Mental health court would benefit Bucks County, mentally ill defendants, report says

A University of Pennsylvania law school report suggests Bucks County would improve  quality of life and public safety for residents if it created a trial diversion court for individuals with mental illness. 

Researchers at Penn’s Quattrone Center for the Fair Administration of Justice concluded that a mental health court would provide a pathway for treatment and recovery, aim to reduce the recidivism rates and improve the quality of life for participants, which would improve the community as a whole. 

The report also suggested mental health courts benefit the criminal justice system by moving cases quicker through the judicial process rather than letting them languish unresolved for months or years when a defendant is found incompetent to participate in court proceedings.  

Bucks County District Attorney Matt Weintraub requested that Quattrone researchers examine what impact a mental health court would have on criminal justice outcomes, a move county officials say they are considering. The center produced the report at no cost. 

“We’ve too often seen people with mental health issues become hopelessly enmeshed in the ‘spin cycle’ of the criminal justice system due to its inability to address these defendants’ specific issues,”  Weintraub said. 

Advocates for people with mentally ill and their families, though, want assurances the county’s mental health infrastructure has adequate community-based services and resources in place, especially to address the growing number of individuals with complex needs or behavior issues who end up finding appropriate placement only after they enter the criminal justice system. 

“My biggest concern is, if we don’t implement more support services or lessen the standards for helping someone, mental health court in and of itself won’t work,” Lower Makefield resident Martha Stringer said.

Her daughter Kim Stringer, 28, who has bipolar and borderline personality disorder and a long history of police contacts in Falls, was incarcerated after a violent outburst for 72 days earlier this year, before she was admitted to Norristown state psychiatric hospital in a catatonic state. Her mental health had deteriorated and she was subject to restraint chairs and pepper spray for outbursts and self-injurious behavior while in county jail.

The Stringer case among others have recently renewed calls for Bucks County to create a mental health court.    

Currently, 21 Pennsylvania counties have mental health courts designed to keep individuals with persistent, uncontrolled serious mental illness out of the criminal justice system, which is not equipped to handle their special needs. 

Bucks County has other trial diversion programs in place targeting people with substance abuse issues and military veterans.

Mental health experts agree that incarceration can exacerbate symptoms of serious mental illness, disrupt treatment regimens, and contribute to victimization and suicide. 

Seriously mentally ill individuals are also more likely to be detained longer than sentencing maximums, denied probation or parole, and placed in isolation.

Bucks County is the last suburban Philadelphia county without a mental health court.  

Neighboring Montgomery County created its court 11 years ago. It currently has 60 participants, who are first screened by the District Attorney’s office, according to county spokeswoman Teresa Harris. About 30 individuals graduate from the program annually. 

Co-chief Public Defender Carol A. Sweeney, who has served as the court's liaison, called the program “life changing.” 

Like other diversion programs, mental health court operates as a form of judicially supervised probation. Instead of jailing defendants, they receive community-based services and treatment.

Participants are required to follow conditions required by the Adult Probation and Parole Department and those of an individualized treatment plan designed to coordinate mental health treatment and services under the supervision of the criminal court. 

Ideally, the court should connect participants with agencies that not only provide mental health services, but also things like housing and transportation, which increases the chance of long-term success in sticking with treatment, according to the Quattrone report.

Criminal charges may be expunged or lessened for those who complete the program. If a person is unable to complete the program due to frequent decompensation or refusal to take medications, the person should be given other clinical treatment opportunities, the report suggests.

The report also provided a set of recommendations to successfully implement the mental health court, which include assisting offenders with mental health and substance abuse disorders. It also recommended accepting offenders facing misdemeanor and felony offenders.

It also offered recommendations on the admissions process, court staffing, types of treatment services, counseling and community support for those in the program, conditions of their supervision and how they would successfully complete the program. 

Researchers suggested that candidates be required to provide informed consent to participate and they must sign releases to allow them to be linked with community-based services and confirming the key terms of participation. Participants should be involved in treatment planning, but must agree to the most medically appropriate treatment.

The effectiveness of mental health courts varies, but on the whole it appears to have positive results by reducing repeat arrests even with more at-risk populations and felony offenders, said Benjamin Barsky, one of the Quattrone report authors. 

“Ultimately the success of the court will depend, to some extent, on how much that (courts and community) coordination effort is done,” Barsky added. “That is really where success is derived, a certain reliance on community-based support and services.“

A “properly funded” mental health court is a step in the right direction — and one that is long overdue," said Nicholas Emeigh, outreach director for the National Alliance on Mental Illness, Bucks County, but existing gaps in the system and a deficit in providers and services could impact its effectiveness.

“I can also see the lack of available inpatient beds and willingness of private behavioral health facilities to accept challenging cases as being a problem,” he said. “It is my hope that a fully fleshed plan includes means to address that issue. It's been a long standing problem.” 

While the mental health court is a top priority for the county, there is also a recognition that it cannot move forward without accessible treatment and housing opportunities to divert individuals to, said Donna Duffy Bell, administrator for Bucks County Mental Health and Developmental Program. 

”We remain active with attempting to develop that infrastructure,” Duffy Bell said. “We need both short-term options that are immediately available for stabilization and longer-term options that provide safe and secure transition to the community.”

Her department has a proposed plan for options, but Duffy Bell declined to disclose specifics at this point. But, she said, they are options that she will look to bring up next year.