The Missoula Mental Health Court works with prosecutors, defense attorneys and local treatment agencies to help offenders whose crimes appear linked to their illnesses, much in the same way drug courts seek to treat inmates with addiction problems.
“People noticed that drug treatment courts were having positive results, so they began to look at other populations in the criminal justice system that were defined by very specific aspects of the offenders' lives,” said Theresa Conley, Missoula's mental health court coordinator.
Increasingly, judges and other officials in the justice system are catching on. By treating mentally ill defendants less as criminals and more as sick people who need help, proponents hope to ease jail overcrowding, save money and better serve mentally ill offenders.
For example, a mental health court judge might allow a person convicted of a nonviolent crime the option of participating in counseling or receiving medication rather than serving jail time.
“We have inadequate mental health care in Montana,” said Standing Master Brenda Desmond, Missoula's mental health court judge. “We're a far cry from solving the problem, but incarceration is certainly not the solution.”
According to a national report by the Bureau of Justice Assistance, which is funding the Missoula Mental Health Court, defendants who show signs of mental illness, ranging from depression to schizophrenia, tend to linger in jail two to three times longer than other inmates while officials determine whether or not they're competent to stand trial.
And because these inmates need closer supervision and daily medications, the cost of keeping them locked up is at least twice as high. Pharmacy staff in the Multnomah County, Ore., jail estimate that more than 45 percent of their pharmacy budget is spent on psychotropic medications.
To address the problem, mental health courts started springing up in the late 1990s as a way to stem the tide of mentally ill offenders entering prisons and jails. Now more than 100 mental health courts have been established or are in planning stages nationwide.
According to the Consensus Project Web site, a guide for policy makers and mental health professionals affiliated with the justice system, the term “mental health court” originated in a Broward County, Fla., courtroom in 1997, when a judge wrote of creating a specialized court “to stop the revolving door that causes mentally ill people to spin in and out of the criminal justice system.”
Missoula's mental health court was granted funding in 2003, but wasn't fully implemented until last year and the new program, which accepts offenders from district, justice and municipal courts, is already assisting 19 defendants at various phases in their legal proceedings. The Mental Health Court convenes weekly in District Court and monthly in Justice Court. So far, there hasn't been any demand for Municipal Court hearings, because the charges can be resolved by paying a fine.
It's a solid step in the right direction, says Conley, but much more needs to be done to increase funding for existing community services, as well as to create new programs.
While approximately 5 percent of the United States' general population has a serious mental illness, about 16 percent of the country's prison and jail population is afflicted.
The disparity, Conley said, shows a growing need to tailor the criminal justice system to meet specialized needs, which can only be accomplished by linking offenders who would ordinarily be prison-bound to long-term community-based treatment.
Since 2003, the federal Mental Health Courts Grant Program has funded 37 mental health court initiatives, including the one in Missoula.
But allocating the appropriate alternative services for an offender isn't easy, and the waiting list for treatment, counseling and housing keeps getting longer.
The biggest problems lie in finding access to services that already exist and funding treatment for people because their access is limited, Conley said. Although many offenders don't have Social Security and aren't eligible for Medicaid or Medicare, they can still be eligible to receive funds under Montana's mental health services plan. However, those loopholes are getting more and more scarce.
Mentally ill offenders can be referred to services offered by the Western Montana Mental Health Center, but immediate placement isn't likely.
“We have an array of services for persons with serious mental illness,” said Melinda Mason, director of Missoula's Adult Mental Health Services. “But there's generally a waiting list for those services, and it largely depends on funding streams.”
But even though there's room for improvement in Missoula, it could be a lot worse, Desmond said.
“There certainly are not enough mental health services in Missoula, but we have more than a lot of small rural communities,” Desmond said. “And there are a lot of people in a lot of relevant positions trying to understand the issue and taking some steps to address it.”
Many of those people are state senators introducing legislation seeking funding for additional services.
“We hope it's a legislative priority, but I don't want to curse anything,” Mason said. “I think the need is greater now than it ever has been. It's definitely more difficult to provide mental health services than it's ever been. We hope the Legislature sees it that way.”
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