Revolving door slows; Treating the mentally ill

District judge is at forefront of drive to keep mentally ill out of prison with mental health courts
Andrea Heisinger Sunday, February 11, 2007

OROFINO -- The court that meets weekly in rural Clearwater County has the usual criminals and a judge.

What sets this group apart is the criminals are mentally ill and the judge is trying to keep them out of jail, a place he says they don't belong.

Second District Judge John Bradbury takes his seat on the bench each week to give praise, stern advice or sanctions to the 12 people participating in the court. They range in age from 24 to 38 years old.

The court is the first of its kind in a rural Idaho county, and Bradbury wishes there were more.

It's another successful week for one of the people before the court and everyone claps as he approaches the bench to get his reward -- a candy bar.

The court is about a year old. A second in the region started in Nez Perce County last month, but without additional funds more rural courts aren't expected in the near future. (See related story).

Bradbury counts his court in Clearwater County as a success, so far, mostly because it's in such a sparsely populated area.

"I wanted it to be where the problems were and there was a lot of community support," he says.

"Here they have their support groups and their families. The idea is to get the mental health court where the people are."

The court came about in part from the judge's frustration with continually criminalizing the mentally ill and putting them in a jail cell instead of providing needed medication or treatment. The participants have mental illnesses like schizophrenia, depression, post-traumatic stress, or are bipolar.

As an example, Bradbury references the first person to be in mental health court, a young man with short-cropped hair.

During this court session he tells Bradbury he's not having a good week. He's being falsely accused of having contact with underage girls, he says. At Bradbury's request the man will later submit to a lie-detector test.

The first time he came to court, this now self-assured young man was a different person, Bradbury says, ridden with the effects of his schizophrenia.

"He couldn't even talk when he came in," Bradbury says. "He just cried."

Several months later the man is doing well and has a job. This only backs up Bradbury's claims.

"One reason I'm so pleased is I've seen such dramatic results," he says. "Often the choice is nothing or prison."

A couple of hours before court there is a gathering of minds in the jury room. The 15 or so people who assemble here are the treatment team that decides if participants should be commended or punished.

Mental health court is a privilege, and depending on the severity of someone's mistake, they could be sent to jail. This is the risk participants take by pleading guilty to charges in order to go through the alternative court system.

Joining Bradbury in the room are a probation and parole officer, vocational rehabilitation worker, sheriff's deputy, deputy prosecutor, counselors and Department of Health and Welfare Assertive Community Team members.

They go through file after file, and while some of the offenders will later receive a certificate of praise and a handshake from Bradbury, not everyone has been good.

They come to a file where the man has had previous violations, and has relapsed in marijuana use despite previous sanctions.

"It's not working," says Mark Lacock, a probation and parole officer with the Idaho Department of Correction.

"I think we need to back off of using jail," Clearwater County Deputy Prosecutor Lori Gilmore says in response.

They also talk about pushing the person back a phase in the program.

"He's not interested in this program, he's interested in avoiding consequences," Lacock says.

In the end they decide on a punishment: 12 days in jail, demotion to Phase 2 and giving a presentation to the court about why he committed the infraction.

There are four phases in mental health court, the final one being a probation period that lasts about six months. The minimum time anyone spends in mental health court is 18 months and no one has graduated yet.

There is a discussion spurred by Bradbury, who voices his frustrations about a lack of transitional housing. Such housing provides a somewhat supervised environment for offenders until they are ready to live on their own.

Many in the court system also don't have transportation or a driver's license, which makes it difficult for those who live outside of town to get to appointments or jobs.

"We've got to do something about housing in Orofino," Bradbury says.

The treatment team then discusses two possible new candidates for the court.

One has a long criminal history and some dealings with the Clearwater County Sheriff's Office.

"For me, he's too dangerous for mental health court," says Chief Deputy Chris Goetz.

"Short of sending him to prison, I don't know what else to do with this guy," Lacock adds.

In the end the man is given a chance to enter mental health court, as is a woman just released from State Hospital North.

The court in Clearwater County is Bradbury's baby, and he fought for it to be born.

He calls state Sen. Joe Stegner, R-Lewiston, "a real hero in this battle" and gets animated as he talks about his dealings with the state Department of Health and Welfare.

"We had 13 reasons given to us why an ACT (Assertive Community Team) won't work," he says.

"I had a knock-down, drag-out fight with health and welfare. I thought we were through criminalizing (the mentally ill) a long time ago."

Bradbury won the fight. He says the court in Nez Perce County came about because of the success of Clearwater County.

He also oversees drug court, but says mental health court gives him a lot more early gratification.

"We get people on meds and often get dramatic, quick results," he says.

It costs about $6,000 to $7,000 per year for a person to go through mental health court, Bradbury says. This compares to his estimate of $26,000 to $27,000 for someone in prison.

He brushes aside the notion of a cap on the number of participants in the court, saying if someone needs help they'll find more funding.

The sanctions given to people in court range from writing a paper and doing community service to jail time with or without work release.

And the rewards are just as important.

"Punishment doesn't work for its own sake but rewards do," Bradbury says. "If they're sanctioned for what they do wrong right away it works. The candy bars are really important to them. For some of them, this is the first time they've gotten a pat on the back in their lives."

The next thing he would like to see accomplished is an extra ACT team person who would go to outlying areas.

He says hospitals are willing to help the mental health court because they're sick of the mentally ill constantly in their emergency rooms.

Lisa Billings, the court's coordinator for the 2nd Judicial District, says the difference with the clients is they're up against some big obstacles. It's often their mental health history that gets them in the court system.

"A lot of them are charged with eluding an officer, because they might be hearing voices telling them to run," Billings says. "They have committed a crime but don't have criminal types of behaviors."

Billings also has seen a good chunk of those in mental health court doing well.

"The success rate is about 40 percent," she says. "It's really high and shows that this works."

Originally published by the Lewiston Tribune