Mental health courts: Understanding, healing and redirection

We must care for hurting persons among us. I have had experience over my career with an outpatient counseling center and a psychiatric office, an inpatient psychiatric hospital, a pastoral counseling center, pastoral care as a clergyperson, as well as caring for patients with behavioral problems at a family medicine center. I have witnessed the profound suffering of persons and their families when a psychiatric disorder is present.

Those with behavioral health issues are no longer chained to walls in dungeons, and we would see such as inhumane. However, maybe to a degree we have cycled back closer than we realize, or wish to admit, to less than just or humane treatment for some. Some do not have to look very far in their family tree and are well acquainted with the great pains and struggles mental distress may bring. Many live in quiet desperation and isolation, wishing someone cared and could understand.

If we think the health care system overall is broken, this is magnified many more times with our fragmented mental health system.

For decades psychiatric hospitals around Georgia provided a place for those with severe aliments. While acknowledging that the state has implemented some new programs since the closing of such treatment centers, I do believe that a case can easily be made that many persons who were and would have been treated at the regional psychiatric institutions often end up in our jails or prisons.

It is estimated that 50 percent or more of our jail and prison populations in the United States have mental health problems (estimates used to be around 20 percent). A survey by the National Sheriff’s Association reported that America’s jails and prisons have become our new mental health hospitals. Many of the penal institutions are overwhelmed already and do not have resources to care for those with behavioral health issues. Thus no or very little treatment is given; this criminalization of those who need treatment is a national tragedy.

The legal system has difficulty as a whole with having the time and resources to be sensitive to persons who have mental health difficulties and who get into legal trouble. There are gifted and caring persons who work in the legal system (from police officers to judges, district attorneys, guards and so on), but as a whole, the system itself cannot provide the nuances and exceptions that might assist persons who get into legal jeopardy because of mental health vulnerabilities.

For example, it could be that a person has a psychotic break and takes something while in that state, not intending to steal it; or a person may create a disturbance or get into an altercation because of Post-Traumatic Stress Disorder from military combat and get into legal problems. There are consequences to such behaviors, and rightly so; but it is unfair to ignore the person in the total context and put these individuals in the same category as those who intentionally steal or create disturbances.

In recent years many of our counties have developed a way to intervene with such persons within the criminal justice system called Mental Health Court (MHC). These courts have quietly been making a difference in the lives of persons who have the double whammy of having a mental disorder and getting entangled in the legal system.

And let me be clear” This is not a “get out of jail free” approach. These courts involve a team of professionals trained in the justice system and in mental health so they can offer a balanced approach and accountability. The persons who are accepted into MHC have to accept very close monitoring (including random drug screens), structured treatment, group sessions, community service, and regular appearances in court. It is a problem-solving and treatment approach rather than incarceration (although participants can be put in jail for periods of time if necessary). Persons can benefit greatly from such an approach and can be less likely to reoffend and more likely to become productive members of society.

As most are well aware, such work can be very involved, intense and messy; however, the potential to keep persons from being shoved away into a dark corner of some prison cell is great.

As a psychotherapist, I affirm and commend the work of our mental health courts throughout our state. May we always be a people of caring and compassion for the most vulnerable; at some point in time we or a member of our families could be the person in need.

This story was originally published November 3, 2017 at 10:00 AM with the headline "Mental health courts: Understanding, healing and redirection."