Mental Health Court, Round Two
Yesterday I linked to a story in the Philly Inquirer about the establishment of a Mental Health Court here in Philly. A reader left this comment:
Well that settles it, not moving back to Philly. MH Courts are just another form of forced drugging. Why not use parole and probation which are set up to do the same thing but do it better?
I have to vehemently disagree. As someone who worked for an agency that advocated for incarcerated people and people with criminal background issues–including many people who have mental illnesses–I can assure you parole or probation do not do it better.
Probation officers are often like any other civil employees: overworked, under-resourced, frustrated by the limitations of the system. They can be burdened by high caseloads and unable–through no fault of their own–to pay sufficient attention to individual needs. They are tasked with ensuring that people who have been deemed problematically unable to abide by society’s rules now comply–with the understanding that further punishment is just around the corner. Anyone who’s been in jail or prison knows that being on probation is a horrendous state of purgatory; and due to lack of appropriate staffing and systemic inadequacies, mistakes get made. People get cycled back into jail by accident, paperwork gets lost, individual concerns go unaddressed. The priority? Keeping society safe from the perpetrator.
At no point in this fabulous process–despite the best efforts of the many wonderful people who work in probation and parole for all the right reasons–is the issue of the best mental health care truly assessed. “You taking your meds?” Check. “You pee into the cup?” Check. “You change your address?” Nope. Hello and goodbye. How many times did I, as an advocate, try to get people to have more fruitful relationships with their parole officers based on expanding the understanding of mental illnesses and how they could or did not promote certain behaviors? How do you educate the world?
The reality is that specialization is key. If someone has a mental illness, and this illness is implicated in their inability to abide by certain rules, it is far better to have their case adjudicated by a body that comprehends such issues and motivations, not by people who lump them in with everyone else. There’s an interesting 2001 article from Law & Psychiatry that talks about the growing use of “therapeutic jurisprudence”:
Both mental health and drug courts have their genesis in the concept of specialty courts and the idea of therapeutic jurisprudence (2). The latter concept reflects a focus on “the extent to which legal rule or practice promotes the psychological and physical well-being of a person subject to legal proceedings” (3) as well as an “exploration of ways mental health and related disciplines can help shape the law” (4) and concern with “the roles of lawyers and judges [in] produc[ing] therapeutic and antitherapeutic consequences for individuals involved in the legal process” (5). Both drug courts and mental health courts embrace a therapeutic approach.
Now, granted, the article is old now. And it talks about the limitations of such courts at the time, which still hold: They’re idiosyncratic. Philly’s court will likely be extremely idiosyncratic, given its judge. But if we trace the possible course of a person through the “normal” system vs. a Mental Health Court, you’d see the positive difference, despite whatever frustrations you might have. The biggest difference? Potentially avoiding jail time. This is crucial. You could only believe that mental hospitals are worse than prison if you’ve never been to prison.
This is all I’m going to write now. Later I hope to write more about the problem of being imprisoned in a punitive facility rather than a treatment facility (and the question of “forced drugging”) when you’re severely mentally ill. But this should get you thinking and talking (civilly?) for now.
liz | 10:18 AM | criminal justice system
Hi Liz,
It’s a shame your reader’s perception and comments about the Philly “MH courts” differ from my reality. While I am unknowledgeable about your new court or that in any other state I can more knowledgably discuss Florida and also relate far better to your knowledge and understanding and the realistic comment of your other reader Joe who strikes a more reasonable accord as to the “the devil is in the details”.
I can share that Florida State and more specifically Broward County instituted the first mental health court in the United States and was administrated and presided over by Judge Ginger Lerner-Wren who I have had the pleasure to not only listen to personally on several occasions but also have the opportunity to chat and ask questions of her.
I’d also like to share that as former DBSA facilitator I chaired a number of support groups with a number participants that past through the Broward Mental Health Court and who heaped praise upon their luck and fortune. The important point they offered up was the court was sincerely intent upon seeking help for these individuals in lieu of incarceration through the criminal justice system.
Warmly,
Herb
VNSdepression.com
I did not find your response civil Liz. You do not know if I have ever visited a prison or compared it to a hospital and I disagree completely that psychiatric units and hospitals are not punitive in nature or are all about treatment rather than social control, nice upholding the dominant oppressive paradigm towards our people though… Make prison better, don’t use the horrible and shameful state of our prisons an excuse for more segregation and more forced drugging in MH courts. If you aren’t against forced drugging, you have never been force drugged Liz.
You’re kidding yourself if you think prison is worse than a psychiatric “hospital”… both are prisons, in both your freedom of movement is removed, in one, your freedom of neurology is intact, in one your freedom of neurology is raped and stolen by the state. How dare you even attempt to claim that prison is worse. How dare you. I’m serious, you’ve really rubbed me the wrong way here….but I shouldn’t get so worked up, I mean who are you, you’re just a co-opted, indoctrinated pro force pro biopsychiatric mythology ideologue anyway. There is no greater rape than neurological rape, and that is what forced drugging is. Don’t thinkyou can make such ill-informed comments online without facing those will tell you are wrong Spikol. You act like you’re bought and paid for by psychiatry.
The very nature of the existence of a “Mental Health Court” is punitive. That is why there is no other kind of “Health Court.”
Should we have physical health courts for people who are too physically sick to obey the law?
Mental Hospitals vs. Prisons: which is better?, is probably not how this should be framed. Mental Hospitals offer many immediate benefits over prisons to prisoners, which prisoners would agree to treatment for these benefits that they might not accept without the incentive. I would view this as the state manipulating the prisoners. Instead of forced druggings of prisoners, the prisoners “willing” accept the drugs under the promise (bribe) of entering the more humane “treatment facility.” Why not improve conditions in the prisons and provide treatment within the prison for prisoners who seek it. Sensationalizing this story for this purpose seems unethical. Are there other examples of lunatics gone wild. Why is not more emphasis put on the cops and their decision. Society’s “safety” may be YOUR priority, but not everyone’s. Nor is it the prisoner’s responsibility to “abide by society’s laws”. The INQUIRER story mentions that this method is CHEAPER. This seems to ignore that this is the same trend with mental hospitals closing, viz: It is CHEAPER to treat mental illness OUTPATIENT with drugs than inpatient say with something that ACTUALLY ADDRESSES the PROBLEM. Drugs allow the state to quickly PROCESS lunatics. Prisoners should not be punished for the inhumane conditions maintained by the state who punishes them. Ridonk. On a side note are you familiar with FOUCAULT’s work? This story has eerie similarities to the history he describes: lunatics out among us (oh no!), criminals and lunatics kept together, etc.
I love how I read this entry along with the replies while hearing the audio from ‘One Flew Over The Cuckoos Nest’ playing on a television upstairs.
Mental health courts are potentially threatening. Most are founded by people with no mental health experience, and are used by many as an easy way to get out of criminal charges. In most jurisdictions, mental health courts are given only to felons, participation is voluntary, but the rub is by virtue of the mental illness that landed a person in court, they could end up in jail or prison. Guilty pleas should not be required to participate in mental health courts, and the use of psychotropic drugs should be up to the participant. The federal law establishing mental health court is the source folks should be looking at.
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