Tuesday, July 20, 2010

HHS-PS Committee Work Session Summary—Monday July 19th

Members of the Public Safety and Health and Human Services Committees met today to continue their discussion of how to better address the needs of mentally ill individuals, who have committed minor offenses, through the possible establishment of a Mental Health Court (a court with a specialized docket for eligible defendants with mental illnesses) or other programs with the goal of decriminalizing mental illness and increasing treatment compliance. The expected outcome from such efforts is to reduce recidivism by treating the underlying root causes of behaviors that bring defendants to court.

BACKGROUND:

The joint Committee last met on the topic in October 2009, when it received presentations from Dr. Fred Osher, from the Council of State Governments Justice Center; Art Wallenstein, Director of the Department of Correction and Rehabilitation; and Uma Ahluwalia, Director of the Department of Health and Human Services. It was noted then that this critical issue was also raised in the 2002 Report from the Blue Ribbon Task Force on Mental Health.

The study (Osher) found that the rate of current serious mental illness (such as major depressive disorder, bipolar disorder, schizophrenia, and psychotic disorder) for male inmates across all five study sites was 14.5% and for females 31%. In the first phase of the study (2002-2003), 18% of male inmates and 28% of female inmates in Montgomery County were found to have serious mental illness. In the second phase of the study (2005-2006) 8% of male inmates and 21% of female inmates were found to have serious mental illness.

PRESENTATION/DISCUSSION SUMMARY:

A. In addition to a presentation on FY10 Clinical Assessment Triage Service (CATS) data highlighting that 22% (1,833 persons) of those arrested were bi-polar and 15% (331 persons) had mental health disorders, two very important questions—in a policy paper by Dr. Raymond Crowe1, Montgomery County’s Chief of Behavioral Health and Crisis Services—framed the discussion between Committee members, mental health advocates and administrators, “Is Montgomery County ready for a mental health court?” and “What can we do short-term to better serve the needs of the justice-involved persons with mental illness?”

B. There were discussions about Dr. Crowel’s suggestion that the Criminal Justice Behavioral Health Initiative (CJBHI) be asked to serve as the collaborative work group to develop recommendations on strategies to support a mental health court or “mini-mental health court” that might use another mechanism, such as placing a case on the stet docket (a docket, maintained by the state’s attorney’s office, in which the court indefinitely postpones trial of a criminal charge), as an incentive to comply with treatment while addressing the court’s concern about additional workload. (The County’s Intervention Program for Substance Abusers (IPSA) places the cases of certain misdemeanor drug offenders on the stet docket while they complete a required program. If they are successful, the case is dropped, if not, the case may move forward. These cases require no special docketing by the District Court.)

C. The primary challenge to the creation of a Montgomery County mental health Court has been insufficient judicial system support. No effort to create a mental health court can succeed without the active participation of district court judges, the state’s attorney, and the public defender’s office. Paul DeWolfe, Jr., Office of the Public Defender, has sent a memorandum to State Public Defenders giving them greater latitude to become involved in specialty courts, including mental health and drug courts. This change may represent an opportunity to build legal system support for a mental health court. Citizens will need to lend their voice to that of advocates to rally support from the Sate and judicial system.

D. In the short-term, a recommended best-practice solution is to conduct a small pilot using existing resources to brief the District court, and implement other court-based initiatives, and include a “stet (inactive court) docket”. With the support of an interested and willing judge, prosecutor, and public defender, and a case manager provided by DHS.

Please review the session packet for more recommendations and details; and contact Saschane Stephenson, Legislative Aide for Health and Human Services, at 240-777-7963 (direct dial) or saschane.stephenson@montgomerycountymd.gov with your questions regarding this HHS-PS Committee session.

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