Thursday, September 4, 2008

Evaluation of a Mental Health Court




The folks over in Norfolk Virginia have posted an article about the evaluation of their Mental Health Court. They are reporting that the four year old program has reduced recidivism and saved approximatley 1.63 million dollars in tax player money. They have kept these indivdiuals out of Virginia jails, and instead, have utilized the services of social workers and probation officers, along with already estblished court programs, in an attempt to slowly stabilize these individuals. Click the link to read the article and let me know what you think about this program.


78 comments:

Anonymous said...

Way to go state of Virginia!!! I think there should be a pilot program in Alabama to see how well it works here. Mentally ill people don't need jails, they need structure, understanding and help. Not a jail cell. Those receiving treatment through this program are held accountable for their actions and know there are consequences if they do not follow through with the treatment plans. I think cost wise, this is much cheaper than jail and they are also able to receive treatment to make them responsible citizens in their communities. Finally, I think as social workers, we must decide if we are going to help change the view/care of mentally ill and the court system OR continue to band-aid the problem. It is up the us, as current and future social workers to be a part of change.
Angel P. (Tuscaloosa)

jefN said...

I believe that jails and prisons are an extreme measure when dealing with substance-use or misdemeanors, the current phrase is "non-violent drug offenders" (usually "first time" precedes it). We have been locking people away for their behaviors, far too long, without addressing the cause of their behaviors. I would love to see a Mental Health Court in Calhoun County. We have sooo many individuals here with co-occuring disorders and not enough programs to send them to.

jefN gadsden said...

Angel has a great point, helping our mental health (or any other) client's to practice the principle of accountability is certainly a worthwhile endeavor.

Destinc said...

Wow, the study showed that the participants while in the program that had remained out of jail resluted is 1.63 million savings in jailcost. I agree with Angel that mentally ill people need structure and assistance.I too would love to see a Mental Health Court in Marshall county. Getting to the root of their problem (MI) rather than focusing on the substance use, is alot of times the reason they drink, etc. to help cope with the underlying issue.

Tiffiney Brittingham said...

The U.S. prison and jail system is beyond over crowded. I applaud any program that will improve or enhance the jail and prison system for any state. The program not only helped the mentally ill, but those who have drug addictions and alcohol problems.

I agree with jefn...people have been locked away and their issues never being meet or discussed. We do need a program similar in Alabama.

The program has a six month turn around. The coordinators of the program should do six month follow-up to reduce the recidivism rate low than what it is and possible reduce the two year rate.

Tiffiney Brittingham
(Tuscaloosa)

scarlett holt said...

I think that the people in Virginia are on to something, begining with the down-to-earth style of the Judge in addressing the clients. I have seen many times in Jefferson County where the Judge will not even speak to the client, and talk "around them" to the professionals invovled in their lives, using jargon that the lay person would have difficulty understanding. It seemed that the program mentioned had been successful in assisting offenders dealing with mental health issues, who in the past were treated as those without these issues, while continuing to hold them accountable for behaviors. In agreement with Angel and Jeff, locally,there is too much "band-aiding" going on and not enough emphasis on cause and treatment for behaviors. I think that it would be beneficial to adopt this program or a similar one in
Alabama.
Scarlett H.

Stu J. said...

Josh, I appreciate you sharing the article. GReat to hear about an effort to not simply have prison serve as de facto shelter for individuals suffering from mental illness. Using team resources to monitor and help folks along their way makes perfect sense to me.

Stu J. said...

I appreciate Angel's perspective and proactive perspective that social workers must bring to situations and clients.

T M Morgan said...

Wow! This is an awesome program! All of what they are saying makes perfect sense. Imprisonment is no place for minor offenders to get treatment. This saves money on so many different levels and helps the individual. I hope we will see many more states follow suit in the coming years.

T M Morgan said...

Right on Jeff. You are so right-warehousing those with a mental health diagnosis is just downright counterproductive.

Walter Leanier said...

The State of Virgina has a great program to help the mentally ill avoid jails. This not only will help keep them out of jails but homeless shelters and hopefully stop them from sleeping on public streets. this program has reduced the recidivism rate among mentally ill, alcoholics, and addicts is a great start. Walter L.

I, agree with Angel P. (Tuscaloosa) The money this program has saved the State can be used for other programs. This intervention can be use by present and future social workers. How was it done?

S.Ray said...

As members of society we can no longer continue doing the same things and expect different results. It certainly seems that the state of Virginia is thinking “outside the box.” The numbers in the study are impressive. The amount of money saved should make the politicians take note, and many times the money factor is the catalyst for change regarding social programs. I was surprised to learn there are only 180 mental health courts in the United States, especially considering the success rate of Virginia’s court. Perhaps this research will convince other jurisdictions to try it. Participants are required to see social workers “regularly”, and I wonder how often that means. It would be interesting to know the caseload of these workers and other services that provided to the participants.

S.Ray said...

I agree with Destin regarding treating the underlying issues instead of putting a band-aid on the problem. The fact the program coordinates between agencies and requires participants to see social workers regularly may be the reason for its success. The program also employs “sanctions” and this could be the motivation that creates such a success rate!

ojwashington said...

I want to commend the state of Virginia!! I think it is wonderful that they are not using prisons as means of addressing mental illness. After watching the program Lock-Up Holman which is a prison in south Alabama. I became aware of the number of inmates in prison that suffer from some form of mental illness. I think this would be a very effective program for our state in which we can actually provide treatment options for those with mental health and substance abuse issues instead of just placing them in jail. This would allow us to get to the base of the problem and put effective treatment measures in place.

ojwashington said...

I agree with Jeff's point that there is not enough programs to help clients with mental health illness and subtance abuse treatment. Within the last year, the City of Fort Payne has built a newer, bigger jail to house more inmates locally and federally. Since I relocated back here in the last five years, I dont recall any new programs started to address the needs of the mentally ill and substance abusers.

Anonymous said...

I was really impressed by Virginia's mental health court's stats. It confirms what we already know that with treatment and access to resources people actually do get better. I did a volunteer placement at TASC of UAB in Birmingham they had a Mental Health Court, and they were really doing some great things with their clients. One client sticks out that was a great artist who was also dually diagnosed. He had some minor legal issues that the court helped him resolve along with providing some treatment that continues to work for him. Today you can go into some of the restaurants in B'ham and find his work hanging on the walls.
Donna A

Anonymous said...

This sounds like a very worthwhile program. This article was very interesting because I have never heard of anything like this offered in Alabama. There is such a huge problem with jail overcrowding and the expenses related to inmates everday care. I do believe as the article stated, that if an individual is mentally ill, their condition will probably only worsen in a jail environment. This sounds like a wonderful program and it would offer more career choices for professionals. Robin G

Anonymous said...

I agree with Walter, that this program will branch off to help the offenders in other ways besides simply keeping them out of jail. It can help to reduce the homeless shelters and ensure that more people are getting the help that they need. This will help to open more doors to people who are mentally ill and may not feel that they have many choices. Robin G

Anonymous said...

Robin G:
I agree with you about those mentally ill and in prisons declining mentally. Maybe if those who don't really need to be in prison are treated in drug court, then there will be enough space for those who commit crimes and need to be in prison. Too many are being let out early because of overcrowding.
Angel P.

SWilliams said...

I agree with ojwashington, Alabama, and other states need to look at how they house prisoners with mental illness. It seems like now days all we hear about is the over crowding in the prison system and that bigger jails need to be built. Maybe if other options are looked at, the prisons would not be overcrowded and it would save taxpayer dollars.

Anonymous said...

Virginia H. Tusc. responsed to Angel P.
I certainly agree that the mentally ill should be dealt with in another way other than throwing them in jail to become institutionalized. We stopped institutionalization years ago, now the criminal justice system seesm to be trying to control the mentally ill through institutionalization. As SW we need to be concerned with having people assessed for mental illnesses prior to prosecution and then seek a GAL to represent them, as they are not able to respresent themselves. I realize that a lot of the homeless population is mentally ill, being homeless puts them at risk for being involved with criminal activities. Often the mentally ill, are also discarded by their families after years of struggle or their elderly parents die leaving them to care for themselves. So I am glad to see this pilot program trying to help the mentally ill. I look forward to such a program in Alabama. SW need to challenge social injustices of this sort and bring about change.

SWilliams said...

Finally, someone has realized that our criminal justice system needs some reform. I really like this program. Not only will this program give accountability and structure but also it leaves the parents at home to be members of society. Many research studies have shown that parents who maintain a relationship with their children keep them out of trouble. Many times these relationships are damaged because of the parent’s incarceration, for whatever reason. This program will reach all sorts of individuals and families. Every state needs to look at this program for their own use.

Anonymous said...

Virginia H. Tusc. Said...
After reading the article on Norfolk's mental health courts, I was surprised by the Judge's indepth discussions with each client pertaining to their case. However, I was impressed to see that the judge asked the client, not only did he attend anger management but was it a waste of his time? Often times, if a person gets the certificate, courts will let them go, but we as SW need to be concerned with whether or not the client actually benefited from the program or gained any knowledge to assit with change. I noticed that the participants have to attend court weekly, this might be a little much. I wonder if the clients are visited in their home environments and if there is any medication management.
This appears to be a great program with excellent long term recidivism rates as compared to programs that do not have mental health courts.

LaTasha T. said...

I believe that the mentally ill should be treated separately from the general population! As stated in the article, sending the mental ill to jail can be very expensive! Some states require that individuals with mental illnesses serve small sentences in jail for petty crimes; this can become expensive over a period of time! I believe that the cost can be drastically reduced through the exploration of other options such as a mental health court.

I think that the state of Alabama could benefit greatly from having a mental health court. I understand that working with the mentally ill can be a challenge for many social work professionals. However, I believe that with the right direction and people who have a sincere interest in turning the behavior around, there can be a large reduction in the recidivism rate for the mentally ill.

I think that the mental health court in Virginia is an awesome idea. If used effectively, this could serve as a model for other states, such as Alabama, to follow!

LaTasha T. said...

I agree with what Virginia and Angel said. The current court system can be so unfair when it comes to treating the mentally ill. I do not agree with the concept of assigning a GAL without having interaction with the client. I understand that individuals with mental illness has limited cognitive abilities. However, I believe that all individuals have the right to be treated fairly despite their mental competence or incompetence.

I agree that establishing a mental health court teaches accountability. In a sense it helps the client to have something to look forward to! Generally if individuals have something to look forward to, they are going to learn to attempt to and/or learn to do better.

I think that this is a program that would be very beneficial in the state of Alabama to help with our growing population of the mentally ill. I also believe that it could help with the rate of homelessness as some individuals with mental illness have or will be homeless at some point in their life.

Stacey L said...

Hats off to the Norfolk mental health courts. I was really impressed with the fact that this program places the responsibility on the individual. The court offered the structured supervision and guidance to the mentally ill offender. The mentally ill offenders were aware that they would be held accountable for their action and could face incarceration. So it was almost set up like a positive reward system, which I feel receives better response than a negative system. The last sentence of the article “The work is on their part; we just set up the structure and they do all the work”, speaks volume. This program was a win/win for all involved. The mentally ill offender was able to receive the treatment that they needed, stay at home with their family, keep their jobs, etc while the city saved money and kept the space at the jail for those that really were in need of a jail cell. Stacey L

Stacey L. said...

After reading all of the post, I feel that we all agree that locking up the mentally ill is not the cure. I agree with Jeff, we need to look at the behavior that has lead the individual to appear before the judge. Then address this problem instead of putting the individual in jail and not looking at the whole picture that has lead to the behavior. Also we must remember that all individuals are different and what might work on one person might not work on the next, so I feel that the justice system needs to get rid of the one size fits all way of thinking. Stacey L.

Anonymous said...

Well, it's about time. Finally a program that works! I think this is an excellent program. I have argued for years that the prison system is over crowded, to expensive & not set up for any rehabilitation purposes,strictly punitive. Three key words that more people need to understand; accountability, structure & stability. This will make all the difference in the inmates & decrease the amount of repeat offenders, as well as leave them home with their familes & with monitoring a chance to be a productive citizen!
Faye S.

Anonymous said...

Way to go Angel! I sure agree with you. Mentally ill people do not need jail sentences but therapy, understanding & structure. State of Virginia sure seems to have a great thing going & think of the money it saves to be better spent in other areas!
Faye S.

Teresa D. / Gadsden Center said...

I agree Angel! Why not get the great state of Alabama in on this program and save some of the incaration costs here. Also, I agree that the menatlly ill don't need jail, they need help. This program allows that and is making a difference!

Anonymous said...

I agree with my fellow students (Robin, Jeff, Otis) the way the prison system has been operating has not been working the mental health court does offer some solution to the problem of overcrowding. Donna A

Anonymous said...

This program seems to truly assess and meet the needs of its participants. It’s good to see that someone is looking at the issue of jail / prison time and mental illness or substance abuse. I feel that prison is not a very good deterrent for substance abuse; I think this is an obvious fact as our jails and prisons are over run with people who have some connection with drug use and they have multiple incarcerations for the same offenses. This is not to say that some type of punishment for crimes is not warranted, but incarceration does not treat the actual problem of addiction and it definitely does not treat mental health issues. When a prisoner is released, they have increased trauma from their jail time plus a continuing addiction or untreated mental health issue. The program in Norfolk appears to address the problem by meeting the needs of its clients. This looks like a resource that we all could utilize.
Heather Morris

Anonymous said...

In response to Scarlett, I agree with you that the judge being down to earth and personable makes this program even more successful. When I was working at DHR, we had an Intensive Reunification Court (which was pretty much family drug court for parents of children in foster care for drug related offenses) and our judge was a great advocate for the clients, she was able to get on their level. I don’t think the IRC program would have worked with a judge that placed themselves on a pedestal or looked down on the clients.
Heather M.

Anonymous said...

I agree with Angela P. that their should be a pilot program, because if we never start one, we will never know the results of it. I totally agree that the mental ill should not be locked up, however they should be help accountable for their actions. So, through medication and guidance their various problems can be managed through structure and guidance of individuals who believe that things can get better.

Anonymous said...

Hi Joshua I just posted a respond to Angela P. in tuscaloosa, but I don't think that I put my name on it.
This is Conteria Williams

Anonymous said...

Conteria Williams original post on the Virginia Study.

In reference to the study, I strongly believe that everyone has the potential to change. So, I am against individuals being placed in jail, because they are mentally challenged. Through the recent statics of individuals being placed in jail for what ever reason the outcome has not been good. Therefore, the return rate is very high for repeat offenders, which should set off a light bulb in our head that we should try something different, like a prevention program rather than jail.

Linda B said...

What a great program! It is time that the legal system realizes that jail time is not the only alternative, or the most appropriate alternative for inappropriate behavior, particularily with the mentally ill. The Marshall/Jackson Mental Health System recently started a similar intensive EBP case management program, except that it targets individuals with frequent hospitalizations. From what I have heard about this program, it is also showing a high rate of success at reducing re-hospitalizations. It's great that social work is being proven successful by evidenced based research!

Sara said...

Original post

I found the article about Mental Health Courts in Virginia to be interesting. As I was reading the article I began to wonder why we don’t have more mental health courts like this. According to the article there are only about 180 in the nation. It seems as if they are reducing the number of non-violent mentally ill persons who are incarcerated and putting them in the care of professionals who know how to help them. This is also creating more jobs for social workers and utilizing more resources, instead of wasting what is already limited jail space for violent criminals. I also started thinking about a long term study on mental health courts. According to this article, the mental health court setting seems to be working in Virginia, but a long term research study with many mental health systems involved may prove more effective. The study mentioned in the article was four years old. Maybe more studies on mental health courts and longer studies could show how effective they are and therefore more mental health courts could be utilized in all states.

Sara S. (Tuscaloosa)

chadknight said...

I think that programs like the one in Norfolk show that progress is being made in the field of criminal justice. It has taken way to long for us to realize that locking up nonviolent offenders really doesn't solve the problem. Finally, some changes are being made. There are some similar programs in the works locally. Calhoun County has a drug court, which seems to be based on the same premise as the mental health court in Virginia. The court provides services to the offender and monitors progress while keeping the person out of jail. Calhoun County's Sheriff's Department has also recently hired a mental health officer who is a licenced counselor. I'm not sure about the specifics of this position, but it is a step in the right direction. Also, this article shows, again, that evaluation research is important in showing cost-effectiveness, which is often the bottom line when starting new programs such as these.

chadknight said...

I agree with what Robin said about an inmate's condition only worsening while in jail. Without any mental health treatment, the incarceration is only a waste of time and money and does a disservice to both society and the person being incarcerated.

Anonymous said...

ODU study touts success of Norfolk's mental health courts
There is article after article on the net about large municipalities being caught dumping mentally ill and homeless, especially mentally ill individuals who self medicate, clients into the city streets once local assistance programs have reached their limits. Therefore, it is refreshing to see a municipality that has created a preventive program, which assist individuals with Mental illness needs. The article mentioned that, there was a recidivism rate, which ranged from 3.5 percent for those who had been out of the program for six months to 30 percent for those who had been done for two years. However, there was a 70 percent recidivism rate for those who did not participate in Mental Health court program. Therefore, within a two-year period 70 percent of individual with mental illness had learned to sufficiently maintain their illness or were aware of service needed to stabilize their disease, which did not include services from the criminal justice system, which saved Norfolk, Virginia 1.63 million in criminal justices services. We need these programs in Alabama.
COMMENTS FROM RA MONTGOMERY


Destinc:
I agree that individuals with mental illness needs should receive preventative health care by having their cases reviewed in a Mental Health court. This is a concept that is long overdue. Mental Illness is exactly how it sounds an illness or disease. It is about time that this disease with it's multitude of signs and symptoms be treated with preventative measures like any other disease or illness

ojwashington
I agree with everything you said. I think this would be a very effective program for Alabama, and an opportunity to go a step further by providing follow up to those consumers who may need a little more than a year to stabilize their issues.
RA.MONTGOMERY

R.A.Montgomery said...

ODU study touts success of Norfolk's mental health courts
There is article after article on the net about large municipalities being caught dumping mentally ill and homeless, especially mentally ill individuals who self medicate, clients into the city streets once local assistance programs have reached their limits. Therefore, it is refreshing to see a municipality that has created a preventive program, which assist individuals with Mental illness needs. The article mentioned that, there was a recidivism rate, which ranged from 3.5 percent for those who had been out of the program for six months to 30 percent for those who had been done for two years. However, there was a 70 percent recidivism rate for those who did not participate in Mental Health court program. Therefore, within a two-year period 70 percent of individual with mental illness had learned to sufficiently maintain their illness or were aware of service needed to stabilize their disease, which did not include services from the criminal justice system, which saved Norfolk, Virginia 1.63 million in criminal justices services. We need these programs in Alabama.
COMMENTS FROM RA MONTGOMERY


Destinc:
I agree that individuals with mental illness needs should receive preventative health care by having their cases reviewed in a Mental Health court. This is a concept that is long overdue. Mental Illness is exactly how it sounds an illness or disease. It is about time that this disease with it's multitude of signs and symptoms be treated with preventative measures like any other disease or illness

ojwashington
I agree with everything you said. I think this would be a very effective program for Alabama, and an opportunity to go a step further by providing follow up to those consumers who may need a little more than a year to stabilize their issues.
RA.MONTGOMERY

amanda said...

I was so excited to read about this program. I worked with a program very similar to this one for juveniles. Until recently, the kids I worked with had been in a DYS (Department of Youth Services) facility and were returning home. Each client had an Axis I diagnosis. The program was expanded to include first time offenders in order to keep them from entering the juvenile system any further. The children were between the ages of 12 and 17. They had to go to court every two weeks so that any problems could be dealt with immediately instead of waiting the typical 30, 60, or 90 days between court reviews. We used graduated sanctions including: essays, sentences, detention stints, EM lock down, community service. Each child had a case manager, JPO, therapist and psychiatrist. I had concerns for the children who would need to continue to follow up with psychiatric services after they turned 18. I could only work with them until they turned 18. It was difficult to get services unless they had a serious mental illness. So, I am excited to see at least one state taking initiative to help mentally ill people as adults. Especially since this program is so similar to the one that I work and we have data proving that the program is effective. I can only hope that more states take notice and fall in line.
Amanda H

amanda said...

I agree with Stephanie on the fact that this will help keep the parents at home with their children, if they have any. We know that it is better for children to be with parents. Even those in the program that do not have children, they will be able to perform normal everyday activities and have the opportunity to receive services that they need.
Amanda H

david said...

As I was reading the article, I was excited to see positive outcomes. The approach that the Virginia mental health courts are using is unconventional but effective. Working with people is and interesting and challenging task and sometimes it takes that thinking “outside of the box” perspective to reach persons in need. The article stated that the state of Virginia recorded a savings of $1.63 million dollars in jail cost alone, not to mention the improved behaviors of the mentally ill offenders. At the end of the day, people are looking for results and that sounds like a fairly good starting point. Good job state of Virginia.
David L Tuscaloosa

david said...

Angel, I fully agree with your reaction to the article. I think the state of Alabama should implement different programs with the intent to make positive change. Personally, I feel like we are living in historical times and a time for change. How can society and helping professional do more to find solutions instead of always presenting the problems in society? Effective change does not magical happening one day, but it takes educated, devoted persons such as us to influence the process.
David L. Tuscaloosa

Anonymous said...

Wow! I'm impressed. We could learn something from the approach used in the mental health court in Virginia. The participants apprear to be pleased with their progress, fairness, and the accountability, which motivates them want to do better, and the positive attitude of the judge.

I agree with a comment made regarding a polit program in our state; it would be a wise financial choice in terms of cost related with jail expenses and a worthwhile investment in mental health wellness.

LDW

Kim B. said...

Very Cool program I think that more states need to have mental health courts like Virginia. I have worked with many mentally challenged individuals and have seen them enter in and out of jail. The majority of the clients I have served have limited family or professional support, so a program like the one in Virginia would and is needed.

Kristie said...

I think community corrections is the way to go for those who are mentally ill or are substance abusers. Developing a task force of social workers, probation officers, and other professionals to assisst those who have mental illness or substance abuse problems is way more effective (and cheaper) than sending them back through the judicial system and back to jail or prison. Kristie R.

Amy H. said...

I think this was a good article to read and it discussed a topic that needs to be adddressed in our own state. There are so many substance abusers with mental health issues who are caught up in the prison system. There are limited resources for them and limited treatment options for them. The prison system continues to be over crowded and very few good ideas are being discussed on how to solve the problems.

Amy H. said...

In response to Scarlett Holt:
I also think Virginia is on to something good and agree that the approach and attitude that a judge has towards the cases they are seeing can also depend on how well a program works. It would be good to address the mental health problems at hand instead of allowing them to go untreated.

Sara said...

In response to: Angela P.

I think Angela had a great idea about using a pilot study in Alabama. We have such a problem with overcrowding in prison and people with mental health diagnosis are not getting the help they need in that setting. If they are properly diagnosed through the mental health court system then they could be placed in the correct facility and get the help they need. A pilot study would be a great tool to help the state see if the mental health court system was working. If it works then it could be implemented in more states.

Sara S. (Tuscaloosa)

Karen P said...

Response to Stacey:

The article reference to: “the work is on their part; we just set up the structure and they do all the work”, absolutely speak volumes because I think most offenders (definitely not all), mentally ill or not, desire to take responsibility back for their life. However, they don’t know how or where to start and can’t seem to get the direction needed to begin again. A little structure, oversight, compassion, trust, and accountability can go a long way. This program is evidence.

Karen P. (Gadsden)

Tysie Baker said...

The study on Mental Health Court conducted by Old Dominion University has proven very effective. Some of the major ways the program has succeeded is because the recidivism rate has decreased and people with mental illness are not being placed in jail for 6 months for trespassing. Also, this program seems to help people with mental illnesses because they are not placed in jails that end up costing the states millions of dollars. This program is a true success.

Tysie Baker

Gina Smith said...

This was an interesting article and from the contents it appears that this is a successful program. It would be interesting to see what benefits and results would occur if this idea was extended to the juvenile courts and reach out to children that are already showing signs of varying types of mental illness. Many of the adolescents and teenagers that I have worked with are also involved with the court system and with mental health. I have seen our local juvenile judge become frustrated because juveniles with low IQ's, bad school performance, involvment with the local mental health center, etc., come before him and do not appear to understand what they have done or what he is requiring them to do. If there were ways to reach out to these children before they reach adulthood and end up in situations that necessitate the need for prisons, the overall benefits to society could only increase.

Gina S.

Gina Smith said...

In response to Karen P. I would like to say that I agree that people should be allowed to take responsibility for their life. In doing so, those are now involved with that life should offer guidance and understanding, but should also hold those individuals accountable for their decisions. No matter how old or young, or what race or gender, or whether you are rich or poor or somewhere in between, everyone needs to recognize that they are accountable for their decisions and their actions. As an employee of the State of Alabama, I am accountable for my work performance. As a wife, I am accountable to my husband and as a mother, I am accountable to my children. But, on the bigger picture, I am accountable to society to be a law abiding citizen, with compassion for my fellow man/woman, and a sense of duty to leave this world a better place for generations to come.

Gina S.

Karen P said...

RESENDING MY ORIGINAL POST:

My first thought after reading the article for "Evaluation of a Mental Health Court" was: “Why are there just 180 mental health courts in the United States?" I must be honest, I have never heard of a Mental Health Court, but I would have thought the concept would be more attractive and accepted by other cities in the United States. Nationally, with the overcrowding of our prison systems and high recidivism rates, it seems logical that more programs such as these would be in place. However, I am sure funding and resources would appear at the top of the list of contributing factors as to why such programs are not in place.

An additional thought I had while reading this article was about the undiagnosed mentally ill individuals within the criminal system that could benefit from such programs, but instead just become repeat offenders or worse, a statistic to some other tragic incident. While I understood this article to be related to more of a stabilization program for diagnosed mentally ill offenders, I wonder if there is some type of assessment component within this criminal justice system for those that our undiagnosed and could benefit from such a program. I am unfortunately reminded of several former classmates, friends, family, etc. that become part of the criminal justice system and even after release, and supposed rehabilitation, remain mentally incarcerated. I would be interested to learn more about similar programs as these in other cities and how the programs operate.

Karen P. (Gadsden)

Ariel said...

I am appalled at how hard social workers must work to keep their jobs within the school system. Yes it is impotant to evaluate the programs but I do not neccesarily think that it is fair that they must do this to meet all of the stakeholders needs.
Ariel C

Ariel said...

RE: Angel

Although it is true that mentally ill patients need structure, understanding, and help, some refuse to continue seek and continue treatment. I believe that they are the ones who indeed should be behind bars whether they have a mental illness or not.
Ariel C.

Taylor said...

I found this article to very interesting. Prior to reading it, I honestly had never heard of a mental health court. But now I can see how one would be an effective alternative to incarcerating non-violent mentally ill criminals. Ron Honberg’s comment in the article was especially insightful on the matter, stating “A lot of the individuals served in mental health courts end up in the criminal justice system because they didn’t get the services they needed.” I think developing more programs like these across the United States would really help America’s mentally ill population stay out of jail.

Taylor said...

I agree with R.A Montgomery's comment about the recidivism rate. A reduced recidivism rate is always a good indication of a program's success. It seems almost funny to me that a program, with such positive results, was not developed earlier. Nevertheless, I am glad the United States is finally taking an initiative to address the needs of the mentally ill.

bekkah_s said...

I am very interested in the concept of mental health courts. I agree with previous comments regarding the more commonly known way of addressing this population by warehousing and increasing accountability by structured support system.

One comment made in the article pertained to the amount of money saved. From a purely financial standpoint, I am interested to know how much the program cost in relation to the savings. My experience has been that for outcomes to be the most successful, there is usually a great deal of cost involved not soley with money, but also time and resources. The manpower to administer and execute a program like this sounds like it would take massive efforts. Although I see how it could work and has been working in other states, my concern for the state of Alabama taking on an project such as this one is the money issue. A great deal of funding would have to be put forth and return may not come as soon as the state could handle. Strong advocacy work will be key to achieving a program such as this in this state.

Another factor for this program that I would have liked to know more about is the average time that it takes for one to complete the program. I read the portion of the article about the receidivism rates. However, how does one determine how long a client needs supervision? Is it based on the degree of their mental illness?

One additional thing that I would add to the program would be, that if incarceration had to be utilized, to combine their sentence with community service. Most people, in general, benefit from knowing that they are needed and have a job to do. This opportunity might open up doors for employment or continued volunteer service in their neighborhoods.

I think that this topic was very relevant to today's social challenges with the mentally ill. Thanks for posting this info!

Rebekkah Smith (Tuscaloosa)

bekkah_s said...

I am interested by Amanda H.'s comment regarding her work with juveniles. I love the collaborative method for dealing with this population. I whole heartedly subscribe to the "village" concept for raising children and adolescents. But, I don't know why we should have to end it there. People in general need each other to make it in this world. Vulnerable populations such as the mentally ill need advocates even more so.

Unfortunately, prevention is scarcely utilized. Social workers are called after the fact and sometimes have to "band aid" their way through treatment due to money, time, or other reasons. It is a breath of fresh air to know that there is prevention work being done at the juvenile level as this crucial time period is when many problems begin for our clients.

Also, I really like the variety of interventions that Amanda described used in the juvenile court system. The same thing does not work for each person. It is important for us as social workers to have our bag of tricks, plus some, ready when dealing with our unique clients.

Anonymous said...

This is a great idea and it seems like a trend that catching on. Hopefully the state of Alabama will be forward thinking enough to embrace this necessary intervention. I agree that jail is not the answer in treating this population. It certainly does not help the client, the jails, or the community. When a mental health client is incarcerated, it is a crapshoot at best whether or not they will receive their psych meds. Of course their symptoms will become worse. We also know that with each relapse, they never quite return to the level of functioning prior to relapse. It makes sense to place them where they can get the treatment they need and hopefully prevent relapse.
I would be interested in how severe the mental illness is of the population they are working with in their court. I believe the mental health courts will probably be most successful with bipolar, personality disorders and antisocial traits where their behaviors/acting out are getting them into trouble. Also for the person that is self-medicating to cope with symptoms, it gives them viable Tx options. It seems a person with a Schizophrenia diagnosis, drug and alcohol problems and are used to living on the “streets” is probably the greatest challenging combination. Many times they are so disorganized and paranoid even at baseline. Sometimes they don’t really stay in one place very long. This makes it very difficult to track them down for home visits and if they are not compliant, the officer must have an address before they can pick them up.
Matt G. (gadsden)

Anonymous said...

In response to JEFN
I have heard that there is a mental health court somewhere in Birmingham. I have heard that there is one in the works for Calhoun County. A mental health liaison (not the mental health officer that works for the Sheriffs Department.) was recently hired to coordinate relations between the state hospitals, jails, and local psychiatric units. This helps coordinate placement for these people in the community. The courts are starting to refer people for court-mandated treatment at local mental health clinics. So far, this seems to be working well. It is not a full blown “mental health court”, but it is probably not too far down the road. The liaison receives reports from the therapist about attendance in the program, progress, and med compliance and then takes that information and makes it available to the judge and court referral officers.
Matt g. (gadsden)

Tysie Baker said...

I must agree with Tiffiney Brittingham because our prison systems are very crowded. People are piling up on top each other, and, although crimes were committed by them, they are still human. I am very happy to have read this article and any program that can help the crowded prison system is wonderful. To my belief people who have mental disorders should not be in the prison system anyway. My question, do they really know right from wrong in the first place?

TIF.V said...

This is a great program and it is great to see the courts taking initiative to go above and beyond. My concern with these types of programs is when the program ends what does the consumer do? I know that we hope that they take something from their trainings and change their lives; but what about those consumers who don't? These are still the same people who will be in and out of the system for the rest of their lives. Do we keep giving them the same services or do we keep coming up with new ones?

TIF.V said...

In response to Matt,
I also think that it is important that the severity of these clients illness be taken into account, because you cannot treat two people with the same services. I think that these types of programs are suitable for people with mild symptoms and that can function on their own.

Anonymous said...

I feel there are many different ways to reach success with a mentally ill person. Finding a direction to make a positive different is defiantly a challenge. It is exciting to hear Norfolk celebrate their accomplishments. Although this technique may not be the answer for every court, it gives hope. joann

Anonymous said...

(Response from Angel P’s post) A pilot program in Alabama is a wonderful idea. Having the ability to save money and provide assistance for the mentally ill are two great reasons to expand on the Norfolk’s ideas. joann

Linda B said...

In response to Kristie R's comment, I agree that Community Corrections is a great way to deal with mental health/drug offenders. Albertville has a Community Corrections program that allows the minor offender to work and pay off fines while being incarcerated, while also providing part of their pay to the court system. I feel that this is a good concept, to make individuals accountable, and to also give them a means of re-entering society with a balanced check-book.

nikkig said...

LOL, I had the exact same response as Angel P. Finally someone has realized that jail is not the key for the mentally ill, but that case management by qualified social workers in collaboration with POs is.
Shelby County is attempting to move to a similar model, but I think they should certainly examine what Virginia has done to ensure that they are helping, not enabling the mentally ill. Excellent program!

nikkig said...

In response to Donna A., isn't it wonderful what can happen when you're able to keep our clients out of jail, but in placements that directly address their needs? I had a client who was headed to jail, and we had to FIGHT with his PO to make him understand that in-home intervention with his entire family system was well worth giving a try. After our services, he is getting ready to graduate high school, and head to college, and his parents were able to keep their sanity.

nikkig said...

In response to Donna A., isn't it wonderful what can happen when you're able to keep our clients out of jail, but in placements that directly address their needs? I had a client who was headed to jail, and we had to FIGHT with his PO to make him understand that in-home intervention with his entire family system was well worth giving a try. After our services, he is getting ready to graduate high school, and head to college, and his parents were able to keep their sanity.

STACY C said...

Jails are not suited to be helpful for the mentally ill. Many times it only makes their problems and difficulties worse. I agree that jails are overcrowded as it is and I like the idea of intervening in the lives of those that need help instead of just encarcerating them.
STACY C

Stacy C said...

I also agree with jefN that throwing drug-offenders in jail is not and has never really been helpfull. Once in jail these individuals do not receive the proper help for their drup addictions and once they get out they are usually right back at it and with better connections than before due to meeting other users in jail. It is really a vicious cycle. STACY C

Debbie Walker said...

Tuscaloosa desperately needs a mental health court like Norfolk has. ODU’s study of Norfolk’s mental health courts identified improved outcomes for inmates who have mental illness. It would be awesome to have a program with support interventions to link these folks up with immediately upon admission to the court system.

Debbie Walker said...

I agree with Angel we do need mental health courts in AL. UAB does sponsor a mental health court that is located in Bessemer. The team that works with this court is awesome and there have been positive outcomes for consumers because of the case management and therapy interventions upon admission to the court system.