Up until a year ago, "Mr. Smith" was arrested 30 to 40 times a year in Carson City. Usually, it was for crimes like being drunk and disorderly in public, stealing small items from stores and sleeping in public places.
Then, a year ago, Mr. Smith entered a Mental Health Court. Since then, he has not been re-arrested. Instead, several times a week he attends group and individual therapy sessions. He takes medication. Each week he is tested for drug and alcohol use and he has mostly stayed clean and sober (with a few bumps along the way). He meets with his probation officer several times a month to discuss goals like taking classes and finding a job. Five days a week he goes to AA meetings. He goes to church now and he has an apartment. And, he goes before the judge each week to report on his progress.
Mr. Smith is older than you might think. He is in his 40s. He was diagnosed with schizophrenia as a young man but hit the streets, rather than a mental health facility, soon after. He began drinking because it made his "voices" and his emotional pain go away. Soon, he was always drinking.
Since the 1960s, mentally ill people, and those with drug and alcohol addictions, have flooded our judicial systems. Prior to this, they were institutionalized. Today, the U.S. Department of Justice reports that 80 percent of people in prison are addicted to drugs or alcohol and 40 percent have a serious mental illness. Twenty-four percent of people in jail are experiencing at least one psychotic symptom. Somewhere between 60 to 90 percent of prisoners were abused as children.
In the 1980s, progressive judges in Alaska and Florida started the first mental health court and then drug court. Judge Stephanie Rhoades (Alaska) stated, "I started seeing a lot of people in criminal misdemeanor cases who were cycling through the system and who simply did not understand their probation conditions or what they were doing in jail. I saw police arresting people to get them help. I felt there had to be a better solution."
Today, there are 2232 drug courts across the country, 150 mental health courts, and many other variations of these specialty courts. The goal of specialty courts are the same: To improve public safety by reducing crime, to increase the quality of life for individuals' by increasing their participation in effective treatment, and to reduce court and correction related costs by providing alternatives to incarceration.
Nevada has 42 specialty courts. These include drug courts, family drug courts, mental health courts, juvenile drug courts, DUI courts, veterans' court, and a new co-occurring disorders (having both a mental illness and a substance addiction) court in Reno. Carson City has a drug court and a mental health court.
So, you might wonder, do they work?
Yes. Rates vary from state to state but only 4 to 29 percent of people who participate in specialty courts are re-arrested after they graduate. The re-arrest rate is nearly three times this for people who don't participate in specialty courts. Participants are significantly more likely to keep taking medications, to attend self-help groups, and to continue mental health treatment after graduation. Nationally, on average, it costs about $47 a day to have an individual in a specialty court; it costs about $142 a day for jail or prison.
The United States locks up more people than any other country in the world. It is likely that Mr. Smith still would be in and out of jail if it weren't for a mental health court program. Thank you to all of the judges, legislators, law enforcement, court staff, and treators who create these positive solutions for the Mr. Smiths in the world.
• Lisa Keating, Ph.D., is a Carson City clinical psychologist.
