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Mental health courts expand to treat offenders

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Michigan is expanding a system that allows people with a mental illness to be sentenced to treatment rather than serve jail time.

Legislation was recently signed to expand Michigan’s mental health court system after a three-year study proved that the courts are effective.

Recidivism

The State Administrative Corrections Office evaluated 10 mental health courts and found that the rate participants offended again is 300 percent lower than non-participants.

Michigan now has 16 mental health courts, with 11 or 12 funded by the state, said Mark Reinstein, president of the Mental Health Association in Michigan.

Counties with mental health courts include Allegan, Muskegon, Kalamazoo, Wayne, Oakland, Genesee, Montcalm, Grand Traverse, Cheboygan, Jackson, Livingston, Saginaw, St. Claire and Berrien.

Funding for the program in Gov. Rick Snyder’s proposed budget is $5.8 million for 2015, compared to $4.1 million right now.

Mainstreaming

“This expansion is to move courts beyond the experimental phase to something that can be implemented as more mainstream into the state,” said Marcia McBrien, a Michigan Supreme Court spokesperson.

Common offenses that the new system deals with are drug charges, driving under the influence, public intoxication and indecent exposure, McBrien said. A lot of cases involve individuals who are self-medicating with drugs.

Seventy-nine percent of cases involved some type of substance abuse.

“It treats the issue without dragging the person into the justice system and gets them the appropriate care for their illness,” said Angela Minicuci, a Michigan Department of Community Health spokesperson.

Savings

The program is expected to save taxpayers money in the long run, McBrien said.

“For every dollar invested in a mental health participant, you save multiples of that compared to the person being dealt with in a traditional way,” McBrien said. “The cost to house and provide mental services to prisoners is huge.”

Pilot

The program, run by the corrections office and the health department, started in 2008 as a pilot with 10 courts, Minicuci said

Only 14 percent of participants sentenced by them were arrested again.

“Most people in jail to begin with were repeat offenders, and by getting them into treatment and out of crime, it greatly reduced the number of people we saw come back,” Minicuci said.

Macomb County is the latest to join the list of mental health courts and can handle up to 40 nonviolent adult participants at a time. It recently received funding from the state court administrative office.

“Our program has only been in existence for a couple months and was inspired largely by need,” said Lisa Ellis, court administrator for Macomb County. “We were looking for alternatives to incarcerating people with mental health issues, where they were basically set up to fail.”

Participants are sentenced to probation that includes treatment coordinated with the community mental health department. They undergo drug testing and criminal record checks.

Regulation

The expansion came with more statewide regulations for each court’s operations.

“Up until recently, it has been up to each court,” Reinstein said. “We wish the state would have waited a little longer to pass statewide laws, so that every local community starting a court had the flexibility to run it how they want.”

Under the new laws, a guilty plea has to be entered, and if someone successfully completes the program and has never gone through it before, the guilty plea can get discharged, he said. This is only guaranteed once.

“I don’t think we should give them a pass, because they are still violating the law, so there should be a one-time opportunity to use the mental health court and get the help that they need, before they go back into the correctional facilities,” said Rep. Thomas Hooker, R-Byron Center, who serves on the Health Policy committee.

Sentencing

Sentencing for the mental health courts includes high- and low-intensity services, Minicuci said.

“High-intensity services are less common and include the individual being hospitalized to ensure that they get treatment that typically lasts 41 days,” Minicuci said. “Low-intensity services are much like probation. The individual is monitored to make sure they are staying on their medications and their prescriptions are being filled.”

Being tried in a mental health court as opposed to a criminal court is the offender’s choice.

“One of the key foundations of mental health courts is that patients should not be forced into it,” Reinstein said. “Hopefully, the courts are making it clear that it is an optional alternative.”

Probation under mental health courts last 18 months, which may be longer than the crime’s jail or probation sentence in a normal court, Reinstein said.

Danger to society

Not everyone is completely sold on the concept.

“I think there are people in the prison system that have done bad things that society still needs protection from, even if they are mentally ill,” said Dr. Dan Carrel, a visiting physician at Corizon Health, a Grand Rapids prison health care provider.

Many prisons have psychiatrists and psychologists to talk to the prisoners, as well as medical and behavioral doctors to deal with mentally ill patients, Carrel said.

Some people believe that mental health courts are a good answer for people who are not dangerous criminals.

Mentally ill

“A third or more of those in the correction system are there because they are mentally ill, but not because they are real criminals,” Hooker said. “They aren’t on the right medications or do not have the tools they need to function in a normal society, so I think a mental health court is a good answer to give them these tools.”

The most common diagnoses found in the program were bipolar disorder (40 percent), depression (29 percent), schizophrenia and other delusions (21 percent) and developmental personality disorders (12 percent), Minicuci said.

“We aren’t benefiting from having someone with a mental illness in jail and paying $35,000-$40,000 per year to house them in a correction system where they are getting no treatment,” Hooker said.

While relatively new to Michigan, health courts have been around in other states for a while.

“Michigan was late to the game even six years ago when the first one or two started,” Reinstein said, “Florida had the first one and now there are over 200 across the country.”

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