Posts Tagged mental health court

Recidivism is Expensive, Let’s Try Something Else

Published by EducationNews.org — Trying to punish people into compliance costs a lot, and more importantly, doesn’t work.

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This is our third look at how Judge Pamela Williams, in her mental health court in Nova Scotia, successfully kept offenders from further contact with police, courts, and jail.  Using the CoSA model — see last week’s column — she worked with experts in different fields to figure out how to “help them out of the place that they are in,” as she put it.

Today’s question is: CoSA works, but at what cost?

To set the stage, first conjure in your mind an Excel budget sheet.  Labels at the top read: Housing, Health, Mental Health, Prison, Courts, Children Protective Services, Schools, Higher Ed, Workforce Development, and I’m sure you can think of more.  Each of these state or city public services has its own mission, and not to confuse things, each has its own huge budget spreadsheet. Hierarchies, job descriptions, and business habits are baked into those budgets, leaving little flexibility.  So as we consider another of Judge Williams’ stories illustrating her Court’s challenges, mentally map where various costs might be posted, but remember that Judge Williams herself controls only her portion of the Excel column marked “Courts.”

A woman we’ll call Rosalie was “a very complex case.”

Rosalie had limited intelligence, schizophrenia, anxiety, depression and suicidal ideation.  Also, she was an unusually large woman, which added to the extent that she was hard to control at times.

Occasionally she’d sink into a depression so severe she became suicidal.  She’d sneak out of her group home and head for a particular bridge where she’d threaten to end her life.  Not that she did.  But the police couldn’t just let traffic flow by an apparent suicide in progress; they had to close the bridge.  Bridges over water, such as this one, have no side streets to which traffic can be diverted.

A competent bean-counter could probably arrive at a solid estimated cost for the small platoon of police needed to get her into an ambulance or patrol car… and the emergency efforts of the Department of Transportation, her subsequent hospitalization, public defenders, and so on.  However, it’s impossible to monetize the inconvenienced drivers who were late to appointments, no-shows at job interviews, or charged extra for late daycare pick-up.

Yes, of course they had tried to stop her.  Ferverently.  Rosalie had been in court repeatedly, jailed, on probation, back in prison — caught in an expensive, vicious cycle.  The Law could keep her locked up, but she was a wretched innocent, not a criminal deserving the punishment of prison.  The costs of punishing her into compliance were also not cheap, but more importantly, not working.

The traditional courts sent her over to Judge Williams.

Williams assembled her CoSA team of professionals, including the directors of Rosalie’s group home.  Obviously the directors had talked to the police and other agencies on her behalf.  But under what circumstances, other than a CoSA meeting at Williams’ court, would they sit down together to get it to stop?  Typically, the psychiatrist of record hardly talks to the therapist, never mind solves problems with a team that includes family and other stakeholders.  Where is the Excel column for cross-agency collaboration?

In any case, the group discovered that Rosalie absolutely treasured her home.  It was comfortable, with kind friends who took her back, fed and soothed her.  They concluded that her love of her home could be carefully deployed as leverage.  No one wants to do tough love.  But they worked with Rosalie to get a deal with her — if she did her bridge thing again, she would be banned from the home and need to live somewhere else.

Predictably, in time, it happened once more.  Williams didn’t say where Rosalie lived or for how long after her poor choice.  Wherever it was, she hated it passionately, as all had hoped.  Per prior agreement, and after a painful amount of time, she was allowed back into the home and never offended again.  It worked.

Williams says, “We have one mental-health court.  Even that court doesn’t have enough resources.  It’s expensive to restore broken people and relationships.  The people around those offenders are broken.  Victims are broken.”  Everyone involved in a crime needs the healing powers of restoration — or the problems linger, or worse, fester.

But only through sheer power of persuasion, and judicious use of scarce resources, did Judge Williams get experts from across the Excel spreadsheet to jump their column.  Who pays for that?  No group home runs on such a cushy margin, they can easily send people for team meetings.  Therapists and psychiatrists don’t work for free, so the entire spreadsheet would have to ease up so the resources are there to make up these teams.   Think of the cost savings to Police, Health, Transportation, etc.

Recidivism is absurdly expensive.  Rosalie’s trips to the bridge cost a fortune.  Stopping them, in a humane fashion, saved a lot of money for Police, Transportation, Emergency Medicine, and more, not to mention the taxpaying public.  If the real goal of Justice is to reduce recidivism, Judge Williams has excellent answers.  What we’re doing now doesn’t work for anyone.

 

Julia Steiny is a freelance columnist who also blogs about Restorative Practices and Restorative Justice. After serving on the Providence School Board, she became the Providence Journal’s education columnist for 16 years, and has written for many other outlets. As the founding director of the Youth Restoration Project, she’s been building demonstration projects in Rhode Island since 2008. She analyses data and provides communications consulting on Information Works! and the RIDataHUB, through The Providence Plan. For more detail, see juliasteiny.com or contact her at juliasteiny@gmail.com or 24 Corliss Street #40022, Providence, RI 02904.

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The Justice System Can’t Ignore Mental Health

Published by EducationNews.org — We need to understand each other’s stories for justice to get done.

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Chief Judge Pamela Williams, Provincial and Family Courts of Nova Scotia

A woman we’ll call Jane embezzled money from her company. She’d been feeding a nasty gambling habit and her boss figured it out.  She was arrested, jailed, and wound up in front of a judge.

Now, what would normally happen at this point in her story is that the courts would determine her guilt or innocence, via lawyers and evidence.  Actually, her crime was so blatant, they hardly needed to bother.  After exhausting a lot of resources proving the obvious, she normally would have been sentenced and added to the prison population for who-knows-how long.

Instead, lucky Jane came before Judge Pamela Williams, who then presided over the mental health court in Halifax, Nova Scotia.  Williams has since become the Chief Judge of the region’s Family Courts.  Her career began with 20 years working with Legal Aid, focusing mostly on the mentally ill, drug-addicted, poor, and illiterate.  In 2003 she was appointed to be a judge in the juvenile justice courts.  In that role, she made a name for herself by radically reducing recidivism, which really should be the point of a court system.  Her success led to her being tapped to develop a specialized mental health court in 2010.  It was there that she met Jane.

For years, Jane had been diagnosed with bi-polar disorder. 

Jane gambled compulsively during her manic episodes.  This is by no means excuses what she did.  But she was falling apart.  Her marriage was on the rocks, and of course her former employer all but wanted blood.  The traditional justice system is not really set up to consider the conditions in which a crime is committed.  A crook is a crook, no matter the complicated circumstances such as mental illness.

Whether in Halifax or the U.S., the mentally ill tend to get involved with the law, which only sees guilt and innocence as the issue, not how to stop the cycle.  In America, the largest mental health facilities are prisons.

When working in the juvenile justice system, Williams began using restorative justice techniques.  As such, she used the occasion of the crime as a red flag signaling mental or social illness.  Before passing judgment, she reached out to the kid’s immediate and extended family, social services, teachers, and whomever could help get him or her out of whatever wretched place they were in and onto a more productive road.

When possible, the offender would face his victims and hear their experience.  The kid needed to make things right by doing restitution and taking responsibility for her actions.  But the group needed to get to the root problem and solve it so the community was not continuously harmed by the anti-social behavior, or recidivism would surely occur.  Not surprisingly, the RJ is far more effective at reducing reoffending than traditional justice, because its techniques unpack mitigating circumstances like mental illness.

Jane’s was a relatively simple case.  

Williams got professionals involved to get her stabilized on proper drugs.  Once she was stable, Jane’s husband was willing to let those same professionals educate him about the illness itself and what he could do to de-escalate her symptoms and to take care of himself.  She learned to be more responsible; he learned to avoid being victimized by her.

Once Jane had a support system in place, Williams held a RJ conference (meeting) with the employer who, frankly, called Jane a liar and a thief.  But when he heard the larger story about her journey with mental illness, he felt less targeted and also less victimized.  The conference participants helped her figure out how to make restitution to the employer.  He walked away satisfied.

Williams says, “Once we understand each others’ stories, it helps.  Jane heard how her actions had affected others.”  She felt the hurt she’d caused.  Her remorse motivates her to be med compliant and self-controlled.  End of story.

The Courts never saw her again.  A very good thing.  We need to understand more about mental health courts because they have the ability to stop whatever cycle the troubled person is in.

We’ll hear more of William’s fund of cases and experiences in the coming couple of weeks.

 

Julia Steiny is a freelance columnist who also blogs about Restorative Practices and Restorative Justice. After serving on the Providence School Board, she became the Providence Journal’s education columnist for 16 years, and has written for many other outlets. As the founding director of the Youth Restoration Project, she’s been building demonstration projects in Rhode Island since 2008. She analyses data and provides communications consulting on Information Works! and the RIDataHUB, through The Providence Plan. For more detail, see juliasteiny.com or contact her at juliasteiny@gmail.com or 24 Corliss Street #40022, Providence, RI 02904.

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