Monday 7 February 2011

Program that gets care to mentally ill offenders cuts costs of justice system Read more: Program that gets care to mentally ill offenders cuts costs of justice system

Getting arrested for robbery may have been the best thing that ever happened to Dale Edgin.
Facing a long jail term, Edgin got something else: a diagnosis, medication and treatment — for the first time — for the mental illness that by then had made a mess of his life.
In a rare stroke of luck, Edgin's arrest came just as a newly assembled team of mental health and criminal justice professionals were starting a project that they were calling Mental Health Court.
When they asked him to join, Edgin figured that he had little to lose. "I was homeless. I was desperate. I'd had mental-health issues all my life," he said.
Last month, the 18th Judicial District's Mental Health Court celebrated its first anniversary, trumpeting tens of thousands of dollars in savings to taxpayers, along with a couple dozen success stories like Edgin's.
The program, a collaboration between the staffs at Arapahoe/Douglas Mental Health Network and the 18th Judicial District, diverts the mentally ill away from prison. The goal, those behind it say, is to shut the revolving door that moves the mentally ill in and out of jail or prison but rarely addresses the disease at the root of their crimes.
A chance to commit to treatment under the supervision of a judge is offered to people with serious mental illness who are charged with felonies that don't involve violence or sex crimes. In exchange, they stay out of prison.
In its first year, roughly 30 people participated, which means they plead guilty to a crime, live in secure housing, submit to drug tests, take part in therapy and allow virtually every element of their lives to be scrutinized. Not complying can mean jail.
In most cases, it also means getting off street drugs and staying on court-ordered medications.
Many people with serious mental illnesses have trouble working, have no insurance and receive only spotty health care. Many don't believe they are sick, so they don't think they need medications.
Many get relief from their symptoms through illegal drugs, just as Edgin once did.
"I was addicted to everything. Heroin, cocaine, meth," he said.
Barbara Becker, supervisor of the criminal justice team at Arapahoe/Douglas Mental Health, said nearly everyone had substance abuse problems when they started. "All but two of them. And I question one of those two."
Not everybody completed the program, and several went to jail, if only temporarily. But, court coordinator Gina Shimeall said, none have committed another crime.
Mental Health Court, which is funded through federal, state and private grants, convenes every Friday in a standard courtroom with a bailiff and a black-robed judge in charge.
That's where the similarities to regular court end.
When Magistrate Laura Findorff calls participants, she uses their first names.
From there, the conversations often start with pleasantries. Then each person recites how many sober days they've racked up, which usually generates applause.
On a recent Friday, one woman complimented Findorff on her new haircut.
To one man, the magistrate said, "You're struggling with not smoking, aren't you?"
Participant: "Yes, yes hon, I am."
"Well, we're going to get you some help for that," she said.
Not that judicial weight doesn't get thrown around when necessary.
The first name Findorff called that Friday was a no- show, so she issued a bench warrant for his arrest.
One of the 16 who stood before her was a wiry young man who got a stern lecture on showing respect and following directions, areas he had trouble with the previous week.
Then, she laid out the consequences.
"I want you to write a paper about what boundaries are appropriate with staff and others," she said.
Writing assignments are common, and Findorff assigns a freewheeling mix of topics designed to invite self-examination: One participant had to write about hobbies, another physical exercise.
Findorff had been briefed on what all 16 participants had accomplished, or not, before they came to court.
The court is staffed by a supervisor, therapists, case managers, a probation officer and a nurse, and it gets input from an assistant district attorney who closely watches how each participant is doing.
All that scrutiny doesn't come cheap, of course.
But when expenses are totaled, the program is a money- saver compared with the $20,000 a year it costs to keep someone in prison, Becker said. In Arapahoe County Jail, the basic cost is about $83 a day.
"Even with startup costs, we've been able to save the county jail close to $200,000 and (the state) $400,000," Becker said.
Measuring success may be different for each participant.
Eventually, the goal is to move participants into their own homes and, if they can work, into jobs.
Edgin, for one, plans to stay on his medications as well.
"I love my meds! If I didn't have them, I wouldn't be able to sit here and have a conversation."
A year into treatment, 437 days clean of illegal drugs, Edgin is working and is busy repairing relationships.
His life is better in many ways, he said. "I'd say the biggest change is in how I see things. In my belief system. I have a certain amount of control over what I choose to do."
When it was Edgin's turn at the podium, Findorff nagged him gently to stop eating just Hot Pockets and try cooking once in a while.
Then she congratulated him.
"Whatever you've figured out about how to maintain that sobriety, please share that."
Then everyone in the courtroom stood and applauded.
"That was awesome," Edgin said of the standing ovation. "It was embarrassing."

Karen Auge

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