For the week of June 11 - 17, 2003

Will county get next mental health court?

Task force gathers positive 
response during tour

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By TONY EVANS
For the Idaho Mountain Express

Several Blaine County participants of a Mental Health Court Task Force that visited Idaho Falls last month were impressed enough with the services in that city to inventory resources in Blaine County to see what can be done here for the mentally ill.

"It was a powerful thing to have a lot of key people together from the judiciary, law enforcement, mental health, and community advocates, all talking and asking questions of one another." said Tom Hanson, president of the Wood River Valley chapter of the National Alliance for the Mentally Ill. Hanson was instrumental in forming the task force.

NAMI is a Washington, D.C.-based advocacy group with 125 affiliates nationwide. Mental health courts are the result of collaboration in recent years between the mental health and criminal justice systems in the United States to keep the mentally ill out of jails and increase community-based treatment options.

A mental health court is made up of 12 dynamic and dedicated mental health professionals known as an ACT team, or Assertive Community Treatment. The ACT team is authorized by a judge to conduct ongoing assessments and follow-up care for the mentally ill in a community who have had run-ins with the law. Mental health courts have been established in at least 50 U.S. communities since the first one was established in Broward County, Florida, in 1997. Judge James Saint Claire’s court in Idaho Falls is modeled on a San Bernardino, Calif., court which addresses both felony and misdemeanor offenses.

Blaine County Magistrate Bob Elgee observed the Idaho Falls court in progress.

"I thought the judge was great," Elgee said. "A mental health court could keep people from falling through the cracks here, to where they have only the State Hospital or Canyon View as alternatives. You’d have judicial support for this, but we are only one piece."

Ketchum Police Chief Cory Lyman, who also went to Idaho Falls, agreed.

"We need to inventory resources here, perhaps form partnerships, and work hard to make it happen. If not, we would be letting a lot of people down," Lyman said.

The Idaho Falls program has saved the state $81,000 in it’s first nine-months of operation, said ACT Team leader Eric Olson. These are costs that would have gone toward hospitalization, incarceration and legal fees for the 15 people enrolled in the volunteer program. Mental Health Court clients submit to the 24-month program in lieu of sentencing for felony and misdemeanor charges. The court provides what Olson described as "a rather strict probation." ACT teams have been described as hospitals without walls, taking advantage of the revolution in psychopharmacological drugs for mental illness.

"The ACT team and staff in Idaho Falls are far superior to anything we have here, especially, their high level of monitoring to serve the needs of the community." said Blaine County Deputy Prosecuting Attorney Tim Graves.

The Blaine County office is assessing the case-load of severe and persistent mental illness in the county to see if its population, one-quarter that of Idaho Falls, warrants the establishment of a mental health court.

"First someone has to be mentally ill. Second, they have to break the law. Right now, for cases of severe mental illness, I don’t think that amounts to more than four or five cases per year--if we are only counting schizophrenia and bi-polar, as they do in Idaho Falls," Graves said.

He calls this "a real community problem."

"First they have to have mental illness, then they have to break the law. I think this amounts to only four or five cases a year," Graves said. "We have to sit down and have a good look at the numbers before going to the county commissioners for money."

However, Hanson would like to see more community-based treatment on the "front end" before someone gets into serious trouble. "We could begin by getting a Crisis Intervention Team off the ground," he said. "CIT teams are made up of a dispatcher, trained law enforcement personnel and a psychological technician." He said Hailey Police Chief Brian McNary is in the process of putting forward a proposal for such a team.

Graves and others also expressed concern for those suffering from severe depression in the county, which has led in recent years to an increase in suicides.

Based on statistics from Eilleen Rodman at County Health Services, there is a rapidly growing demand for mental health services in Blaine County. In 2001, she saw 21 cases involving mental illness. The following year the number more than doubled to 49.

"There are services here, but people do not know about them," Rodman said. "We should make them more visible, create networks with the crisis-hotline, the police departments."

Of those 49 cases last year involving mental illness and the county assistance office, nine were involuntarily committed by a Designated Examiner to either the State Hospital or Canyon View. What remains to be known is what happens to the other 40 people who werenot committed, yet may be in need of help? "That is a very good question," said Rodman. "No one can be forced into treatment. We provide money and other forms of assistance. There are psychologists working pro bono. But it comes down to a matter of self-respect with individuals."

Judge Elgee believes the wording of statute 66.329 may allow for court authorization to get the people who need mental health services to stay in service programs.

"There is a part of statute 66.329 that may have an ‘outpatient provision.’" This provision may allow the court to take a more "hands-on" role in encouraging mental health treatment for those in need.

State Rep. Donna Boe, D-Pocatello, who serves on the State Judiciary Committee, also joined the Blaine County task force. She advised looking into the surcharge on liquor that has been used to fund drug courts in Region VII. Mental health courts are based on the drug court model, which also has been under way in Idaho Falls for four years. "With so many dual-diagnoses of mental illness and drug problems it seems a likely match," Boe said.

Boe’s colleague, Rep.Wendy Jaquet, D-Ketchum, also thinks the liquor surcharge may be worth looking into for funding, but warns that there is "no such thing as a surplus of funding at the legislative level."

Jaquet advises a system modeled on Judge Zairn’s juvenile court, which oversees underage offenses in eight counties across the Magic Valley. "He (Zairn) gets to know the people and the services in each county. And so there is a lot of accountability. A judge could meet with each county mental health court one or two days a month."

A number of task force delegates also toured the Pocatello Women’s Prison following the mental health court observation in Idaho Falls.

"Any effort to stem the tide of mentally ill from the Idaho prison system would be met with welcome" said Thomas J. Beauclair, director of the Idaho Department of Corrections. "There is a 7 percent annual growth rate in prison populations, 18 percent for women, and yet they pose the least threat to our society.

"Currently, there are four psychiatrists serving 1,000 mentally ill prisoners in Idaho. These are people who 20 or 30 years ago would have been in mental hospitals. We are not trained for this. Unfortunately, there are no advocates for prisons. We are at the bottom of the food chain."

Hanson and NAMI plan to gather task force participants in the near future to "see where to go from here."

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