Tuesday, March 31, 2009

The Growth of Specialty Courts


By Amy Hinton

The most promising national policy trend in alternative corrections has been the emergence of specialty courts. These alternative courts -- such as mental health or drug courts -- route eligible offenders into the appropriate social service delivery system while maintaining accountability and protecting public safety.

More than 150 mental health courts in over 25 states are providing offenders with needed mental health services and supports under close court supervision. Significant cost savings could be generated in Alabama if specialty court models for offenders with mental health and addiction disorders were implemented across the state. Results so far from these specialty courts are extremely promising, particularly in reduced recidivism.

In 2008, the Los Angeles County Jail was essentially the nation’s largest mental institution, housing approximately 1,400 seriously mentally ill inmates. Mental health professionals, consumers and advocates would say that this is not a surprising revelation given the fact that so many mentally ill people end up in the criminal justice system.

The deinstitutionalization movement that began in the 1970s was appropriately focused on moving individuals with mental health disorders out of large institutions and into less restrictive community-based programs. But, the movement that began with the best intentions nearly four decades ago has failed the very mental health consumers it was supposed to serve. Due in large part to more politically expedient priorities, money that was previously directed to large, state-operated psychiatric hospitals was never really dedicated to local mental health centers for treating individuals with mental health needs living in the community. The result is that community mental health programs are almost always chronically underfunded, understaffed and unable to respond in a timely manner to the public demand for mental health services.

It is easy to see how prisons and jails across the United States have become the de facto mental health system for vulnerable individuals, particularly those with undiagnosed and/or untreated mental health conditions who self-medicate with alcohol and drugs. Once incarcerated, however, the mentally ill offender faces additional challenges and obstacles to recovery. The high cost of psychotropic medications means that inmates often do not receive the preferred or most appropriate medications for their particular disorder.

Incarcerated adult offenders with mental health disorders are far more likely to commit suicide or to be victimized by other inmates. Inadequate medical care for mental health disorders often makes these conditions much more difficult and expensive to treat over time.

Correctional officers are not mental health professionals and are poorly equipped to serve inmates with serious mental health needs. Correctional facilities are not therapeutic environments. Nationally, the problem of inmates with mental health needs has reached a crisis stage and is magnifying in both size and scope.

In Alabama, Montgomery County is already working to address these issues with its two specialty courts for adult offenders – a drug court and a mental health court. Our attention now must shift toward juvenile offenders with mental health needs.

To that end, a coalition of parent advocates, juvenile justice officials and mental health and substance abuse treatment professionals in Montgomery County have recently completed a 12-month collaborative strategic planning initiative funded by the U.S. Department of Justice and have produced a blueprint for addressing the mental health needs of local juvenile offenders.

The key element of the strategic plan is the development and implementation of a “co-occurring” juvenile mental health court -- the first of its kind in Alabama -- that would concurrently address the mental health and substance abuse treatment needs of eligible juvenile offenders. Efforts like this provide Alabama with the opportunity to be a national leader in this policy area.

As one of Alabama’s greatest federal jurists, Judge Frank M. Johnson noted in his landmark 1972 Wyatt v. Stickney decision, committing mentally ill individuals to psychiatric institutions without providing treatment is little more than “human warehousing.”

The growing overrepresentation of mental illness and addiction disorders among incarcerated populations is a troubling indication that, as a society, we have merely exchanged one type of human warehouse for another. This is both an inappropriate use of limited resources and an affront to human dignity. Expansion of the specialty court model through collaborative mental health policymaking is the best possible solution to a problem that is not going away anytime soon.
Hinton is a senior consultant with the Auburn University Montgomery Center for Government and Public Affairs specializing in health and human services policy.
Copyright (C) 2009 by the Alabama Forum. 3/09

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