State considers The Judiciary is exploring creation of a special mental health court similar to the drug court to deal with misdemeanor and low-level felony cases involving mental health issues.
new court for
mental health cases
Similar to drug court, it would
deal with certain minor crimesWashington court system gets offenders treatment
By Helen Altonn
haltonn@starbulletin.comHonolulu District Judge Marcia Waldorf said she believes Hawaii, starting with Oahu, "could definitely use a mental health court system."
The goal is to decriminalize certain criminal offenders with mental health issues and get them into treatment, she said. "It's not that the person is necessarily outside the criminal justice system, but outside the incarceration mode, as most people agree they should be."
Waldorf said she talked to Chief Justice Ronald Moon about the idea, and he asked her to look into creating a model for Oahu.
The chief justice asked her to look into a program a little different than mental health courts on the mainland, she said. "We're looking at all types of cases that could be appropriately dealt with in such a court."
Most mental health courts exclude violent crimes, so domestic violence is a questionable area for the proposed court, but it will be studied, Waldorf said.
Among those supporting the concept of a mental health court are Circuit Judge Marie Milks, city Prosecutor Peter Carlisle and Sharon Black, Honolulu Police Department crisis intervention coordinator.
"It's a very innovative program," Milks said, noting "a lot of mental health patients are very endearing. A lot of them are honest and really need a lot of help."
A mental health court, like the drug court, "has more of a therapeutic orientation," Milks said. "It legitimizes health issues and gives a more neutral forum ... to apply to treatment policies and practices."
Carlisle said: "Where you've got criminal behavior sort of interfacing with a mental disease, disorder or defect, you can understand why it would be appropriate to have an institution dedicated to that special problem.
"This would have nothing to do with the Uyesugis of the world, but problematic street people who are mentally ill and offending criminal statutes." (Byran Uyesugi was convicted of murdering seven Xerox co-workers on Nov. 2, 1999.)
Carlisle said, for example, that a specialized mental health court could handle "shoplifters, people harassing people as they go by on the streets -- the people who really can't take care of themselves particularly well and where civil remedies are inadequate to address their criminal conduct.
"It's very much of a public health concern for them and for others.
"Murders, robberies, kidnappings and sexual headlines get headlines," Carlisle added, "but the merchant on the street generally is worried about the person defecating in front of his street every morning. That is a very legitimate concern. Or a person living in an alleyway next to his produce stand who reeks, and visual clutter ...
"All of those things are types of things people have a right to have addressed by their government."
Black said: "I'm pretty sad because, to me, I feel it (the mental health system) has gotten worse, when you start criminalizing patients coming out of the mental hospital. ...
"How many patients are going to wind up in a cellblock because of their mental illness, not because of an intent to be criminal?"
She said: "Patients would get the treatment they need and make the community a safer place. If a person cannot function time and again, they are a danger to the community or themselves."
Black said Project Outreach has made "a huge difference" in keeping many mentally ill people out of the legal system. "They no longer are a problem in the community. We try to get them in programs. ... We're not funded by the Department of Health, so we don't have to play their games."
Waldorf said organizing a mental health court "is a huge networking project" that involves the state departments of Health and Public Safety. Many issues must be examined, she said, such as the best treatment method for people with a dual diagnosis, or two problems, such as mental health and substance abuse.
She said the project must be done in incremental stages, but she envisions that it eventually could be used to re-integrate patients coming out of Hawaii State Hospital into the community.
Waldorf said she has long been interested in a different way of handling criminals with mental illnesses.
She looked into mental health courts on the mainland and visited the King County District Court's Mental Health Court in Seattle.
She does not anticipate the need for any new legislation, pointing out the cases already exist and would just be dealt with differently.
The court would require a more specialized public defender and prosecutor, a mental health clinician and nonprobation staff members, which might entail some extra expenses, she said.
Milks said inadequate community resources will be a big problem, just as it is with drug treatment.
But she said: "That is always going to be a problem. That doesn't mean we don't try to be innovative and focus on human needs."
About four years ago in Seattle, a retired firefighter was stabbed by a person who had been convicted of a misdemeanor for shoplifting and had mental illness that was not addressed by any system. Washington court system
gets offenders treatmentBy Helen Altonn
haltonn@starbulletin.comThat was the catalyst for a Mental Health Court in the King County District Court, said Mark C. Chow, judge of the specialized court.
Chow met with Honolulu District Judge Marcia Waldorf and Circuit Judge Marie Milks on a recent visit to Hawaii. While here, he read a Star-Bulletin story about problems treating the mentally ill, and responded.
"Like many cities and various jurisdictions, we are all struggling with the criminalization of the mentally ill," he wrote in a letter.
He described his Mental Health Court, saying its goals are community safety, collaboration of service and treatment, and reduction of repeat crimes.
In a telephone interview, Chow said that typically, when criminals with mental health issues are booked, they stay in jail three times longer than others before they are charged and six times longer before the case is heard.
Now, in his county, people with mental health issues are diverted to the Mental Health Court when first arrested, he said.
"I would see them before the end of the next day, and they would have been evaluated by a clinician. The defense attorney would have talked to them, and I would know how long it's been since they were linked with services or in touch with a case manager."
In an evaluation of the court's first year, he said, the University of Washington reported decreased jail bookings, less time in jail and more treatment for the mentally ill.
"The court for the first time in the Judiciary has outside participation," Chow said. His staff includes a clinician linked to mental health services, a prosecutor, defense attorney, three probation officers, a part-time social worker for the public defender, a clerk and program manager.
Chow handles the calendar on a half-time basis.
"I knew when we were starting this, we would be touching the tip of the iceberg," he said. "Well, we've run into the iceberg. The existing staff is just overloaded."
He is working on getting another defense attorney and hopes to put together a foundation with private-sector involvement to finance another clinician so they can reach more people.
Most people assigned to the court are specialized in mental health issues so they can provide a quick assessment on whether community safety is an issue, Chow said.
Although the court is more of a therapeutic-type setting, he said, "We're still calling for accountability."
Community safety is balanced with efforts to link the defendant to mental health services and get them released from jail or dispose of the case, Chow said.
He said: "We're not dealing, necessarily, with insanity issues. We're trying to head it off kind of at the pass."
The court gets a lot of referrals, particularly in domestic violence, he said, noting a lot of family situations involve mental health issues.
About 15 mental health courts in the country will be established by the end of this year, he said. His court collaborates with a similar court in the city of Seattle.
He said the court tracks people more closely than the regular criminal justice system.
"It's a great thing for the community, a great thing for people and a great thing for families," the judge said.