Research Adm inistrative Office of the Courts Interest: II is e~t1mated that 11% oi all male Inmates in Georgia'~ State Prison System are ment,1lly ill.' Approximately 4 I% oi participants in the Dougherty County Menial Health/ Suh,t,mn; Abuse Court Program did not relllrn to jail after enrolling 1n the program. There are nirrently more than 125 mental health court, (MHC,l in operation across the United States. About 37% of the MHC', 111 the cou ntry are located in the II is estimilted that .!5'?,, of AIHC') are foe ,1ted in rural m111ow11i1ie) similar en Doug/Jeri) Count). Between IO ,1ncl 16 percent 0 1 person, booked into j,1il in the U1111ed St.lie~ have a mental health problem. The cost to hou,e a prisoner in a loc,11 Jail c-.in range from thirt>' lCJ iiny dollar,, 11 not more, depemling on the jurisdiction. Such co,t, do not inl lude presuiption medic.1- Information, contact: Yo landa Lewis Senior Research A,,oc. 404-656-64 l 2 lewisy@gaaoc. u~ DOUGHERTY COUNTY MENTAL HEALTH COURT: A Learning Site for the Future In the development of programs that push 2004 - Norcross Police arrest a 19 year old 111n11 a11d the boundaries of traditional justice has come c/carge /ci111 wil/c disorderly comillc/ for stnndi11g ile the birth of mental health courts (MHCs ). t/ce middle ofn local Jciglcwny and I/crowing rocks at Although recent in their conception, such pro- passing cars. Tltc 111nn was diag11osed wit/c n bipolar grams have quickly proven to be one of the disorder a11d scleizop/11-e,,in. The offender'sfailure lo most viable res ponses to assisting citizens with take leis prescribed 1111:dications leads to leis nrresl n11d mental health concerns facing subsequent involvc111e11I i11 tlce justice sentencing by the court. ,,,..,,,------- syste111i. Ml-IC programs are rapidly expanding as a gateway to more equitable justice, and their vi tality has been illustra ted across the country, and 2005- A 30 year old 111n11 i11 Albn11y, Georgia is arrestedfor walking i11 flee street naked. As officers trn11sport tlw defendant lo jail, he kick;, 011/ a wi11- he re in Georgia. Consider the following cases: dow aud leaps from the patrol car. Tice 111n11, a sclcizoplcre11ic, 11eglecled lo take :;.ii!!!~~"I leis 111edicntio11 prior to flee i11cide11t 2003 - A 41 year old Mariella med leis arrest'. 111a11 wit/, 111m1ic depressio11 storms i11to a family di11- 1ecr naked, waves hvo butclcer k11ives, stalis hvo rela- Each of the cases mentioned has a s imila r ti'ves, onefatally, med is co11victed of 11111nter. Tice underly ing theme: failure to maintain an appro- assniln11/ Jailed to take leis prescribed medirntion med priate medication regime. While the lack of instead took n volatile 111ixt11re of111nrij11min and medicatio n may be o nly o ne of multiple factors, cocni11e. Tice man, prior to tlcis incident, lend n Jcisto- il is clear Lhat without the monitoring a nd possi- ry ofsimilar attacks w/cere clcnrges had bee11 dis- bly the leverage of the court to implement sanc- missed'. tions; offenders pose a n increased probability of committing a crime a nd entering the judicial system. At First Glance: Program Overview The Dougherty County Mental Health / Subs tance Abuse Court Treatment Program is one of more than 125 programs across the country. As a collaborative entity, the court operates by worki ng with a host o r local social service programs and the Albany Area Community Service Board. The program ta rgets adult offenders facing felony charges a nd detem, ines eligible candida tes through an estab- lished selection and evaluation criteria. Structurally, the court operates with a dedicated judge, a group of trained mental health practitioners, and professio nal probation staff. The court administers a Substance Abuse component, Drug Court, which provides treatment to clients with substance abuse issues. This program aspect is importan t as some offenders with mental health conditions may a lso engage in the use of illegal narcotics. Mental health courts are modeled after effective drug court programs. The Dougherty County Superior Court program has been chosen as a learning s ite and will act as a planning and implementation model for othe r jurisdictions across the country interested in creating a MHC. Thi m_fonnat1m1 n111ti1m6l UI ll1f.. rr,,-1r1 lll'l'llL~ --]k'L1fiu1lly to the 1l111" <1lh'L'lt'1I to wmkt, lllr! 11ilot +mnlyM:-. Tilt ll"Sttlt-s ufllri"i :;tt,dy slrould uot b.,i.:rrrrrol1z,.f It 1rll j11ri~lirtl1m5, a.. ii 1..w1sl11utr.1- 1l1i- ff',Jjlts 1.f~l"tcifir ol~roatm11.; fnr 011' ('1/lrl< ec./n tr,1, F.i1t7Y n1Jrm11t /tit!: lwn ,11arl, tv l'mmu ll1t utfomintlcm L~ pl'tSeuttd ,,1,,.-,11rYl&1, 011m1m1, pn-v,1l.-d arr tJu,q "/ll1r l<,"'t'ard, S.:Ylrim aml d,1 m,t nm;;:tJtuh 1hr o{firwl 1tv.--iti1111 if tfo. Atlrrrioi,tmthit O,fficr u/llrt' C:mrl'!- tl1r /ur1irir1I Couuril vr ,my ,pr~1fii.- wurl. Page 2 ~--- ---------------History of the Court The Dougherty County Mental Shortly after the meeting, training for Health /Substance Abuse Treahnent public safety officers was provided. Program commenced in 2002. Vision for the However, concerns confronting the court program materialized one year prior when would take several small focus group meet- Judge Goss, the Presiding Judge, convened a ings to identify and to develop a viable meeting of about 50 to 60 judges and stake- approach to service options. The end resu lt holders from the criminal justice, mental of this prolonged coordination is a well con- health, and legal arena. Discussion centered structed program that performs a true bal- on the increasing number of "revolving door ancing act by ensuring that the judicial sys- type cases" appearing before the court for tem is responsive and the MHC plays an persons exhibiting mental illness. This sum- active role in public safety while also mon of professionals identified two major addressing the mental health concerns of concerns: (1) /he 11eed for ndditio11nl trni11illg each party involved. The program has not for public snfety perso1111el nnd (2) tire 11eed to only had an immediate impact on the local systemnticnlly nddress such cnses in tire local court caseload, but the community as a court system. whole. -------------------------~ I Court Administration The program consists of a presiding judge, two assistant district attorneys, two assistant public defenders, three probation officers, a program coordinator, and two case managers. The staff is collectively tasked with determining eligible candidates for treatment and monitoring in one of three separate tracks that include: mental health, substance abuse, and co-occurring disord ers. The mental health track is utilized for participants exhibiting psychiatric disabilities as a primary symptom, while the addiction track focuses on drug offenders with less severe mental health concerns. Participants selected for the third track receive blended treatment for co-occurring disorders. Addressing sud, disorders is of critical importance for most clients. As Judge Goss states, " ... with the volatile mixture of alcohol and drugs; the patient's mental state decompensates". Such actions may result in the person becoming combative and arrests are often made for the safety of the person and the com- munity. Once in ., the program, case managers develop specific treatment programs based People with mental illnesses are significantly overrepresented among the segment ofour population in contad with the criminal on individual justice system. Tl,e lack needs, while of treatment may lead to being mindful of a continuous cycle of the basic 12-step structure utilized with traditional drug courts. involvements in Georgia courts. - Jane H. Martin J L Assistant Director The target population for the program is that of felony offenders primarily in the post adjudication phase. The program utilizes trained probation professionals to monitor the participants either i.n local treatment or residential programs. To ensure that participants are assigned the most appropriate treatment path, the Program Coordinator Ms. Queen Hall, a reg istered nurse and licensed counselor, reviews ead1 case extensively. (M enial Heahh Condi1ions Only) ~ 6L% ,.o,l 3~ Reference Point Impact on the Community The Mental Health Court is a welcomed addition to the local community. The program has received support from a multitude of local agencies who believe that the court's existence will have a lasting impact across the state. Highly regarded in Georgia and nationally, the program serves a beacon of hope for many citizens a nd practitioners. Kenneth Brandon of the Division of Mental Health Developmental Disabilities and Addictive Diseases states, "The program has been very effective in reducing the population of consumers with mental i.Unesses and addictive diseases [being] incarcerated in the Dougherty County jail, and diverting consumers from being admitted to the State Hospital System". The court expects future studies of the program to reveal a cost savings for the county and citizens based on the decreased number of jail stays for clients. Issu e 3 Preliminary Program Results Page 3 Preliminary res ults of a gram the probationers 27 month, vertical study averaged 12.4 days per conducted by the court month in jail, whereas reveal that the program the same group aver- has a promising s tart. aged a little over 1.8 From Decembe r 2002 to 11 days per mo nth after Mard1 2005, the prog ram treated approxi- MHC enrollment. (SA) Approximately 63 per- mately 50 participants. The study looked at participants in three categories: (1) persons who 0IAGNOSI Dlog nosls Key: SA(Mi IC) rrunory dlognosis of Subston,-c Ab use \\i th M ental I teatth Condition; S,>, Sub,,toncc Abuse Only: MliC Mento! Health Condition; MliC(SA) Primnry diagn osis of Mental Health Condition with Subst.ioCC!' AbuSC" Concern~. cent of the participants in this g roup d id not require any jail time. There were 16 pro have been discharged, participation . The vast majority of the bationers (group 3) (2) persons remaining in the program individuals in this group had no jail remaining in the program exh ibiting with mental health d iagnoses or the co- stays after being enro lled. Six of the substance abuse concerns as the pri- occurrence of s ubs tance a buse, and (3) seven unsuccessfu l probationers were mary condition for treatm ent. In a 17 persons remaining i11 the program with dismissed from the prog ram for re peat- month period prior to the program, 4 of subs tance abuse concerns only. ed subs tance abuse problems. the 16 probationers had setbacks but Approximately 9 of the 16 persons Approximately 12 probationers the number of jail s tays per month discha rged (group 1) had positive (group 2) remained in the program decreased from 8. 1 to 5.3 days. In addi- res ults. l.n the 12 months prior to with mental health concerns. Of this tion, six of the probationers were acceptance in the program, probation- group, 67 percent of the participants extremely successful and required no ers averaged 8.2 days a month in jail. exhibited favorable res ults, while 33 jaiJ s tays from the point of enrollment. However, this total was reduced to 2.9 percent had poor o r mixed res ults. In --- --- - --- ---- ---- --- -------- -- staysduring the12month period of the 14 month period prior to the pro- I I Elements of Success I Administration & Monitoring The Multi-disciplinary Approach Collaborative Networks One of the most important aspects The effective operation of the The court is largely structured to of the court is effectively identifyi ng individuals s uitable for the program. Prog ram d e pends heavily on a multi- adminis ter justice through collaboradisciplinary team approach for treat- tive networks. For this reason, infor- Generally, the court coordinato r man- ment. The court, in itself, is not mation sharing is ages this process and establishes continuity in methods of client selection and refe rral. While the court maintains a som ewhat lig hter caseload defendan t wise, the cases often require extensive management. More importantly the court has leverage in that it is able to establis h terms of participation and enforce compliance to encourage participant success. The program is capable of employing intensive monitoring strategies and equipped to diagnose and treat mentally ill citizens, as its larger res ponsibility lies in dispensing justice. 1-!owever, dis pensing justice is not often an easy task and the need to brLng representatives from multiple professional disciplines to the table is an essential piece in developing the most comprehens ive treatme nt for participants. As a result, the court acts as a central clearinghouse bringing together pro fessionals from the an on-going process. The program works collaboratively w ith superio1~ s tate, and mUJ1icipal court judges across the county and Georgia. Building capacity for service networks also extend to the coun- "We have had dramatic (positive} results with the felons that have a ment,1/ health problem without signifi- cant overlapping substance abuse issues. 11 - Judge Stephen Goss implementing a variety of treatment orders that are case s pecific. As a judicial system, the medical field, and ty jail, legal coun- public safety sector, in addition to a sel, probation offices, and social serv- note, the court carefully screens the hos t of social service and faith-based ice provide rs. Because many clients criminal his tories of probationers and entities to s upport its work. in the program require a diverse spec- may not accept a client if the district attorney's office has concerns about a trum of services beyond treatmen t, s uch as housing, transportation, and client's criminal involvement. basic hfe s kills, these extensive net- Eligibility criteria, multiple points o f works provide the court a broad set of referral, and effective monitoring and compliance are aU components of case management options for participants. effective court administration. ------------------------------- --------------------~-- Summary Note: ' I I The Dougherty County Mental H ealth and Substance Ab use I Program was the first its kind for Superior Courts in Georgia. I The court's has clearl y had a p ositive impact on services fo r I felony offende rs with mental ilJnesses w ho are often left to naviga te the legal and correcti onal system in Dougherty County. I The court ho pes to bring more awareness to the prevalence of I such offenders in the judicial system and embark upon more I intensive research concerning the impact of the program. I Selected as one of only fi ve Learning Sites across the United States by the Bureau of Justice Assistance, the program looks I I forward to providing information to other mental health cou rts - ... -~-- in Georgia and across the country. I -.- Rcftrc11ce Notes 1. The Atlanta Journal-Constitution, October 30, 2004 2. Gwinnett Daily Po~t. April 14, 2004 3. WA LB-TV, January 10, 2005 4. Mental Health Courts Program, Bureau of Justice Assistance, 2005 5. Menta l Health Courts: A National Snap~hot, Council of State Governments, 2005 6. Georgia Department of Corrections website, www.dcor.statc.us.ga "Path to Jail among Mentally Ill Persons: Service Needs and Service O,arnctcristics", Psychiatric Annuals 3 1,7 Quly 2001) Jane H. Martin, Assistant Director for Grants and Performance Outcomes, Administrative Office of the Courts Related Information Dougherty County Superior Court, Mental Health /Substance Abuse Treatment Program, Judge Stephen Goss gossS@ga j udges.org or Ms. Queen Hall QHal l@dougherty.ga.us Bureau of Justice Assistance, www.<>jp.usdc1j.g1iv/HINgranl/mentalhealth.html Council of State Governments, www.consensusprojecl.org/mhcourts National Institute of Mental Health, www.nimh.nih.gov Refere11ce Poi,,t was created as a resource to p11l,/is /1 research ft11di11gs affiliated w ill, court prog,11111s, j udicial projects a11d i11depc11de11t st1111ies preformed by the Researd, Divisio11. Official caseload reports w ill co11ti1111e to be 1mblished i11 "Tl1e Work ofGeorgia's Courts." All q11eslio11s or official re,Jltcsts for i11/orm11tio11 should l,e directed to /lte Atl111i11istrntive Office of tlrn Court's Rcsearclt Divisio11 /Jy plto11c at 404.656.6412 or by email at /\O CUesearc/1Gro11p&g1111oc.11s 1/.lllJiJSiJH JO/ JO/,VJ.1/0 /111115'/SSV ~S a10,v11v a.w9 S,J:J/,LIJS tlllO:J JI>/ JOJ:JiJ.J/O il/11/.J0,\0 \'V llll//.1\' NOSll,IJJ.l'J SIHll:J m,, JO/JilJ/0 ,1::ru.1411 1 \Ia ,1.)JJ.~11( f.1/11:J Slll'HS OHVM 11 11:17 L006-v0 V9 'e1uepv 00 a1,ns ' M-s '1aa11s uo18u,4seM vvc simo:) a q1 ;10 aJ!:1)0 aApe.JlS!LI!LLIPV lU!Od a:,u~ua1a~ Research Administrative Office oi the Courts Reference Point ,' ' Interest: Accountab11ity Couns include Adult/Felony Drug Courts, DUI Court;, Juvenile Drug Courts, Family Dependenry Treatment Couns, and Mental Health Coun~. The objective of an accountability court program i; to promote personal responsibi lity by holding the participant accountable 1or hb/her actiun; and behaviors. There are approximately 11 Accountability Courb in development acro5s the state. Issue J November 2006 ACCOUNTABILITY COURTS IN GEORGIA Existing Programs Adult Felony .,, Juvenile Drug Famfly Drug ...+ DUI Mental Health For More Information on Accountability Courts, contact: W\vw.georg1acourls.org or contact the AOC a t 404-656-5171 Judi,.:-1.QJCi.mah lri bold. h.ulu:i,cJ ',------------ ---------------------~ I Mental Health Courts Currently in Operation \ I I Muscogee County MHC D o ug herty County MHC HaJJ County MHC I DeKal b County MHC I Pres iding Judge John Allen Presiding Judge Ste phe n Goss Presiding Judg e Pres iding Judge I Contact: Ms . Cynthia Pattillo Contact: Ms. Queen Ha ll Kathlene Goss e lin Winston P. Be the l '------------------- -------------- -, I (706.596.5510) I (229.878.3113) Learni ng S ite Contact: Michael Devine (770.531.4950) Contact: Ms. Amy Ratoosh Simoni 404.371.2241 I Page 2 MHC's accept offenders with Axis I diagnosis which include: Bipolar disorder, Schizophrenia, Sc/1izoaffective disorder, and Major depression NOTE: Courts providing supervision for felony offenders do not accept sex offenders, persons charged with murder, and some other l1igh level offenses. To learn more about individual court programs and Mental Health Courts visit: ,,,,,.,v.consensusproject.org ---- -------, Overview of Accountability Courts I Adult Felony Drug Courts: Drug Courts are Juvenile Drug Courts have been arrested for intended to change offender behavior drugs and or alcohol related offenses. The through a team approach for participants length of the program is usually 12 - 24 who have committed non-violent drug relat- months. ed crimes who have no history of drug sales offenses. The leng th of the program is usual- Family Dependency Treatment Courts ly 24 - 30 months. (FDTC): Family Dependency Treatment Court works with adult parents who have DUI Courts: Similar to the Drug Courts, lost custod y o r are in danger of losing cus- DUl Courts a lso work through a team tody of their children du e to abuse of drugs approad, and are geared towards persons or alcoho l. The length of the prog ram is usu- who have had at least 2 DUJ arrests in 5 ally 24 - 30 months. years or 3 DUI arrests in a lifetime. The length of the program is usually 12 - 24 Mental Health Courts: Mental health courts months. are adult criminal courts that have sepa rate dockets dedicated to persons with mental Juvenile Drug Courts: JuveniJe Drug Courts illnesses. These courts di vert criminal defen- focus on the juvenile while at the same time dants from jail into heatment programs, and addressing the needs of the fami ly. Judges, monitor the defendants during treatment district attorneys, public defenders, case and have the abiJity to impose criminal workers, probation officers, heatment sanctions for failure to comply. The length of providers work as a team to change delin- the program is usually 24 - 30 months. quent juvenile behavior. Participants in -------------------------; I QUICK FACTS ABOUT BJA LEARNING SITES.. Washoe County, Nevada Established in 2001 Targets persons with multip le offenses to reduce jail overcrowding and rec.idivism. Routinely su pervise 200 participants. Accepts participants with misdemeanor or low level offe ns e s. Akron (Summit County), Ohio Established in 2001 Targets persons with offense that wa rrant 60 days or more in jail. Routinely supervise 100 pa rticipates. Accepts participant with misdemeanor offenses. Dougherty County, Georgia Established in 2002 Targets recidivist charged with "quality of life offenses" . Routinely supe rvise about 40 participants . Accepts participants with felony o ffenses; operates as a dual mental health and drng court program. (Superior Cou rt Prog ram) Bonneville County, Idaho Established in 2002 Targets person committing serious crimes a nd extensive criminal histories. Routinely supe rvise about 25 pa rticipa nts . Accepts participants with felony o r serious misdemeanor offenses. Bronx County, New York Established in 2001 Targets persons with more se rio us offenses and lengthy criminal records . Routinely supervise about 225 participants. Accepts participants with felony offense. 0ttail.; mrtl iufammtumaljr1d~ co11-ccrnmg i\crountnhility Courb ,n,n,lnMtfrom llw Ailumri