Georgia Behavioral Health Legislative Caucus

Mental Health Courts in Georgia Appalachian Circuit Superior Court (Pickens, Gilmer and Fannin Counties) Appalachian Circuit Superior Court (Pickens, Gilmer and Fannin Counties) Athens-Clarke County Superior, State, Municipal, Magistrate, and Probate Courts Athens-Clarke County Superior, State, Municipal, Magistrate, and Probate Courts Bibb County Superior Court Bibb County Superior Court Chatham County Superior and State Courts Chatham County Superior and State Courts Chatham County Juvenile Court Chatham County Juvenile Court DeKalb County Superior and Magistrate Courts DeKalb County Superior and Magistrate Courts Dougherty County Superior Court (National Learning Site) Dougherty County Superior Court (National Learning Site)

Mental Health Courts in Georgia, cont. Fulton County Superior and State Courts Fulton County Superior and State Courts Hall County Superior Court with concurrent misdemeanor jurisdiction Hall County Superior Court with concurrent misdemeanor jurisdiction Henry County Superior, State, and Probate Courts Henry County Superior, State, and Probate Courts Mitchell County State Court Mitchell County State Court Muscogee County Superior and State Courts Muscogee County Superior and State Courts Piedmont Circuit Superior and State Courts Piedmont Circuit Superior and State Courts Pickens County Superior, State, and Magistrate Courts Pickens County Superior, State, and Magistrate Courts In Planning: Augusta Circuit Superior Court Augusta Circuit Superior Court

Over last 20 years  State prison population has increased 209%  County jail population has increased 134%  State population has increased 51%

Data on Extent of Problem  15% of county jail population are persons with a serious mental illness; 5% of state population  66% - 75% have co-occurring drug addiction  Out of 51, Georgia ranks  35th in state hospital spending  42nd in community spending  45th for state agency mental health spending

Role of the Court  Persons with untreated mental illness often become trapped in a cycle in the criminal justice system, clogging court dockets.  Most have committed misdemeanor or non-violent, low-level felonies precipitated by their mental illness.

Role of the Court  Through civil commitment cases, judges order persons to involuntary inpatient or outpatient treatment.  Courts balance individual liberties with security concerns for community.

Typical MHC Case Flow Arrest and arraignment Arrest and arraignment Identification, screening, assessment and referral Identification, screening, assessment and referral Decisions re: eligibility and interest in participation (defense counsel) Decisions re: eligibility and interest in participation (defense counsel) MH evaluation and preparation of treatment plan MH evaluation and preparation of treatment plan Plea/contract: MHC participation (judge, prosecutor, defendant and defense attorney all agree) Plea/contract: MHC participation (judge, prosecutor, defendant and defense attorney all agree) Treatment and court monitoring Treatment and court monitoring Compliance: No jail/prison, reduced or dismissed charges Compliance: No jail/prison, reduced or dismissed charges Non-compliance: Jail/prison sentence Non-compliance: Jail/prison sentence

Terms of Participation Stage of proceedings (post plea, pre- sentence, post sentence, etc.) Stage of proceedings (post plea, pre- sentence, post sentence, etc.) Length of treatment mandate Length of treatment mandate Requirements for graduation: Requirements for graduation: Standardized goals, individually applied Standardized goals, individually applied Graduation from court is not graduation from treatment/services Graduation from court is not graduation from treatment/services Lifelong treatment needs vs. time-bound court process Lifelong treatment needs vs. time-bound court process Rewards/incentives for successful completion Rewards/incentives for successful completion Sanctions for non-compliance Sanctions for non-compliance

Informed Choice Competence (regarding legal proceedings and treatment) Competence (regarding legal proceedings and treatment) Superior Courts in both Dougherty and Hall Counties have Specialized Competency Dockets Superior Courts in both Dougherty and Hall Counties have Specialized Competency Dockets Decision to participate, MHC is voluntary Decision to participate, MHC is voluntary Understanding the Criminal Justice and Mental Health consequences of participation Understanding the Criminal Justice and Mental Health consequences of participation

Service Gaps  Lack of -  Comprehensive treatment in the community  Care management/court diversion coordinators  Appropriate medication  Supportive and permanent housing  Job training and supported employment  Early identification and diversion to appropriate care  Communication, coordination and collaboration among systems  Prevention efforts

Recommendations  Fully funded, comprehensive system of community-based services will reduce court case loads  Evidence-based treatment  Active care management, including diversion coordinators  Access to quality medication  Access to medical care  Treatment for co-occurring addictive diseases  Consistent access to benefits

Mental Health Court Research Mental Health Court research continues to emerge Mental Health Court research continues to emerge The current research shows that MHC is a cost effective alternative to incarceration, improves psychosocial functioning of participants, and positively impacts re-arrests rates. The current research shows that MHC is a cost effective alternative to incarceration, improves psychosocial functioning of participants, and positively impacts re-arrests rates.

Acknowledgements This presentation was adapted from This presentation was adapted from New York Center for Court Innovation, Carol Fisher, Director, Mental Health Court Programs New York Center for Court Innovation, Carol Fisher, Director, Mental Health Court Programs TASC, Inc., Alicia M. Kusiak, Senior Administrator TASC, Inc., Alicia M. Kusiak, Senior Administrator Chief Justice-led Task Force to Promote Criminal Justice/Mental Health Collaboration, Judge Stephen Goss, Dougherty County Mental Health/Substance Abuse Court, Judge Winston Bethel, DeKalb County Mental Health Court, Baldwin County Sheriff Bill Massee Chief Justice-led Task Force to Promote Criminal Justice/Mental Health Collaboration, Judge Stephen Goss, Dougherty County Mental Health/Substance Abuse Court, Judge Winston Bethel, DeKalb County Mental Health Court, Baldwin County Sheriff Bill Massee Chief Justice-led Task Force to Promote Criminal Justice/Mental Health Collaboration, Chair Chief Justice Leah Ward Sears, Co- Chair Judge John Allen, Chattahoochee Circuit Superior Court, and Co-Chair Judge Winston Bethel, DeKalb County Magistrate Court Chief Justice-led Task Force to Promote Criminal Justice/Mental Health Collaboration, Chair Chief Justice Leah Ward Sears, Co- Chair Judge John Allen, Chattahoochee Circuit Superior Court, and Co-Chair Judge Winston Bethel, DeKalb County Magistrate Court