Mentally ill get a break

The second, then third time Judge John Mitchell saw the same woman in his 1st District courtroom in Coeur d’Alene on repeat drug charges, he knew something wasn’t working.

She’d served her time and completed a clean-up program for substance abusers, then went right back to her dangerous habits shortly after her release.

Mitchell studied the background information collected on the woman and on other repeat offenders who were showing up. Some were addicts – nothing more – and determined to stay that way. But a good portion suffered from mental illness. Some were bipolar or schizophrenic. Others battled major depression.

“If they don’t get treatment for their mental health problem, the substance abuse counseling probably isn’t worth it,” Mitchell says.

He maintains that mental illness is the root of their problems. The drug crowd accepted them when they didn’t fit in anywhere else and their need for social contacts keeps them in the drug crowd. Treating their mental illnesses with the right medications should help them move into the mainstream, he says.

Thanks to Mitchell, a mental health drug court that offers a chance at lifestyle change began for the five northern counties in mid-September. But it almost didn’t happen.

Mitchell is no lock-em-up-throw-away-the-key judge. He recognized a year ago a missing component that could change lives as well as save taxpayers money. He’d read about a drug court for people with mental illnesses in Idaho Falls and asked if such a program would work in the five northern counties.

He was told it wouldn’t because the state Department of Health and Welfare operates differently here than it does in the eastern end of the state. Mitchell dropped the issue.

“It’s my fault for not doing more digging,” he says now.

Bonneville County started its mental health drug court three years ago when Judge Brent Moss noticed his drug court wasn’t correcting some offenders. Mental health courts were sprinkled throughout the United States. Health and Welfare agreed to help Moss start one in Idaho Falls for 10 counties.

Judge Richard St. Clair also agreed to help. A team of prosecutors, public defenders, probation officers, jail representatives and specialists in mental health, low-cost housing and vocational rehabilitation worked closely with the judges.

They set up a one- to two-year program for offenders approved to participate. Offenders regularly updated the judges in court on their progress, underwent counseling and treatment for their mental illnesses, took random urine analyses and faced jail time for their drug crimes if they failed to stick with the program.

“It’s very rewarding to see the changes to many of the participants,” St. Clair says. Of the 30 or so participants so far, six have graduated and are working. About half were kicked out or decided the program was too intense and opted instead for jail time. Some people with mental illness prefer the structure and safety of jail, mental health specialists say.

“Even those who wash out certainly gain from the program,” St. Clair says.

Marcy Black, a probation and parole officer in Coeur d’Alene, sat through a drug court sentencing last spring, then asked Mitchell if he was interested in starting a mental health drug court. He didn’t hesitate. He traveled to Idaho Falls three weeks later to watch the 7th District’s mental health drug court in action.

A woman finishing the program told Mitchell North Idaho needs the special court.

“She was bipolar, an addict since 18 and homeless. She’s 37 now,” Mitchell says. “She’d been a prostitute for six years. The last two years in mental health drug court was the first time her mental illness was treated.”

The woman was working, had a home and was getting custody of her two children back.

“It was pretty powerful,” Mitchell says. “I said we’d do what we could.”

Health and Welfare couldn’t manage the program for the 1st District the way it does for the 7th District, where a historical fluke puts the state department in charge of mental health treatment for the courts. But North Idaho’s regional office wanted to help. It trained Powder Basin, a private counseling group, to provide the treatment and rehabilitation portion of mental health drug court.

With Powder Basin on a team with judicial and law enforcement representatives, the 1st District’s mental health drug court opened for business in September.

“We couldn’t dedicate the staff to make it successful, but Powder Basin has done that and filled the void,” says Jack Cotton, Health and Welfare’s mental health coordinator in Kootenai County. “It seems to be working.”

Without Health and Welfare’s payroll covering the special court’s counselors, mental health drug court either needed to find money to pay Powder Basin or allow only offenders eligible for Medicaid to participate. The new court had no money, so Powder Basin agreed to accept Medicaid as payment.

Five offenders fit the criteria for participation and wanted to be part of the program. They were Medicaid-eligible and had no crimes of violence or sex on their records. Black explained that the program includes intensive supervision by a mental health professional, frequent appearances before Mitchell, mandatory mental health counseling, classes and mental health and substance abuse testing.

The program is 14 months. Those who fail finish out their prison sentences. Those who succeed face a new life.

Mental health drug court is two months old now. The program has grown to 10 men and two women. They visit Judge Mitchell every week, standing next to his bench like kids facing the school principal. He shakes each offender’s hand, asks how they’re doing. Most come with essays he’s assigned, recommended by the team that meets with him the hour before mental health drug court begins.

“The Importance of a Schedule,” a woman reads proudly to the judge, other offenders and a team of specialists in the courtroom. Her essay mentions the risks of sanctions, missing medical appointments and eventually losing a job for not sticking to a schedule. Mitchell smiles like a pleased teacher as the woman hands him her paper.

Some offenders tell Mitchell about their stress or bad dreams. Offenders who had a good week have little to say. Mitchell sends one woman back to jail for four days. She tells him she’s trying, but she’s missed too many of her obligations. He’s reluctant to toss participants from the program until they’ve proven beyond a doubt that they won’t fulfill their obligation. Occasional weekends in jail are his hand slaps.

It’s too soon to know who will make it and who won’t, but Mitchell passionately believes mental health drug court is needed. He wants to include the many offenders not eligible for Medicaid. To do that, his program will need money. Mitchell and the team are looking into grants and hope county commissioners will notice the program is saving money in jail costs.

“We’re helping to solve the problem rather than just punishing people,” Mitchell says. He’s seen progress in some offenders but knows how quickly things can change. “I know there will be setbacks and I’m gearing myself up to that. I have to be patient. But I’m hopeful we’re making progress.”