IN RECENT YEARS, officials in the criminal justice and mental health systems have become increasingly aware that many offenders suffer from mental illnesses. At the same time, counties across the country have grappled with jail overcrowding.
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The Northern Kentucky Regional Mental Health Court is tackling these problems in the Greater Cincinnati region. The court, launched with the help of funding from The Health Foundation of Greater Cincinnati, sends offenders with severe mental illnesses to treatment rather than to jail. Since the program began in 2008, it has diverted 123 low-level offenders, saving taxpayers $371,575.
“The Northern Kentucky Regional Mental Health Court has demonstrated that defendants with mental health disorders are more effectively and efficiently served in the community,” said David Wilkerson, director of the Training and Development Center/Mental Health Court Services Program at Northern Kentucky University. “It serves as a model program providing intensive, community-based case management that reduces symptoms, improves quality of life, and closes the revolving door of the criminal justice system for this population.”
Creating something new for Northern Kentucky
In April 2006, the Campbell County Fiscal Court brought together agencies and individuals in the criminal justice system to create the Criminal Justice Advisory Commission. Its goal: to find ways to ease jail overcrowding in Campbell County. According to the commission, the number of people in local jails in Kentucky had increased 50 percent between 1993 and 1998.
Meanwhile, studies found that many offenders in the criminal justice system had mental health problems. The Bureau of Justice Statistics estimated that in 2005, 479,900 local jail inmates across the country, or 64 percent of the total jail population, had a mental health problem. Locally, a 2003 study by the Health Foundation found that 90 percent of Cincinnati-area men convicted of low-level crimes had at least one previously unidentified mental illness.
The commission conceived the mental health court as a way to ease overcrowding while treating low-level offenders with severe mental illnesses. After helping to fund planning for the court, the Health Foundation awarded $162,000 to the Northern Kentucky University Research Foundation to implement the court.
How it works
After an arrest, people charged with nonviolent misdemeanors and minor felonies in Boone, Campbell or Kenton counties are screened for mental illnesses. Defense attorneys for those flagged with a possible mental illness may ask the judge to send their clients to mental health court for an assessment. Defendants with a history of a mental health disorder or treatment may also be referred for an assessment.
Mental health court clinicians assess those who are referred and determine if they meet the court’s admission criteria. Clinicians look for persistent severe mental illnesses, such as major depression with psychotic features, schizophrenia and bipolar 
disorder, that have lasted six weeks or longer. The referring judge is notified if a person is eligible for the program. Ultimately, the judge decides who gets diverted to mental health court. If chosen, clients must volunteer for the program; completion of the program will be part of their sentencing.
Once admitted to the program, which lasts at least 12 months, clients can receive medications from NorthKey Community Care or a private physician and counseling from mental health court clinical staff members. They also appear frequently before one of six judges assigned by Chief Justice John D. Minton Jr. to preside over the mental health court. Participants must attend all scheduled treatment appointments and all court dates. To graduate from the program, participants must get the treatment they need, establish stable housing and income, show a reduction in symptoms, avoid criminal charges and improve their social supports.
Benefits beyond diversion
Beyond saving money by diverting mentally ill offenders from jail, the Health Foundation wanted its grant to help improve clients’ health status and keep them from returning to jail on other charges. The court exceeded both of those goals.
“We are very happy that the court helps people with mental illness live healthier lives,” said Janice Bogner, senior program officer for severe mental illnesses at the Health Foundation.
- When clients were surveyed after completing the program, 72 percent of respondents reported improved mental health functioning and 73 percent reported improved quality of life.
- Mental health court clients were also less likely to return to jail on another charge. Only 15 percent of participants were arrested again, compared with 38 percent of people arrested again in all of Kentucky.
- Besides improving clients’ health, the program also helped educate Northern Kentucky University students. Over the three years of the grant, 36 students completed their field work with the mental health court.
“Social work students assist with case management, clinical and administrative duties,” Wilkerson said. “Counseling interns assist in conducting diagnostic assessments, eligibility determination and counseling with the clients.”
In addition, four students from NKU’s Chase Law School completed the pro bono hours required for graduation by assisting the program to determine the amount of fines, court costs and restitution owed by participants.
Promising future ahead
Though the Health Foundation grant has ended, the mental health court has been able to sustain itself by obtaining other funds. The Kentucky Department of Corrections has increased its funding of the court each year, reaching $194,075 in fiscal year 2012. In addition, the fiscal courts of Boone, Campbell and Kenton counties have provided $89,061 in funding for 2012.
All six judges appointed to the mental health court are still presiding over the program. They hear cases twice weekly in all three counties. The staff of three case managers, a clinician, a court administrator and a clinical director works out of a permanent office at the Campbell County Circuit Courthouse in Newport. After only three years, the Northern Kentucky Mental Health Court has become an established part of the local court system that can help people with mental illnesses in the criminal justice system.
Original article available here: The Health Foundation of Greater Cincinnati
