It is tragic that our jails have become our nation’s largest mental-health treatment facilities. It’s a public policy disaster resulting from a 90 percent reduction in U.S. psychiatric beds since deinstitutionalization began in the 1960s. Clearly, inadequate funding for community-based mental-health services has compounded the crisis.
That’s why the criminal-justice system is the default valve for many people who have mental illness, and why Montgomery County’s new mental-health courts are in high demand. Mental-health courts divert from prosecution to treatment defendants who are accused of low-level crimes such as vandalism, trespassing, disorderly conduct, theft or simple assault whose alleged offense is attributed to mental illness.
Our nation’s more than 300 mental-health courts advance justice. A 2009 study by the MacArthur Foundation and the Council of State Governments found they cut criminal recidivism of participants by 20 percent to 25 percent and provide better links to mental-health treatment that lead to productive lives. Mental-health courts also reduce emergency room visits. Reduced recidivism also improves criminal-justice system efficiency by avoiding repeated arrests of the same individuals for minor offenses.
Many people booked into jails need immediate mental-health care. In Montgomery County, that number skyrocketed from 1,011 in 2011 to 2,137 in 2015. Calls to Montgomery County Police related to a mental-health crisis increased from 4,440 in 2011 to 6,892 in 2016. Nineteen percent of men and 28 percent of women in our jail have a serious and persistent mental illness, and many have a substance-use disorder, too. Some have been arrested multiple times for the same minor offense because the underlying cause hasn’t been addressed. Each booking costs thousands of dollars.
Montgomery mental-health courts are Maryland’s most recent “problem-solving” courts, joining long-standing, successful mental-health courts in Baltimore City, Harford County and Prince George’s County. Mental-health courts are challenging to establish and operate because they require collaboration among many different agency personnel, including judges and court administrators, prosecutors, public defenders, correctional staff, probation officers, mental-health clinicians and case managers, state hospitals, and private providers.
A blue-ribbon task force chaired by Phil Andrews, a former County Council member, studied Maryland’s and the District’s mental-health courts, reviewed best practices and developed recommendations that became the blueprint for our mental-health courts.
In July 2016, Circuit Court Administrative Judge John W. Debelius III and District Court Administrative Judge Eugene Wolfe secured approval from the Maryland judiciary to launch mental-health courts. The County Council unanimously approved a start-up appropriation of $193,000, requested by County Executive Isiah Leggett (D), for case management in the Circuit Court and to fund two county mental-health therapists to serve both courts. Maryland’s Office of Problem-Solving Courts provided funding for District Court administration and case management. Nine months ago, Montgomery’s mental-health courts opened for justice.
Mental-health court participants must be 18 or older, county residents, deemed to be competent and not dangerous to the public and assessed to have a mental illness. As an incentive to participate, defendants who complete the program have charges dropped or reduced. Mental-health court referrals come from many agencies, as well as from defense attorneys and family members. My prosecutors will veto a proposed participant if the charge or the defendant’s criminal history or behavior threatens public safety. Mental-health court team meetings and sessions are held weekly.
A large majority of Montgomery’s 57 mental-health court participants — 45 in District Court and 12 in Circuit Court — are on track to complete the 18-month program. Success requires taking prescribed medication, weekly court check-ins, consulting with case managers and therapists, following probation rules, living in court-approved housing and, often, drug testing. Only three participants have been re-arrested, none for major crimes.
Montgomery County’s District Court mental-health court is at full capacity. Diverting eligible defendants from jail to treatment requires additional financial support from the county. That this court is at capacity just months after it began shows that it was needed. Expansion of the county’s mental-health courts is the smart and just thing to do.
The writer is the Montgomery County state’s attorney.