Jackson's Mental Health Court features unique approach

By Frank Weir

Legal News

A fundamental part of Jackson County's Mental Health Court is the presentation of a certificate and gift card to those who have successfully completed its requirements.

A minor afterthought akin to the punch and cookies served at their graduation ceremony?

Not so.

"Our participants typically have never gotten a certificate in their lives or a gift card for anything," says Diane Cranston, executive director of clinical services for Lifeways.

LifeWays is the Community Mental Health organization responsible for the behavioral health services for residents of Jackson and Hillsdale County, and is the mental health court partner responsible for the behavioral health treatment services.

"They've never had anyone tell them they did a good job no matter what their strengths or weaknesses might be. That's something the rest of us take for granted."

District Judge Michael Klaeren who presides over the court added, "They've never had anyone of substance or significance give them the time of day. Yet here we have a judge, probation agents, therapists, and a prosecutor offering to help them solve their problems.

"If there's one thing I'm convinced of, it's that the quality of the lives of our court participants can be dramatically improved if they are willing to work with us," he said.

The Mental Health Court is in its second year and is a spin off of the county's first specialty court that deals with substance abuse, and its second, addressing domestic aggression.

Recovery Court is presided over by Judge Chad Schmucker. He also heads the planning committee for the Mental Health Court. District Court Chief Judge Darryl Mazur presides over the domestic aggression court.

Those accepted into the Mental Health Court must be Jackson residents; have a pre-existing history of mental illness; and be charged with a felony carrying a possible five-year prison term or a less serious felony or misdemeanor charge.

It's a voluntary program and the incentive is that the participant will stay out of jail so long as he or she cooperates with the program.

Individuals plead guilty to the charge they face and are sentenced to "intensive supervised probation" (ISP) of 12 to 18 months, as a general time frame for the length of the program.

However, Klaeren notes that some felons may be subject to a much longer probation up to as much as five years.

In the Mental Health Court, a team consisting of Judge Klaeren, therapists, probation personnel, police, and prosecutor evaluate participants as they begin the program.

The team, meeting every other week, continues to evaluate the participants' progress as they follow the rules and requirements of the court, which includes:

--coming to court every two weeks where Klaeren interacts with them encouraging and supporting their cooperation or finding out why they are not following the program;

--attending treatment sessions with therapists in the LifeWays Provider Network;

--following an 8 p.m. to 8 a.m. curfew;

--submitting to random drug and alcohol screenings if substance abuse is an issue;

--following other directions from probation agents assigned to their case.

"We have many rules and regulations and we do pick up a lot of violations by our participants over the time of their probation compared to less intensive probation programs but our goal is to get that person to succeed," Klaeren said. "We want quality graduates who will stand the test of time."

Violations can result in extended curfew hours, community service work, or even jail.

Klaeren noted that Jackson is one of 11 mental health courts in the state and the second one to begin.

But it is unique in several ways including a partnership with Brown's Advanced Care Pharmacy in Jackson which allows the mental health court treatment team to make sure participants are receiving and taking medications for their conditions.

Also unique is the participation of the Manager of the Behavioral Health Access Center for Allegiance Health, Jackson County's Community Hospital that has an inpatient psychiatric unit.

"Having these two entities involved is very unusual," Klaeren said. "I am certain our court is the only one in Michigan that has both a single pharmacy and the local community hospital involved with our participants.

"Through Brown's Advanced Care Pharmacy, we can monitor prescribed medications usage and Allegiance Health helps us to know if our people are coming into the emergency room.

"Participants literally can't turn around without someone knowing about it and this pushes participants to do what they are supposed to do. For instance, some of our people historically have gone to the emergency room as a way to avoid something but due to the participation of the Manager of Behavioral Health Unit Access Center, "we are able to monitor what's going on. Maybe the emergency room visit is justified, maybe not, and we can address that. Perhaps there is a medication issue that needs to be looked at," Klaeren said.

Certainly funding for the court is an ongoing issue. Although some start-up grants are gone, the court received federal dollars which will sustain the court's operation through 2012.

But both Cranston and Klaeren are confident in the continued existence of the court.

"Specialty courts are the future and the cost savings from not having people incarcerated is so great that I am very confident the funding will be there," Klaeren said.

And Cranston said, "there's no walking away from this. It will happen no matter what, even if we went back to a bare bones approach.

"We started with just folks who were Medicaid eligible and if we had to, we could go back to that model. But the judge and I continue to grow support for this by speaking with a number of groups.

"And politicians have been very supportive. Mark Schauer was a key component of support when he was a state senator and he still is as a United States Congressman," she said.

The Mental Health Court has served 31 individuals since its inception but in spite of the seemingly small numbers, Klaeren says the program is efficacious.

"We don't need high numbers of participants. We are not talking about first or second time offenders. These are folks who have been in a fair amount of trouble.

"It's the 'frequent flyers' that cost society the most money. If we can educate them about the importance of taking their medications even when feeling better, and develop that as a habit through our program, there is a significant financial and social benefit.

"Add to that the Lifeways Network Providers' treatment component and we are hoping for long-term stability among this core population that in the past has required the most expensive responses." Klaeren said.

Finally, for Klaeren, the court is his passion.

"I really believe in the ability of the District Court to have an impact in the area of rehabilitation even among those who are not mentally ill.

"Most of the people who end up in District Court are not your serious criminals. Often they are young people or folks with chronic problems who have made some bad choices and, with some guidance, can turn their lives around.

"So when the Mental Health Court began, I saw it as a natural fit for me and it was something I really wanted to do."

Cranston continues to be excited by the opportunities that the court offers from her mental health treatment perspective.

"For us, on the treatment side, this is very unique and exciting. It's something very new. In the past, if someone came to us and they were on probation, we of course emphasized the mental health aspects but we, as well as the court, tended to operate in a vacuum.

"To be able to have a combined inter-disciplinary team approach to these individuals really multiplies everyone's efforts and we did not want to miss this. We really enjoy being a part of it.

"Our graduates, and those who are succeeding in the program, physically look better. You can see how much better they are doing with their mental illness. They look better, they dress better, they aren't crying as much; that is what is so neat to see," she said.

Published: Thu, Jul 22, 2010