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Mental health courts connect people to treatment and keep them out of jail. But they also often come at the price of a guilty plea, and participants say that feels like coercion.
A MARTÍNEZ, HOST:
More than 2 million people booked into U.S. jails each year have been diagnosed with a serious mental illness. In recent decades, programs have sprung up across the country to divert people from lockup and connect them to help that could keep them out of jail. They’re called mental health courts. Sam Whitehead with our partner KFF Health News reports the well-intentioned courts can struggle to live up to those goals.
SAM WHITEHEAD, BYLINE: It’s an early December afternoon and Donald Brown (ph) waits nervously for the start of a mental health court hearing in Gainesville, Ga. In just a few minutes, the 55-year-old will find out whether he’s been kicked out of the diversion program for not meeting work and community service mandates and possibly go back to jail.
DONALD BROWN: I’m kind of lost for words. I’m scared to death. I mean, I don’t like jail. So I got a taste of being out. Going back in is just – it’s really hard.
WHITEHEAD: Brown has struggled with depression. Last year, he was threatening to take his life with a gun. His family called 911 for help, the police arrived and Brown was arrested and charged with felony firearm possession. After months in jail, Brown was offered access to the court. If he pleaded guilty, he’d be connected to services and avoid prison time if he completes the program.
BROWN: You know, you’re in there for 10 1/2 months. You got no idea how you’re going to get out. It’s almost like coercion, you know? Here, sign these papers, you can get out of jail.
WHITEHEAD: Brown says the diversion program has helped him stay sober and get on medication for his depression, but it’s also been stressful to keep up with the program’s requirements. If he gets kicked out, Brown worries he faces years in prison.
BROWN: I’ve learned a new way of life. You know, instead of just getting high, you know, I’m learning to feel things now and put forth that effort to try and improve myself. To get locked up for it, it’s just like a kick in the gut.
WHITEHEAD: You can find mental health courts in more than 650 communities. There’s no set way to run them, but generally participants receive treatment plans and access to counseling and medication. Judges and mental health clinicians oversee their progress. Lea Johnston is a professor of law at the University of Florida. She says jails and prisons are not the place for people with mental illness.
LEA JOHNSTON: But I’m also not sure that mental health court is the solution.
WHITEHEAD: Johnston says the programs can distract policymakers from more meaningful investments.
JOHNSTON: The bigger problem is they’re taking attention away from more important solutions that we should be investing in, like community mental health care.
WHITEHEAD: Nearly 60% of participants completed the programs as of 2019, according to the National Treatment Court Resource Center. Researchers there say there’s little evidence whether the diversion programs improved mental health outcomes or impacted recidivism long term. Kristen DeVall co-directs the organization. She says the courts can’t work as well when the social safety net is full of holes. It can be hard to find stable housing, counseling and recovery services in many communities.
KRISTEN DEVALL: If all of these other supports that are necessary aren’t invested in, then it’s kind of a wash.
WHITEHEAD: Critics of mental health courts say participating shouldn’t come at the cost of a guilty plea. Raji Edayathumangalam, a licensed clinical social worker with New York County Defender Services, says judges often aren’t trained to make informed decisions about participants’ care.
RAJI EDAYATHUMANGALAM: It’s inappropriate. We’re all licensed to practice in our different professions for a reason, right? I can’t show up to do a hernia operation just because I read about it or sat next to a hernia surgeon for 10 days.
WHITEHEAD: Some mental health court participants praised the programs for helping them get their lives back on track. During a recent hearing in a metro Atlanta mental health court, many participants thanked Judge Shana Rooks Malone personally. But one woman left the courtroom in tears. She had just been sentenced to seven days in jail for being dishonest about whether she was taking court-required medication. Malone, a lawyer by training, says she doesn’t like to incarcerate.
SHANA ROOKS MALONE: But that particular participant has had some challenges. I’m rooting for her, but all the smaller penalties haven’t worked.
WHITEHEAD: The final straw, Malone said, would be removing her from the program altogether and sending her to prison. Meanwhile, Donald Brown worries that will ultimately be his fate, too. He avoided jail that early December day. A hearing about whether he can remain in mental health court is expected in the coming weeks.
MARTÍNEZ: That was Sam Whitehead with our partner KFF Health News.
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