Robert Sheehan, director of the Community Mental Health Authority, said the Mental Health Court grant permits Platte, or another staffer, to focus on a caseload of 20 clients, compared to 40 to 80 otherwise.
"It´s a fantastic package," Sheehan said. "They can dedicate themselves to the program and not be distracted by other things."
Platte still has her hands full. All of the participants at Ingham´s Mental Heath Court have two or more co-occurring diagnoses, either a serious mental illness or substance abuse disorder. Most participants are repeat offenders.
"We´ve got people who have pretty long rap sheets for little crimes, in and out of jail," Platte said. "They might commit a crime when they´re completely psychotic and not really able to make good decisions. Our mental health system has had difficulty stabilizing them so they´ve fallen through the cracks. They´ve had commitment hearings. They haven´t been able to succeed on a probationary schedule."
"These are very high functioning people, very capable," Boyd said. "They just have a serious mental illness that has pushed them into criminality."
Ingham´s Mental Health Court participants were convicted of a wide range of offenses, including assault, retail fraud, stalking, disorderly charges, auto theft, domestic violence and larceny.
It doesn´t take a new offense to land a mentally ill person back in serious trouble. Probation bristles with hurdles for the mentally ill. "They might have trouble getting to the required appointments, especially regular drug testing," Platte said. The mental health court might furnish transportation to testing site, make phone calls for them if they don´t have a phone, or even pay for the tests.
"When they come out of jail, they don´t want to go back, but they find themselves violating probation and getting into more trouble, because their mental illness has gotten in the way of their follow-through," Platt said.
Sometimes, Boyd said, probation is the worst thing for a troubled defendant. "There isn´t a more anti-social environment in the world than our lobby," Boyd said.
No participants have "graduated" from the 5-month-old Ingham County program yet, but Platte reported "good progress." Some participants, she said, have been free of substance abuse or stuck with their medications for the first time in their lives. "They have improved relationships in their lives, engaged in therapy, and just become more positive," Platte said. One participant has found and kept a part-time job with the health court team´s help.
Boyd had is own way of measuring success. He said that without the Mental Health Court, "each of these people would have spent more time in jail than would have been appropriate."
Boyd is convinced that if the mental health court had existed when he sentenced the gangly young man who heard voices and fled the police, the outcome would have been different.
"We would have talked about his medications and steps we could take to increase the likelihood that he would continue taking them" Boyd said. "We would research possible housing options. We would start the process of stabilizing him in the community, using all the resources available to each team member. "
To Boyd, the program´s success depends on close and frequent huddles between his court, representatives of Ingham County Sheriff Gene Wriggelsworth´s staff and community-based mental health professionals. Each week, the Mental Health Court team assembles to discuss the week´s caseload for an hour and holds about two and a half hours of hearings. The contingent from the Community Mental Health Authority consists of Platt, Platte, services specialist Mary Liska and peer support specialist Marietta Shelton. From the 55th District Court, there´s Judge Boyd, who runs the program, along with chief probation officer Denise Wells, probation officer Al Spencer, and Sgt. Ottke. A defense attorney is also present.
The team is about to grow bigger. Beginning this week, hearings will be held on Wednesdays to accommodate the schedule of new members from the MSU Psychiatry Department, where a new forensic rotation for senior-level psychiatry residents is starting up. MSU residents will do a two-month stint at the Mental Health Court, where they will attend meetings, participate in decisions and help with hands-on treatment, including therapy and medications.
MSU Professor José Herrera will spend four hours a week supervising and helping with treatment.
With the Mental Health Court team in place, the stage is set for growth. At last week´s hearings, Boyd saw 15 participants. There are about 20 in all. The grant establishing the court was written with the expectation of serving about 50 to 60 people a year.
This fall, Platt´s team at the Community Mental Health Authority will help the 55th District Court apply for a grant renewal that will take effect Oct. 1. "We will ask for more resources to expand the program," he said.
Platt estimated that about 15 percent to 20 percent of people that come in and out of Ingham County Jail have a serious mental illness.
"You´ll see studies that go up to 80 percent, but it depends on which diagnoses you´re including," he said.
A 2012 study by the Michigan Supreme Court´s State Court Administrative Office found that mental health courts don´t stop the revolving door of incarceration and mental illness, but they put a stick in the works.
The study compared recidivism rates of participants in mental health courts with a comparison group of offenders who went through regular probation.
Checking in at 12, 18, 24 and 30 months after admission into the program, researchers found a "significant difference" between the groups every step of the way. At 12 months, about 5 percent of mental health court participants had been reconvicted, compared to over 19 percent of the comparison group. By the 30-month mark, more than 40 percent of the comparison group had been convicted of a new offense, compared to under 20 percent of those who went through mental health court.
The study also found that 97 percent of mental health court participants improved their mental health, as assessed by professionals, and about a quarter of the participants gained improvements in education and employment.
(By 2012, more than 300 offenders have "graduated" from a mental health court and hundreds more have successfully completed such programs since then.)
Findings like these have made mental health courts popular on both sides of the state´s legislative aisle. Ingham´s Mental Health Court came into being quickly after Public Act 274 was passed by the state Legislature and signed into law last December. Lt. Gov. Brian Calley chairs the Mental Health Diversion Council, part of the state´s Department of Community Health charged with helping mentally ill offenders get treatment instead of doing jail time.
The law expanded the mental health court system by authorizing the state´s circuit and district courts to set up mental health courts and set guidelines for eligibility. Depending on how many courts decide to write grant proposals, the law promises to add significantly to the 16 that were already in place around the state last fall.
Boyd is encouraged that the Mental Health Court bill passed the state´s contentious Legislature easily.
He cited two compelling reasons for the overwhelming bipartisan support.
"Some people were motivated by the fact that they didn´t believe what we were doing was effective," he said. "Other people were motivated by the fact that it was way too costly. So there´s hardly anybody left to think we should keep doing what we´re doing."
As the program grows, Boyd is spreading the word about the new court to law enforcement and mental health communities. He held two forums with public health and law enforcement agencies this year and plans to hold several more, including a June 6 forum at Lansing´s Alane & Chartier law firm (see info box.)
With the new law on the books, mental health courts are likely to proliferate. According to Platt, the 30th Circuit Court in downtown Lansing is working on a grant from the State Court Administrative Office to develop a mental health court for people who have been convicted of felonies.
Nobody is pretending that 20, or even 200, mental health courts will compensate for the drastic plunge in adequate mental health care and systematic closing of public mental health facilities in Michigan and across the nation since the 1980s.
Boyd and others attended an eye-opening presentation at a National Alliance for the Mentally Ill conference at East Lansing´s Hannah Center last fall. The keynote sparker was Pete Earley, former Washington Post reporter and author of "Crazy: A Father´s Search Through America´s Mental Health Madness."
Earley´s account of grappling with his son´s mental illness and incarceration struck a familiar note. "He was fascinating," Boyd said. "Mental illness is being re-institutionalized, only now it´s through the criminal justice system."
However, in "Crazy," Earley declared the trend toward mental health courts and jail diversion programs "encouraging," but cautioned that they are only reactive steps.
"The mentally ill should not be arrested and go to jail to get mental health services and treatment," he wrote.
Boyd is hoping the Mental Health Court will be part of a solution for those who do run afoul of the law.
"So many times, parents that have been working with their kids´ mental illness, something bad happens or they give up and dial 911 asking for help," Boyd said. "They find out it´s the last thing they get. They just get victimized again.
"One of our goals is to make sure that when families reach out to dial 911, they actually get help."