Mental health advocates fear cuts

Six years ago, former corrections officer Mark Burchell was so sick from bipolar disorder that he imagined himself as a military general out to save the world.

In reality, he was an unwashed, unshaven homeless man searching out bus shelters and still-warm car hoods to sleep on at night.

The habit earned him stay after stay in jail until he was admitted to Nevada's pioneering Mental Health Court system, which steered him to stability and ultimately, a post as president of the Nevada chapter of the National Alliance for Mental Illness.

"This program saved my life," Burchell, 57, told state lawmakers at a recent legislative panel hearing.

Now he's fighting to save the life of the program, which would be moved under Gov. Brian Sandoval's proposed budget from the state's jurisdiction and made the responsibility of cash-strapped counties.

"It's a death sentence for mental health courts in our states," said District Judge Jackie Glass, who presides over the program in Clark County, which includes Las Vegas. People with mental illness "will be homeless, harassing tourists, stealing cars and identities, and committing dangerous crimes because they're untreated."

The state's Mental Health Court system - which provides a voluntary alternative to jail time for offenders suffering from mental illness - was among the first of its kind in the U.S. Since the program began in Reno in 2001, mental health courts have become a national movement, increasing from only a handful in 1997 to nearly 300 now.

Reno's court, established in part by longtime District Judge Peter Breen, is one of five mental health courts in the U.S. designated a "learning court" by the Bureau of Justice Administration. Visitors hoping to start their own programs come from across the country to study the court.

"Nevada is a very conservative state, but these courts have taken hold here," said Breen, now a retired senior judge who is still active with the program. "They've grown because they're successful."

Eligible participants have a misdemeanor or low-level felony charge and a diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or major depression.

Glass said statistics show that, while participating in the program, client arrests drop 87 percent. Graduates of the program have an even higher likelihood of keeping out of trouble - 95 percent do not re-offend.

Judges hold defendants accountable for taking their psychotropic medications, staying off illegal drugs and attending hearings. State funds help pay for housing for participants, who often are homeless because their erratic behavior alienates family members and friends.

Judges coordinate with "team members" that include social workers and attorneys. In a traditional court setting, the defendant might only meet with a judge once, but in a mental health court, the defendant sees the judge as often as weekly over the course of a year or more.

"When the judge sees the defendant, the defendant is reminded of the power of criminal law, and the responsibility they have to the society," Breen said. In effect, the threat of jail time is a motivator for the offenders.

Moving the mental health court system to county control is part of a proposed 12.4 percent cut from the $705 million Nevada Mental Health and Developmental Services Division budget approved for the 2009-11 biennium. Transferring responsibility for the mental health courts would save the state about $6 million in the two-year period, one step in the governor's quest to cut $1.6 billion in spending.

But what's more likely is that the decade-old system - which enrolls more than 300 people at any given time - will vanish, Glass said. Clark County, Nevada's largest, estimates $30 million less in property taxes this year on top of a $70 million deficit it plugged last year with one-time funds that are now gone. Washoe County faces a $33.5 million shortfall.

"Bottom line, we have no funding to absorb any services the state may want to transfer to the county," said Washoe County spokeswoman Kathy Carter.

The decision came when department administrators considered which services were "core" and which were "optional." Compared with services such as psychiatric hospitals and outpatient clinics to administer psychotropic medications, the mental health courts didn't make the cut.

"Everybody realizes how valuable they are, but there just isn't enough general fund to fund it," said Harold Cook, administrator of the Division of Mental Health and Developmental Services. "Triage decisions had to be made. ... I think mental health services are important, but they are expensive."

Glass vowed to continue her quest to save the courts. She told lawmakers that they had a choice of paying now, in funding the program, or paying later, in increased law enforcement, jail and court costs.

That's how Reno Police Officer Patrick O'Bryan sees it. Specially trained in counseling people with mental illness, O'Bryan's days regularly include talking people out of jumping from the roofs of high-rise casinos - an occurrence that's increasingly common as people suffer the psychological effects of the recession.

"It's just skyrocketing," O'Bryan said. "Six years ago, when I started to trek into the mental health world, we'd have one suicidal subject per shift or per day. Now it's two to three per hour."

Some see the mental health courts as a more enlightened approach to dealing with mentally ill offenders, but O'Bryan said the main point is that it's practical.

"When you keep their dignity and find ways to help them and not be judgmental, things just work out well for everyone involved," he said. "We can't afford for (the jail) to be the largest mental health hospital in the area."

What Burchell remembers from those months in solitary confinement is obsessing about specks on the walls, refusing medication he thought was poison, and crumbling into his cell corner in tears.

"Jail is no place for the mentally ill," he said.