Dougherty Superior Court Mental Health/ Substance Abuse Treatment Court Program Mission Statement It is the mission of the Dougherty Superior MH/SA Treatment Court Program to provide services that can be accessed at some level by anyone that meets the program s entrance criteria and is in need of assistance. Vision Statement Our vision is that the consumers we serve will be able to live and function at a productive level in a community of their choosing and will eliminate or minimize further involvement with the criminal justice system. Goal To decrease or eliminate the number of hospitalizations, crisis unit admissions, or arrests experienced by the individual once enrolled in the program.
BACKGROUND INFORMATION In 2001, meetings were held involving judges, law enforcement officers, probation officers, lawyers, mental health professionals, disability advocates, and administrators from the Dougherty County Jail. The meetings were held to address concerns regarding repeat offenders who appeared to be suffering from chronic mental health and addiction issues. Following a planning process, the Dougherty Superior Court Mental Health/Substance Abuse Treatment Program was started in the fall of 2002. This program is for defendants with similar characteristics, such as a past history of mental health problems and/or substance abuse disorders. Many of the participants have little or no support systems, minimal income, and numerous occurrences of arrests, jail stays, and hospital and crisis unit admissions. As a further result of these initial meetings, two local psychologists conducted training for local police officers, paramedics and firemen on how to identify and interact with persons in the field that may be in a decompensated mental state. Through NAMI and the Georgia Department of Human Resources, some local law enforcement officers have completed Crisis Intervention Training (Memphis Model). AREA STATISTICS Albany, Georgia (population of approximately 76,000) is the county seat and only incorporated city in Dougherty County (population of approximately 96,000). Recent census data shows Dougherty County population as 60.1 percent African-American, 37.8 percent Caucasian and 2.1 percent other ethnic origins. Albany is the only small city of any size in a sixty five mile radius in southwest
Georgia. Dougherty Superior Court is the general jurisdiction state circuit court. The Dougherty Judicial Circuit is the only single county circuit in South Georgia. Southwest Georgia still largely has an agricultural based economy. The area is one of the poorest Congressional districts in the country. This area of Georgia has a shortage of mental health professionals and particularly has problems recruiting and retaining psychiatrists. PROGRAM DESCRIPTION The program s staff consists of the judge, an assistant District Attorney, an assistant Public Defender, two probation officers, the program coordinator and two case managers. The program is flexible to ensure that participants are provided access to the most appropriate treatment paths. The program coordinator is a registered nurse and a licensed professional counselor. Participants are screened and assessed by program staff. Some referrals are diverted from the jail and enrolled in other treatment programs to address specific needs on a more intensive scale. Participants who are enrolled in the post-adjudication probation program are placed in either the mental health track or the substance abuse track. The mental health track is utilized for those participants with a primary mental health disability. Many have co-occurring substance abuse disorders. Their encounters with the criminal justice system many times coincide with non-compliance with medications. As a result, there is an increased likelihood the person will decompensate and become psychotic, delusional, or both. The addiction track focuses on repeat drug offenders with little or no history of debilitating mental health issues. This track has a one year program
completion span. It focuses on group sessions, frequent drug tests, and 12 step therapy. Each track has an assigned case manager. Case managers monitor the participants progress, work to restore and/or establish benefits, and oversee other activities pertaining to the participants progress in the program. The program s two state probation officers are assigned to monitor all participants enrolled. They not only monitor the activities of the probationers in local programs, but also monitor those probationers who have been placed in a residential program in other areas of Georgia. Having designated probation officers increases training opportunities and narrows lines of communication. PROGRAM REFERRALS Referrals are accepted from other courts, probation offices, the Public Defender s Office, other attorneys and from the county jail. If family members want to refer a candidate for consideration, they are encouraged to contact the person s probation officer or attorney. LINKAGE Participants are linked with 12-Step programs to address addiction issues. The local mental health center is utilized, where there are several other programs available such as the Substance Abuse Day Services Program, the Hope for Women program and Peer Support. If needed, the Court program has been able to access private practitioners to address those participants with primary mental health concerns. The program also links with the TAPP (Transitional Aftercare for Probationers and Parolees) Program to assist participants who may be
experiencing problems with transportation and re-establishing benefits such as SSI and Medicaid. We also link with the Assertive Community Treatment Team based out of the state hospital. The case managers have been able to build relationships with some of the personal care homes (PCH) in our area where placements have enabled the participants to have continued mental health and medical care when needed. PCH placements have also played a big role in improvement in their overall physical condition and in addressing homelessness in this group. Contact has been made with faith-based programs that provide daily living essentials such as clothing and personal hygiene items. TARGET POPULATION The Treatment Court program targets adults with mental health and/or substance abuse issues who have been directed to services. Many of these individuals have a long history of arrests for technical probation violations including failure to report, positive drug screens, and misdemeanor offenses coinciding with prescription non-compliance. Virtually all participants in this program have felony probation or pending felony charges. GROUP ACTIVITES Persons assigned to the substance abuse outpatient group are required to participate in the treatment court program for one year. If all requirements have been met successfully, the participant is awarded a certificate of completion. The participants are educated on the effect of substance use on their lives. Several films are shown that enable the group members to view the addiction process in others. Group sessions give them the opportunity to discuss their experiences
with each other. There is a phase of the program set aside for updating employment skills. Upon completion of the program, there may be other positive legal incentives which could include early termination of probation or dismissal of the charges. NON-GROUP PARTICIPANTS Placement depends on the severity of the participant s particular disability. Individuals are referred to programs in the community that most closely meet their needs. Participants are monitored frequently by their case manager and probation officer for program compliance. If residential placement is determined to be the most appropriate treatment, the participant is referred to an appropriate long-term program. An appropriate residential program would be one that runs for at least a year, and would include a transitional phase that allows the individual to gain work and/or educational skills, along with training on addiction and relapse prevention. CO-OCCURING DISORDERS Treatment for individuals with a co-occurring (dual) diagnosis is geared towards establishing a treatment plan with the individual that will address the more acute area of the participant s disorder. The program seeks integrated treatment where available. As improvements are made, the treatment plan is updated and revisited with the individual. The case managers update the plan while making contact with the individual, the programs that are providing treatment, family members, and other identified support systems. ADMISSION
The final decision to accept or deny a referral for enrollment into the postadjudication court program is made by Judge Goss, with input from the court staff, the assistant district attorney, assistant public defender and the probation officer. Factors for judicial consideration are the safety of the public at large and how a potential enrollee with a history of substance abuse and/or a mental health disorder will function in the community once placed or released to his/her support system. All individuals who are enrolled in the program have been screened or assessed by the court staff. The probation officer and the District Attorney s office monitor criminal histories to determine if the individual is appropriate for the program. For example, sex offenders, drug dealers and persons with charges involving firearm violence are not enrolled in the core MH/SA program. Probationers have to return to Court for periodic status review hearings before the judge. DISCHARGE A participant who has been diagnosed with a chronic mental health disorder and a long history of repeated arrests is routinely monitored by the Court for at least one year. After that time, the staff will work on transitioning the person out of the program. This could take several additional months depending on the available resources and whether there is a support system in place. If the participants have a substance dependence, but do not require longterm residential treatment, they will be placed in the addictive disease group and required to follow other guidelines that are designed to monitor their drug use and probation reporting mandates. Once they have satisfied all of the program requirements, they will be subject to release from the program.
Eligibility Requirements For Core MH/SA Program The profile of someone who would be considered for enrollment in the Dougherty Superior Court Mental Health Substance Abuse Court Program would be a person who:
1. Has been charged with a non-violent felony or convicted of a non-violent felony in the past and is currently facing charges. 2. May have either a mental health disorder, an addiction disorder, or both (dual diagnosed) and is facing charges. 3. No history/conviction of sale of drugs. 4. No history/conviction of a sexual charge. 5. No history/conviction of a fire arms charge. 6. No history/conviction of an aggravated assault. 7. Has been referred to the drug court by a probation officer, Judge, public defender, other community program, other attorney or other law enforcement. 8. Even though enrollment in the program is voluntary, once enrolled the person is expected to adhere to all guidelines (see sanctions page). INTENSIVE MENTAL HEALTH PROBATION SUPERVISION As noted earlier, certain criminal offenses are excluded for participation in the core MH/SA Treatment Court program. In a community with limited mental health treatment services, a number of clearly mentally ill offenders were lacking in treatment and many times ending up re-arrested. For example, a person with schizophrenia, off medicines, gets into a confrontation with a family member. The victim tries to take a kitchen knife away from the defendant and ends up with five sutures in his/her hand. The defendant is charged with Aggravated Assault and not eligible for the core MH/SA Treatment program.
After a meeting between court staff, the District Attorney, Chief Probation Officer, Sheriff and Judge Goss, a decision was made to create a program track for these defendants. This group of 10-15 mentally ill probationers is supervised in a Intensive Mental Health Probation Supervision track. Probation Officer Nick Perry supervises mentally ill offenders in the core program. He is CIT certified and supervises this group of intensive probationers. The participants are linked with mental health treatment services and case management, much like the core group participants. Frequent court review hearings are part of the supervision plan. Depending on family supports or the lack thereof, referrals can be made for case management services to Albany Area Advocacy Resource Center ( ARC), a local disability services non-profit agency. COMPETENCY DOCKET In 2009, Judge Goss started a competency docket. In all cases in Dougherty Superior Court where the issue of whether a defendant is currently mentally competent to assist counsel and stand trial has been raised, the case is transferred to Judge Goss until the competency issue has been resolved. One day each month, this separate docket is called. Psychologists from the state hospital come to give the judge status reports. The docket is used to coordinate supervision of these cases so that person is not sitting in jail or at the state hospital awaiting resolution of this issue. Once the psychological evaluation of the defendant is performed, if the person is deemed competent, the case transfers back to the original judge for the case to proceed on the merits. If the evaluation reveals issues of competency, a special jury is empanelled pursuant to Georgia statutory law. The cases are followed through resolution and/or civil commitment
proceedings, if competency cannot be restored. Similar efforts to coordinate this process are being done in the District Court of Clark County Nevada (Hon. Jackie Glass) and the courts of King County, Washington (Hon. Mike Finkle). Currently, Judge Goss is working on a national panel with Daphne Burns, Esquire of the National Judicial College. Ms. Burns is working on a comprehensive, national best practices project on criminal competency issues. OUTREACH ACTVITIES In 2006, the Dougherty Superior Court MH/SA Treatment program was designated as one of five national Learning Sites for mental health court programs. We have hosted a number of interested court teams, both from within Georgia, other states, and from as far away as Guam. We answer numerous inquiries by telephone and e-mail. sharing information with other courts. The Learning Sites Initiative is sponsored and supported by the United States Department of Justice Bureau of Justice Assistance (BJA) and the Council of State Governments (CSG) Justice Center. In 2008, we were awarded a two year grant from BJA seeking to evaluate data and to develop an internet based data collection platform. Because these court programs impact multiple budgets with different computer systems (county jail; local emergency room; state hospital), measuring data is a significant challenge. We are working with Dr. Kevin Baldwin of Applied Research Services in Atlanta and Dr. Aaron Johnson of Mercer University Medical School on this project. When the study is completed, this information will be made available. In October 2008, former First Lady Rosalynn Carter visited a session of our court program. We received national recognition from the Rosalynn Carter Institute on Caregiving at their national awards banquet in the October, 2009.
Mrs. Carter prominently featured an account of her court visit in her 2010 book, Within Our Reach: Ending the Mental Health Crisis. Judge Goss has published a number of papers and articles on the issues surrounding mental health courts and persons with co-occurring disorders in the criminal justice system. A listing is attached and copies are available upon request. He has served on the state of Georgia mental health services commission, serves on the executive committee of the Judges Leadership Initiative, and is a member of the mental health court advisory committee for the National Association of Drug Court Professionals. Judge Goss has served on the teaching faculty at the National Judicial College since 2003, presenting on mental health courts and issues involving persons with co-occurring disorders. He has presented in several states working with CSG/BJA, the National Drug Court Institute and The GAINS Center for Co-Occurring Disorders.
Stephen Goss, Building Community Capacity to Deal with Offenders with Mental Health Issues in the Criminal Justice System, a paper on file with the Rosalyn Carter Institute on Caregiving (2002). Stephen S. Goss, Defining a Win in a Mental Health Court Program, a paper submitted to the National Association of State Judicial Educators, available at http://nasje.org/news/newsletter0703/resources01.htm. Stephen S. Goss, Building a Community Based Mental Health Court Program, a paper submitted to the National Association of State Judicial Educators, available at http://nasje.org/news/newsletter0704/resources02.htm. Stephen Goss, Mental Health Issues Arising in Georgia Death Penalty Cases, a paper most recently presented at the Council of Superior Court Judges Seminar, January 2010. Stephen Goss, Forced Medication Issues Involving Mentally Ill Defendants, a paper most recently presented at the National Judicial College, June 2010. Excerpts available at http://www.judges.org/news/news041108.html. Stephen Goss, Mental Health Court Programs in Rural and Nonaffluent Jurisdictions, Criminal Justice Review, Volume 33, Number 3, September 2008, Pages 405-413 (September 2008) Georgia State University Research Foundation, Inc.