Ramsey County Mental Health Court: Working with the Mentally Ill Defendant Judge John H. Guthmann, Second Judicial District, State of Minnesota Judge William H. Leary, Second Judicial District, State of Minnesota Judge Teresa R. Warner, Second Judicial District, State of Minnesota Brandi Stavlo, Program Coordinator, Ramsey County Mental Health Court 1

Topics Covered 2

D ESCRIPTION OF THE N EED 3

Scope of the Need 4

It Is A National Problem ¹ Bureau of Justice Statistics (2006) ² National Institute of Mental Health (2012) 5

6 A mental illness is: A medical condition, disrupting a person’s thinking, feeling, mood, ability to relate to others and daily functioning. The condition is characterized by alterations in thinking, mood, and/or behavior associated with distress and/or impaired functioning in social, occupations, or other areas. A mental illness should be treated with the same urgency as diabetes or heart disease. Most mental illnesses can be treated effectively with medication, therapy, diet, exercise and support. Recovery is possible. What is a Mental Illness?

Mental Health Data 7

R AMSEY C OUNTY M ENTAL H EALTH C OURT 8

9 Development of Mental Health Courts

RCMHC Background 10

Goals 11

Methods Level of Supervision Emphasis on Long Term Recovery Reductions in Recidivism MENTAL HEALTH COURT Highly supervised.Participants develop needed life skills and obtain treatment providers in the community. Treatment plans are developed with each participant and highly individualized. In Ramsey County, graduates are less likely to be charged with a new offense or spend time in jail than those in a comparison group in both a one year and three year follow-up. TRADITIONAL CRIMINAL COURT Court involvement generally does not take place unless a probation violation has been reported post-sentence. Traditional processes may refer offenders to treatment programs but follow-up by probation agents is uneven. In Ramsey County, offenders in a comparison group were almost 4 times more likely to re- offend and over 6 times more likely to spend time in jail. How does RCMHC differ from Traditional Criminal Courts? 12

Eligibility Criteria 13

Program Denial Reasons 14

Criminal Data 15

Important Considerations for Eligibility 16

What is the Incentive for the Participant? 17

The RCMHC uses a collaborative model in making intake, eligibility, evaluation, treatment alternative and case management decisions. The team includes: program coordinator two community human services case managers three judges who rotate two prosecuting attorneys three pro bono defense attorneys who rotate one certified student attorney one graduate clinical case management intern RCMHC Team 18

RCMHC collaborates closely with: Ramsey County Community Mental Health Center Project Remand, Pretrial Conditional Release Agency Ramsey County Community Corrections, Adult Probation Ramsey County Correctional Facility Second Judicial District Research Department Collaboration 19

Referral Sources 20

Demographics 21

Funding 22

How it Works 23

How it Works continued… 24

How it Works continued… 25

How it Works continued… 26

Mental Health Supports 27

Recent Program Statistics [December 2013] 28

Recent Program Statistics Continued… 29

Ramsey County: Research Outcomes 30

National: Research Outcomes 31

RCMHC COMPARISON GROUP Recidivism and Jail Impact RCMHC COMPARISON GROUP Recidivism and Jail Impact In both a one year and three year follow-up, RCMHC graduates have been less likely to be charged with a new offense and spend time in jail than those in a comparison group. Comparison GroupGraduates of RCMHC One Year After RCMHC New Charges 60%16% New Convictions 45%8% Jail Time 65%10% Three Years After RCMHC New Charges 70%31% New Convictions 60%26% Jail Time 68%26% 32

Chemical Health Data 33

Chemical Health Supports 34

Connected defendants to mental health services Reduced the incidence of criminal behavior Reduced costs to the criminal justice system, corrections, public safety, and hospitals Assisted defendants with establishing more productive lives including self-sufficiency and self-confidence Opened defendants options for housing, employment, and improved knowledge of community resources/services. Improved quality of life upon discharge [housing and treatment services in place] Enhanced collaboration between courts and mental health community Accomplishments 35

Awards and Recognition 36

H OW Y OU C AN H ELP ? 37

Lack of Adequate Treatment Facilities in Community o Riverwood Centers, a provider of mental health services for about 3,000 people in east central Minnesota, abruptly closed on March 17, Funding o Treatment and resources need to be funded locally, statewide, and nationally. o Invest in community mental health services which will support individuals when they are discharged from treatment and hospitals. Current Challenges 38

How You Can Help? 39

Invest in Better Mental Health Services 40

Final Thoughts…. 41

Additional Resources on Mental Illness 42 National resources NAMI — National Alliance on Mental Illness A community of mental health advocates, helping those in need receive services, treatment and support. NIMH— National Institute of Mental Health Working through research to better understand how to understand and treat mental illnesses. Minnesota resources NAMI Minnesota Improving the lives of children and adults with mental illnesses in Minnesota through education and support. Mental Health Association of Minnesota Working to enhance mental health, promote individual empowerment and increase access for those with mental illnesses. Minnesota Association for Children’s Mental Health Promoting positive mental health for infants, children, adolescents and their families. Mental Health Consumer/Survivor Network of Minnesota An organization in Minnesota that fosters mental illness recovery and wellness.