Alternative courts, mental health care could lower prison, jail popultions

FAYETTEVILLE -- Two new, statewide groups are focused on breaking the incarceration cycle.

"It always goes back to the same thing," said Washington County Sheriff Tim Helder. "We hook 'em, we book 'em, we try them, we sentence them, we send them to prison, they do whatever time they're gonna do. Then, you give them a $50 or $100 check and a bus ticket and they go right back where they were. Nobody's gonna hire them, they're going to drift back into the same group and therein lies the problem.

Local speciality courts

Almost 3,000 people are being diverted to various speciality courts in Arkansas. Benton County has an adult Drug Court, a Veteran’s Court and a DWI Court. Washington County has adult and juvenile Drug Courts and a Veteran’s Court.

Source: Staff report

Speciality Courts in Arkansas

• Adult Drug Court: A specially designed court calendar or docket designed to reduce recidivism and substance abuse among nonviolent, substance abusing offenders and to increase the offender’s likelihood of successful rehabilitation through early, continuous, and intense court supervised treatment, mandatory periodic drug testing, community supervision, and use of appropriate sanctions and rehabilitation services.

• Juvenile Drug Court: Located within the juvenile or family court system, is a program to which selected juvenile offenders are referred. The youths referred to this docket are identified as having problems with alcohol and/or other drugs.

• DWI Court: An accountability court dedicated to changing the behavior of the hardcore DWI offenders. The goal of DWI Court or DWI/Drug Court is to protect public safety by using a Drug Court model of accountability and long-term treatment.

• Veterans Treatment Court: Links veterans facing mental illness, drug addiction/abuse, and/or reintegration issues to services, intensive treatment, and support while promoting sobriety, recovery and stability. Services may include a coordinated response from traditional partners as well as the Department of Veterans’ Affairs healthcare networks, Veterans Benefits Administration, State Department of Veterans Affairs, volunteer veteran mentors, and organizations that support veterans’ families.

• Mental Health Courts: Link offenders who would ordinarily be prison-bound to long-term community-based treatment. They rely on thorough mental health assessments, individualized treatment plans and ongoing judicial monitoring to address both the mental health needs of offenders and public safety concerns of communities. These courts vary as to the types of charges and mental illness diagnoses accepted as well as the participants’ demographics and plea requirements, but they are united by the common themes of substituting a problem-solving model for traditional criminal court processing and an emphasis on linking defendants to effective treatment and supports.

• H.O.P.E. Court: HOPE Courts are based on the Hawaii Opportunity on Probation with Enforcement program model. Pilot HOPE courts exist nationwide, including Arkansas. The program identifies probationers with a high risk for re-offending, focusing on reducing drug use, new crimes and incarceration. Offenders are deterred from using drugs and committing crimes by frequent and random drug tests, backed by swift and certain jail stays, along with treatment when necessary.

• Swift Court: Swift courts are pilot program problem solving courts in Arkansas. These courts are similar to HOPE courts, using similar structure. While each program is unique, all place emphasis on the certainty of the sanction and the swiftness with which it is applied, rather than the severity of the sanction. Swift and certain sanctioning increases offender compliance with rules of supervision, improving public safety in the short term and allowing for more effective case management. The models distinguish between low and high level offenders and have coordinated responses.

Smarter Sentencing/Alternative Sentencing Court: Problem solving courts in Arkansas that use multiple tracks within their programs for offenders based on risk/need assessment levels. Sanction and incentive responses are tailored to offender track and risk levels. Programs include phase advancement and increased supervision and drug testing.

Source: Arkansas Administrative Office of the Courts

Food for Thought

“This should never have been a repository for people that are suffering from mental illness but that seems to be where we find ourselves these days. It’s not right but all we can do is make people aware of it, then try to find a solution.”

— Washington County Sheriff Tim Helder reflecting on jailing the mentally ill.

"We've got to start looking at these other, maybe newer, more innovative ideas or we're going to be bankrupt just housing people."

Arkansas doesn't have enough room or money for all its prisoners. Building a 1,000-bed prison to ease overcrowding would cost about $100 million and about $25 million a year to maintain, Benny Magness, chairman of the state Board of Correction, told lawmakers last year.

Gov. Asa Hutchinson unveiled a plan in February to spend $33 million over two years to address immediate prison overcrowding by adding some 800 prison beds at various existing facilities, hiring more parole and probation officers and adding more re-entry and alternative sentencing programs.

State lawmakers earlier this year passed Act 895, which established two task forces and a Specialty Court Program Advisory Committee.

The task forces, Legislative Criminal Justice Oversight Task Force and the Behavioral Health Treatment Access Legislative Task Force, are working to find ways to deal with prison and jail overcrowding through implementation of mental health, drug treatment and job training reforms.

The number of inmates in Arkansas prisons and waiting in county jails was about 14,600 in 2012 and jumped to about 17,850 last year. The number was about 21,000 inmates last week, according to the Department of Correction.

More than a quarter of those released are back behind bars within three years, which adds to the problem. According to a report commissioned by the state and researched by JFA Associates, Arkansas' prison population could, very conservatively, be at 26,000 by the end of 2025.

The numbers have risen significantly since lawmakers decided to get tougher on probationers and parolees after the high-profile murder in 2013 of Fayetteville teenager Forrest Abrams in Little Rock by parolee Darrell Dennis. Dennis was given a life sentence May 21.

Dennis' arrest sparked a legislative review of the state Department of Community Correction, which oversees probation and parole, after the Arkansas Democrat-Gazette reported Dennis was released from jail less than two days before the murder and was an eight-time parole absconder. Dennis was never returned to prison even though he'd picked up 10 felony drug charges during more than four years on parole.

MENTAL HEALTH

Helder, 4th Circuit Judge Cristi Beaumont and David Williams, former CEO of Ozark Guidance, are among those from Northwest Arkansas on the Behavioral Health Treatment Access Task Force.

Beaumont said a subcommittee and task force members are deciding how to allocate $2.8 million in state money set aside for specialty courts. Members are to figure out a funding formula and make recommendations to the governor and Legislature.

"The Criminal Justice Task Force is trying to reduce prison and jail overcrowding," Beaumont said. "Improving mental health services and addiction services is one way we can address overcrowding."

Beaumont, who has a background in psychology, said alternative courts have a two-fold goal: providing better help for participants and lowering costs associated with prison overcrowding.

"The people we have the most impact on are the high-risk offenders clogging the jails or who have been using a long time," Beaumont said.

The task force has met three times to hear presentations and toss around ideas. They've formed several subcommittees to look at alternative courts, parole and probation, mental health initiatives and other issues.

"We're talking about a finite amount of money and a lot of these ideas, I don't know that they'll cost more, but it's a shifting, it's a shifting of the finances." Helder said. "I'm excited about the opportunities that are out there for us. I'm guardedly optimistic that we'll make headway."

Helder said the task force hasn't started looking at additional sources of money to pay for alternative programs, but expects it will be a part of the process.

Beaumont, Helder and Williams also are members of Judicial Equality for Mental Illness, a Northwest Arkansas group working to change the state's system of treating the mentally ill. Members want to make sure people who are incarcerated in Northwest Arkansas receive mental health treatment. The group's membership includes current and retired mental health professionals, law enforcement representatives and community members.

The group started two years ago following the death of Benton County Jail inmate Faith Denise Whitcomb. She died of undiagnosed pancreatic cancer May 3, 2012, while awaiting a bed at the State Hospital. A judge had committed Whitcomb to the State Hospital after declaring her unfit to stand trial because of a mental illness. She suffered from schizophrenia.

DIVERSION COURTS

Beaumont, who runs the second largest drug court in the state, said she'd like to have a full-time mental health court, too. Mental Health Courts use a Drug Court model of long-term community-based treatment. They offer thorough mental health assessment, individualized treatment plans and ongoing monitoring to make sure mental health needs of offenders and public safety concerns are met.

"Right now, we do not have the staff to run a mental health court, we just don't," Beaumont said of the 4th Judicial District. "I think mental health courts are good. I'm for them."

The cost of prosecuting and incarcerating a mentally ill prisoner is 20 times, or more, higher than what it would cost to provide that person with crisis treatment and follow-up counseling, according to a report released June 18. "A Brief Cost Analysis of Arkansas Mental Health and Prison Reform" was commissioned by the Arkansas Public Policy Panel and prepared by Histecon Associates of Little Rock.

The study estimates about 20 percent or more of people incarcerated in state prisons, jails and the juvenile justice system suffer from serious mental illnesses.

Helder said a study at the Washington County Jail in 2007 or 2008 found about 60 percent of the inmates were either under the care of a mental health professional, had been under care or had been diagnosed with some form of mental illness.

"What makes sense about this?" Helder said. "Whatever the number is, isn't there a better solution for the majority of people with mental illness?"

Beaumont said she does maintain a mental health docket within drug court one Monday each month through a partnership with Ozark Guidance that treats 30 to 40 people.

Ozark Guidance works up individual treatment plans for each participant for mental health care and the underlying drug problem. Counselors go to court and provide updates on each of the participants.

"If you put an addict in jail, it's not going to fix their problem. They're gonna start using again when they get out. It's like a long recess," Beaumont said. "If you don't treat the mental health issue, they're just going to start using again. A lot of them are self-medicating."

Beaumont's Veterans Court, started in 2012, has about 20 participants now. Veterans get mental health services through the Veterans Administration Hospital at no cost to the court program. Most of the participants suffer from post-traumatic stress disorder, Beaumont said.

Vets are different now, Beaumont said. It used to be 12 months was a typical tour of duty. Now they face multiple tours and the stress disorder gets worse with every tour, and for many the only way they can deal with it is by self-medicating with drugs or alcohol, she said.

The VA does drug testing, group therapy sessions, individual counseling and the court or Ozark Guidance provides probation officers and job training. VA counselors go to Veterans Court to provide updates on participants.

"We're going to have to deal with the mental health issues, otherwise, we won't be able to fix things," Beaumont said.

Lower Cost Than Lock-up

Arkansas has thousands of prisoners who are receiving less than appropriate mental health care when better care could be provided at a fraction of the current cost, according to the mental health cost analysis.

The cost to keep a prisoner at a state facility is about $63 per day, or about $23,000 per year, according to the study. The average cost of adjudicating a criminal suspect through the system is about $6,300 in 2014 dollars. The costs include prosecuting attorneys, judges, court clerks and reporters, and police time during arrests, arraignments, jail time, and testimony at trial.

The study estimates the first-year costs of the criminal justice process and imprisonment of a mentally-ill suspect is about $30,000.

Applying that figure to the estimated 5,000 mentally ill inmates who are believed to be in the state's jails, prisons and juvenile centers, the total cost to local and state governments would be about $150 million for their first year.

For comparison purposes, the projected cost of one year's services for those 5,000 people using crisis centers, which would treat patients from three to five days and provide follow-up care at a cost of $350 to $400 per day, would be about $10 million, plus some follow-up costs for maintaining contact with discharged patients, according to the study. The $10 million includes the estimated cost of establishing the centers.

State officials estimate Medicaid would pay between $2 million and $3 million a year, leaving a net cost to Arkansas of about $7.5 million annually to treat the mentally ill at crisis centers.

Beaumont said Medicaid expansion has helped her court. "They apply and, if they qualify, it covers their mental health care," Beaumont said.

Nancy Kahanak with the Justice Equality group supports setting up a system of crisis centers. She said they would give police more options. The group works with the jails in Benton and Washington counties.

"Right now, people who have a serious mental illness end up in jails, and there're not getting treatment so there are several things that can change when we implement something different," Kahanak said. "That person who has mental illness, the police can take them to a crisis center and have them evaluated, if they're not dangerous, rather than take them to jail or an emergency room, which often isn't suitable."

In addition to the costs, putting mentally ill people in jail creates the potential for violence toward jailers and other detainees, suicide attempts and bizarre behaviors.

"I've told everybody from the start, our people are not adequately trained to deal with that segment of our population," Helder said.

Kahanak said she's hopeful changes are on the horizon because legislators and others in the state finally seem to be paying attention.

"It's a lose/lose right now, so we're all trying to band together and say 'Hey, because this isn't working, let's see what else we can do.'"

Helder said change will require a complete shift in philosophy when it comes to spending money on prisons and jails.

"Instead of funneling it all to incarceration costs, how about we funnel a portion of that to treatment costs and then the cop on the street will have an alternative," Helder said.

"Instead of seeing someone who is obviously, acutely mentally ill wandering around someone's house or being a nuisance at a business, instead of taking them to jail and getting rid of them, why not be able to take them to a treatment facility and they can work with them. Is that far-fetched?"

NW News on 07/04/2015

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