith County commissioners have been asked to establish a “mental health court,” with the aim of providing better care for offenders with mental illness and reducing jail overcrowding ("Commissioners To Consider Creating ‘ Mental Health Court ’", July 27, 2008).

Here's an excerpt:

"It’s something like the county’s drug court, which diverts misdemeanor offenders with addiction problems.

A presentation will be made on Monday by Dr. David Self, chief forensic psychiatrist for the Rusk State Hospital, and Valerie Holcomb, with the Texas Corrections Office on Medically and Mentally Ill at the Andrews Center.

The Andrews Center estimates that about 20 percent of Smith County jail inmates have been treated for mental illness in the past. A mental health court would focus on intensively supervised probation for the mentally ill, who would receive outpatient treatment."
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Numerous counties in Texas, including Bexar, El Paso, Tarrant, and Dallas, have established mental health courts, which addresses the needs of those with mental illness who come into contact with the criminal justice system. There are more than 150 mental health courts in operation throughout the United States.

Mental Health Courts

Last week (March 26, 2008), National Public Radio's "News & Notes" featured commentary on mental health courts from Judge Lynn Toler.

Listen to the segment: "Mental Health: How Do Courts Deal with Mental Health Issues."

Updates on Federal Legislation re Mental Illness

From the Criminal Justice/Mental Health Consensus Project:

"On March 6, 2008, members of the Senate Judiciary Committee passed S. 2304, the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (MIOTCRA). The legislation, introduced last year by Sens. Edward Kennedy (D-MA), Pete Domenici (R-NM), Patrick Leahy (D-VT) and Arlen Specter (R-PA), will now be sent to the Senate floor for consideration.

The bill, which passed the U.S. House of Representatives in January with overwhelming bipartisan support, will help provide states and counties with the resources needed to design and implement collaborative efforts between the criminal justice and mental health systems. The legislation offers grants to communities to develop diversion programs, mental health treatments in jails and prisons, and transition and aftercare services to facilitate reentry into the community. The bill also provides for the cross-training of criminal justice, law enforcement and mental health personnel.

With bipartisan support in both the House and the Senate, the legislation will raise the authorization level of MIOTCRA from $50 million per year to $75 million per year and will extend the authorization through 2014. The bill will also reauthorize the Mental Health Courts grant program (Public Law 106-515) and will require that a study be conducted on the prevalence of mental illness in prisons and jails."

More information is available from the Consensus Project.

Earlier posts on the MIOTCRA are available here and here.
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And last week, the U.S. Senate passed the Second Chance Act (H.R. 1593) by unanimous consent. The U.S. House of Representatives passed the legislation last fall. The legislation would provide transitional assistance to ex-offenders in an effort to reduce a return to alcohol abuse. Additionally, the legislation would extend and provide a full continuum of care for treatment of substance use disorders and improve mental health screening and treatment.

"It is a national tragedy that jails and prisons have become the primary mental health care facilities in the United States today," said American Psychiatric Association President Carolyn Robinowitz, M.D. "This bi-partisan action represents significant steps forward in improving access to mental health services and substance abuse treatment programs for those incarcerated within the prison system."

Read the press release issued by the American Psychiatric Association.

A Holistic Approach to Offenders with Mental Illness

Here's an op-ed from Judge Nancy Hohengarten that appeared in the Austin American-Statesman ("A way to ensure justice for all", February 5, 2008):

"Traditionally, family members of criminal defendants do not discuss cases with the prosecution, but when the defendant is mentally ill, family input is appropriate.

A family member who understands the nature of a defendant's mental illness, behavior and circumstances is a valuable resource to the criminal justice system. Protection of the community requires that the mentally ill receive treatment to prevent recidivism. A mentally ill defendant who does not receive appropriate treatment will often be re-arrested, thrown back in jail and yet another person will have been a victim. In the misdemeanor courts' mental health docket, Travis County Attorney David Escamilla allows his mental health prosecutor to listen to family members because it leads to better decision-making on criminal cases.

The role of a prosecutor, after all, is to seek justice. On a case-by-case basis, it means that the punishment should be appropriate for the offense and the offender. This, of course, requires the prosecutor to show leadership on community problems — like mentalillness — that can lead to crime.

My experience with family members trying to keep a loved one mentally healthy and out of jail is that they are exhausted, frustrated and heartbroken.

Their experience provides valuable guidance to criminal justice professionals so that the justice system appropriately addresses andmonitors mentally ill defendants.

One longtime Austin business owner whose son had damaged her property asked me to put her son on probation so that he could be ordered to take his medication. He did very well and was discharged early.

Another woman asked me to find treatment for her son because the stress was killing her. Unfortunately, her mentally ill son couldn't stop using cocaine while he waited the two months for residential treatment on probation. Now he's spending a month in jail because the wait for such treatment is shorter when you're locked up.

Family members aren't asking for leniency; rather, they want their loved ones mentally healthy so they won't break the law and end up in jail. Thus their interests coincide with the interests of criminal justice.

Prosecutors, judges and defense attorneys need to listen to these families. It is our responsibility to provide protection for thecommunity and fairness and justice for all."

Hohengarten presides over Travis County Court at Law 5. She is a member of the Mayor's Mental Health Task Force Monitoring Committeeand the Austin Travis County Mental Health Jail Diversion Committee.

Read the editorial online.

U.S. House Passes Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act

Yesterday, January 23, 2008, the U.S. House of Representatives passed the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (MIOTCRRIA), H.R. 3992.

Here's a statement from leaders of the Council of State Governments Justice Center, which appears in the January 2008 newsletter of the Consensus Project.

"Leaders of the Council of State Governments Justice Center laud Members of the U.S. House of Representatives for passage yesterday of the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (MIOTCRRIA), H.R. 3992.

The bill, introduced by Rep. Bobby Scott (D-VA) and Rep. Lamar Smith (R-TX), will make a significant commitment to addressing the needs of both the criminal justice system and individuals with mental illnesses who come into contact with it.

'The passage of the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act illustrates the extraordinary bipartisan consensus that exists among elected officials to increase the accessibility of integrated mental health and substance abuse treatment, and to promote collaborative efforts between criminal justice and mental health agencies,' said Dr. James S. Reinhard, Commissioner of the Commonwealth of Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services, and a Justice Center board member.

This legislation, which has received strong support in both the House and the Senate, will reauthorize the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA). Enacted in 2004, MIOTCRA created the Justice and Mental Health Collaboration Grant Program designed to help states and counties design and implement coordinated efforts between criminal justice and mental health systems. Through appropriated funds, the Bureau of Justice Assistance within the Department of Justice has awarded 53 communities in 35 states with additional resources to plan and implement collaborative efforts between criminal justice and mental health systems.

The new bill will raise the authorization level of MIOTCRA from $50 million per year to $75 million per year and will extend the authorization through 2013. The bill will also reauthorize the mental health courts grant program, and require a study to be completed on the prevalence of mental illness in prisons and jails. Download the complete bill text (pdf).

'Reauthorizing MIOTCRA will provide much-needed support to states and local governments across the country. Every state is now seeking to design, implement, and expand initiatives that will improve the response to people with mental illnesses in contact with the criminal justice system. Front-line professionals, like corrections and police officers, are telling us that this will increase public safety, reduce state spending, and save lives,' said Justice Center board member and Connecticut State Representative Michael Lawlor. 'We urge the Senate to take swift action in support of this bill.'"

Earlier coverage of this legislation is available here and here.

Mental Health Court in El Paso

From the El Paso Times, December 10, 2007:

"A new mental health court intervention and treatment program was created today by a unanimous vote by Commissioners Court.

The new court will address mental health issues among adult criminal offenders, including counseling services, treatment, supervision and mental health assessments. The new court will seek grant funds to help fund its operation."

Bexar, Dallas, and Tarrant Counties all have some sort of mental health diversion courts.

Read more about mental health courts at http://consensusproject.org/mhcp/.

House Committee Passes MIOTCRA

Here's an update from the Consensus Project on the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (MIOTCRA):

"On November 7, 2007, just a week after the introduction of the bill, members of the full House Judiciary Committee passed H.R. 3992, the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act. The bill will now be sent to the House floor for consideration, which sponsors say could take place later this month. The Senate sponsors intend to move the companion bill, S. 2304, before Congress breaks for recess.

During the mark-up of the bill, lead sponsors Representatives Bobby Scott (D-VA) and Randy Forbes (R-VA) spoke about the need for continued collaboration between criminal justice and mental health agencies. The bill will make a significant commitment to addressing the needs of both the criminal justice system and the mentally ill offender population. It offers grants to communities to develop diversion programs, mental health treatments in jails and prisons, and transition and after-care services to facilitate reentry into the community.

"I am pleased to be the lead cosponsor of a bi-cameral, bi-partisan legislation," Representative Scott said. "The MIOTCRA will not only provide for appropriate responses to mentally ill offenders, but save localities money in avoided jail and prison costs.

"With bipartisan support in both the House and the Senate, the legislation will raise the authorization level of MIOTCRA from $50 million per year to $75 million per year and will extend the authorization through 2013. The bill will also reauthorize the Mental Health Courts grant program, (Public Law 106-515) and require a study to be completed on the prevalence of mental illness in prisons and jails."

Congress Introduces the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act

From the Consensus Project Newsletter, November 2007:

"This week U.S. Senators Edward Kennedy (D-MA), Pete Domenici (R-NM), Patrick Leahy (D-VT), and Arlen Specter (R-PA), and U.S. Representatives Bobby Scott (D-VA) and Randy Forbes (R-VA) introduced the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act.

This legislation, which has received bipartisan support in both the House and the Senate, will reauthorize the Mentally Ill Offender Treatment and Crime Reduction Act or MIOTCRA (Public Law 108-414). Enacted in 2004, MIOTCRA created the Justice and Mental Health Collaboration Grant Program (JMHCP) designed to help states and counties design and implement collaborative efforts between criminal justice and mental health systems. Through appropriated funds, the Bureau of Justice Assistance (BJA) within the Department of Justice has awarded 53 communities in 35 states with additional resources to plan and implement collaborative efforts between criminal justice and mental health systems."

Here are some provisions of the new bill:

• Raises the authorization level of MIOTCRA from $50 million per year to $75 million per year and will extend the authorization through 2013
• Reauthorizes the Mental Health Courts grant program (Public Law 106-515)
• Requires that a study be completed on the prevalence of mental illness in prisons and jails

The Consensus Project reports that the bill is scheduled for consideration in the full House Judiciary Committee on November 7, 2007; it passed the Crime Subcommittee on November 1. The Senate sponsors intend to move the bill before Congress breaks for recess.

More information available at http://consensusproject.org/.

New Issue of Criminal Justice Magazine Focuses on Mental Health

The Fall 2007 issue of Criminal Justice Magazine, a quarterly publication of the Criminal Justice section of the American Bar Association, focuses on issues related to mental health and the criminal justice system. It includes these articles:


The Supreme Court’s Recent Criminal Mental Health Cases Rulings of Questionable Competence by Christopher Slobogin


Prosecutor as “Nurse Ratched”?: Misusing Criminal Justice as Alternative Medicine by Gerald E. Nora


The Promise of Mental Health Courts: Brooklyn Criminal Justice System Experiments with Treatment as an Alternative to Prison by Matthew J. D’Emic

Executing the Mentally Ill: When Is Someone Sane Enough to Die? by Michael Mello


The entire issue is available at www.abanet.org/crimjust/cjmag/22-3/home.html.

New Mental Health Court in Bexar County

Bexar County now joins El Paso and Dallas Counties in establishing a mental health court, which addresses the needs of those with mental illness who come into contact with the criminal justice system. Travis County has a special public defender's office for defendants with mental illness. The Justice Center, which implements the Criminal Justice/Mental Health Consensus Project, estimates that well over 150 mental health courts are in operation across the country.

Here's a September 23, 2007 editorial from the San Antonio Express-News:

Editorial: For the mentally ill, grant is sign of hope

"Inadequate funding over the years has resulted in a shortage of mental health beds at state hospitals and a growing number of mentally ill individuals in the criminal justice system. Incarceration is an expensive alternative, and it usually does not adequately address the health problems of such defendants. This is clearly illustrated in today's column on Craig Stiffler by Gloria Padilla.

A recently awarded $250,000 grant from the Justice Department to fund a mental health court in Bexar County will go a long way in reducing some of the problems. A portion of the grant will fund two probation officers trained to work with the mentally ill and assigned to a court that will handle some of the mental health criminal docket.

At present, mentally ill criminal defendants are participating in a jail diversion program if they enter a plea and are placed on probation. The program is helping reduce the jail population, but it is doing little to assist the defendants themselves. With the hiring of the specially trained probation officers, Bexar County officials hope to provide a continuum of care for about 80 defendants whose cases will be assigned to County Court-at-Law No. 5 Judge Tim Johnson.

During the past decade, the county has been working to isolate the mentally ill from the regular docket and give them the individualized attention they need, but the sheer volume of the dockets has made that task difficult. Hiring two probation officers whose workload will be limited to 40 cases each, as opposed to the regular caseload of 100 or more, will help tremendously.

The county's next goal is to find the money to establish a public defender's office to represent the mentally ill in court. Without someone looking out for their best interests, the mentally ill tend to have longer stays in jail than the regular population. Their stays are also more expensive. A day in a regular jail bed is about $50 as opposed to $250 for a mental health bed.

If there were adequate health services available for the mentally ill, many of them would not end up in jail. The opening of the Haven for Hope campus of services for the homeless at the end of 2008 will help address a big part of that problem. It will bring together in one location the various agencies that provide resources for the homeless. The criminal justice system, however, also must continue to find ways to address the problem. It is in the best interest of mentally ill patients and the taxpayers to keep the mentally ill out of the county jail and assist them in finding the help they need. The wheels of justice for the mentally ill move slowly, but it's encouraging to see they are gaining momentum."

http://www.mysanantonio.com/opinion/editorials/stories/MYSA092307.02H.mental_health1ed.21c46ad.html