Mental-health court no longer in session

Mental-health court no longer in session

Some suggested you'd have to have your head examined to start a mental-health court. Maybe they were right.

After a little more than two years in operation, Champaign County's experiment with mental-health court has crashed and burned — the victim of philosophical differences between Circuit Judge Jeff Ford and State's Attorney Julia Rietz.

Champaign County Presiding Judge Thomas Difanis announced last week that he's "going to close it down" because Ford and Rietz have differing opinions about how to handle mentally ill people referred to the program.

Ford has stated he believes the best results can be obtained by using the judiciary's power of coercion to force reluctant individuals to take their medications and attend counseling sessions. Rietz disagrees, asserting that helping people and referring them to assistance programs is OK but that compelling them to participate under threat of being jailed is not.

We don't have an opinion as to who is correct on the moral or legal questions raised here. But, given the history of the mentally ill, it's hard to see how a mental-health court could be effective without using all the tools traditionally available to a judge, including the power of coercion to force compliance with court orders.

Then again, should a judge, even one acting on medical advice, be empowered to enforce medical treatment against an individual's wishes? This is tough stuff — no easy answers here.

Under ideal circumstances, the courts would have little to do with mental-health issues, except as they relate to individuals who pose a threat to themselves or others.

But increasingly over the years, our jails and prisons have become second homes for mentally ill people who engage in criminal activity. Champaign County Sheriff Dan Walsh can cite chapter and verse the problems posed by housing and caring for mentally ill individuals who are arrested.

The vast majority of these people are not legally insane. They have mental-health issues that make it difficult for them to stay out of trouble. Some of their issues can be addressed simply by seeing that they take the proper medication.

But that's harder than it sounds, and it's why the Illinois Supreme Court authorized Illinois' 102 counties to set up a court to see if a more creative approach could stanch the problem. The track record in Champaign County is slight — some two dozen people referred to mental-health court, with less than 10 successfully completing it.

The drug court over which Ford presides has had much greater success. But it's much easier to order a defendant not to drink and to attend alcohol counseling than it is to tell someone not to be mentally ill.

Addressing a medical problem in a legal forum would be problematic under the best of circumstances. Throwing in major differences of opinion between the two major players has, for now at least, escalated the degree of difficulty to impossible.

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rsp wrote on May 08, 2013 at 9:05 am

The Judge has research to back his opinion up. I just wish they were trying an advocate with those who were having an issue to see if their problems could be worked out. Maybe a different caseworker, or a med change. Sometimes an outsider can work better to find out what the real issue is. It could just be the dose is too high for a particular patient. Or they don't understand how it works. It's not a one size fits all. But the Judge is right and it's a shame Rietz didn't look at those studies. I've seen them and worked with the homeless. If people refuse to try to work it out them all santions should be open to the Judge. The research backs him up.

EL YATIRI wrote on May 08, 2013 at 11:05 am
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If the Judge has convincing research he should present it for all to analyze.  The truth is that most of the pharmaceutical research is very flawed.  Even if we accept that the research is legit, at best the effectiveness rates are little better than placebo for most psych meds.  They take weeks to take effect, meanwhile a person is just held in jail?  What about informed consent?  It is OK to just medicate someone without their consent?  Why not just do court ordered mandatory ECT as well? 

Please link the research you keep referring to.  I'd like to read it myself. Yes please give us references on the studies you talk about.

rsp wrote on May 08, 2013 at 1:05 pm

Informed consent? They have the option not to try for mental helth court. Then it's jail.  They are asking for mental heath court instead of going to jail and then not co-operating with it. 

EL YATIRI wrote on May 12, 2013 at 10:05 am
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Maybe they should be water boarded for refusing medication?

EL YATIRI wrote on May 08, 2013 at 11:05 am
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Here is a reference about the issue: http://www.nmha.org/go/position-statements/p-36, it doesn't back coerced treatment.

SaintClarence27 wrote on May 11, 2013 at 9:05 am

It doesn't back treatment when it is "coercive AND involuntary." Notice the conjunctive. And the reality is that the OTHER option for people in the Mental Health Court (which will now be forced, not an option) is jail anyway.

 

Bulldogmojo wrote on May 08, 2013 at 10:05 am

"the victim of philosophical differences between Circuit Judge Jeff Ford and State's Attorney Julia Rietz.""

Rietz and Ford are lawyers, where is the psychiatric advocate in all of this? Do these people have medical advocacy when they show up to court? Or is this really about money for resources?

After Ellen Feinberg murdered her child and almost murdered her other one she was through the court sytem and into a mental institution in a very short period of time and now lives in a halfway house. So maybe this really is about who you are and how much you have rather than the mental illness itself. 

Sid Saltfork wrote on May 08, 2013 at 1:05 pm

"some two dozen people referred to mental health court with 10 completing it successfully" is slight?  That means that 42% of mentally ill people successfully completed the program.  This is mental illness that is being addressed.  What do people think is the success rate across the country?  Would 16 out of 24 which is 67%, two thirds, be considered successful?  Do people think that 24 out of 24 , two dozen out of two dozen; would meet the definition of successful?  What is the successful percentage of preventing recidivism for all criminals?  Quite frankly given the types, and numbers of mentally ill; 10 out of 24 is not a bad percentage.

rsp wrote on May 08, 2013 at 2:05 pm

There are 10 people who asked to be in the program who are now refusing to co-operate. The Judge wanted to apply the sanctions available and the Reitz doesn't want to do it. In other words, people asked to be in the program instead of going to jail, agreed to terms, and now have a get out of jail free card. 

rsp wrote on May 08, 2013 at 2:05 pm

Ellen Feinberg complied with everything that was expected of her. She lost everything in her case so it isn't about how much she had but how much she was willing to do to get better. 

Bulldogmojo wrote on May 08, 2013 at 2:05 pm

My point was that if you are poor, a minority, or disadvantaged you are not likely to get a fair shake in the judicial or mental health system. Just look at the demographics of our prison population and the homeless and our displaced veterans. 

Feinberg didn't lose everything she threw everything away, it's an important distinction. I may be wrong but I suspect the surviving Feinberg's would agree.

rsp wrote on May 09, 2013 at 7:05 am

I would beg to differ. She was ruled insane. She didn't know what she was doing. You make it sound as if she chose to do what she did. She didn't. She will spend the rest of her life knowing she killed one son, almost killed another, destroyed her family. She didn't choose to do that. If you think she did you don't have a clue about mental illness. 

The legal system is skewed against those who would attempt to plead insanity. The public is so concerned with the possibility that someone might "get away with it" that laws were changed to keep that from happening. They will drug someone so they are "sane" for trial to convict them and condemn them even though they were insane at the time of the offense. They have become show trials. 

Bulldogmojo wrote on May 10, 2013 at 2:05 pm

Or maybe she was a cold blooded killer who got away with being ruled insane. Maybe not so hard to do with top dollar defense and being an MD with knowledge of what the psychiatrist would be looking for to make that determination. We'll never know for sure.

rsp wrote on May 10, 2013 at 3:05 pm

I don't think you're familiar with this case. It's a disservice to her family that someone would suggest she did it on purpose. She had a long history with mental illness. There were signs that things were wrong before this happened. By the way, she was evaluated by the same psychiatrist who does almost all of them for the court system and it was his belief that she was insane. 

Bulldogmojo wrote on May 10, 2013 at 4:05 pm

Maybe you should refresh your facts. Lots of bipolar depressed people get by without committing murder. http://www.news-gazette.com/news/local/2009-05-06/mother-who-attacked-kids-move-halfway-house.html  I'm sorry you are uncomfortable with the notion that someone would intentially kill their own kids but it does happen. I don't think her family wants this monster roaming the countryside either. She got a slap on the wrist for her crimes. If she were a minority on wellfare she would be in prison.

rsp wrote on May 10, 2013 at 8:05 pm

I'm very familiar with her case,  and with bipolar disorder. I've been around murderers before. I've been around people who are psychotic because their medications were wrong. You did catch that her husband sued her doctor for failing to treat her properly and at the same time says it's all her fault? Collected money because the doctor knew she was a danger and psychotic but won't forgive her. Won't let his son forgive her. His son will never see her again. But he's raising him in fear. Any child who went through something like that would wonder if he did something wrong. Forgiving would let all that go.

Bulldogmojo wrote on May 12, 2013 at 12:05 am

Yes and I've had my share of experiences with coming into contact with mental illness in people I've known as well. You would be hard pressed to find someone who hasn't. Getting back to the legal issues here we are talking about two not very scalable disciplines Psychology/psychiatry and the legal system. One is a system of a great deal of subjective perceptions and the other is completely bogged down in it's own minutia. We have people who have done more years in prison for weed offenses than some people have served for murder.

I am highly suspect how some violent offenders commit their crimes without having to face the scrutiny of a jury and get marginal sentences and punishments while others will be ground under the heal of every harsh aspect of the legal sytem with the inevitable outcome of life imprisonment or even the death penalty in some places.

It is also unusual for someone to just have a psychotic break out of the blue unless they spent a lifetime of laying the ground work of dysfunction in repeated patterns in their lives during more sober minded times. The mental health system and the courts are going to have to interface much more closely rather than just throw in the towel as they have done here if we are going to preempt the finality of someone going completely over the edge.

I am just very curious how the currency of "justice" gets spent more liberally on some people rather than others. 

Dick Cavett once said "don't believe for a second that a suicide Isn't directed at someone."

I think the same could be said for a murder in addition to the actual victim. Wouldn't you?

urbanaman wrote on May 09, 2013 at 12:05 pm

As much as any issue facing our country, and species really, dealing with mental health is about as much of a "Rubik's cube" as it gets. Like many others here, I have ideas about how to begin peeling back the layers to find the bogglingly complex (extensive and systemic, at the very least) solution, and surely differ with many of you on an approach. But maybe we can all agree that progress can't be made when you have someone like Judge It's-all-black-or-white Difanis calling for scrapping the whole endeavor. Has he offered any alternatives? Aurora and Newtown attest to fact that it's no longer just about how to deal with someone peeing in the street behind his loaded shopping cart. Even the Ellen Feinberg situations demand that we start identifying these people who are beyond "stressed out." It's too much to ask to move toward a culture of mental well being in this country, I know, but could we maybe set up an independent commission of some sort on our local level to reach a consensus (simple majority, at least), instead of just two individuals who's differing opinions result in a perpetual tie? 

Hint: It would have to include an odd number of experts voting on only TWO recommendations at any one time...