St. Tammany Parish Justice Center

The St. Tammany Parish Justice Center in Covington.

Before his death in March, Judge Peter Garcia was working to create another specialty court for St. Tammany and Washington parishes. Garcia had launched the 22nd Judicial District's Behavioral Health Court a decade ago, and its success — and his belief that more were needed — spurred him to develop another specialty court aimed at helping people with mental illness.

Called Assistive Outpatient Treatment Court, it differs in a key way from the other six specialty courts already operating in the district, such as Veterans Court and Drug Court. Participants won't be criminal defendants who have run afoul of the law; instead, they'll be people struggling with severe mental illness, with histories of psychiatric hospitalizations and noncompliance with treatment.

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Judge Alan Zaunbrecher looks over paperwork for an upcoming session of Behavioral Health Court in the 22nd Judicial District. He is overseeing a new specialty court designed to help mentally ill participants get a treatment program and comply with it. (Photo by Sara Pagones, The Times-Picayune | The New Orleans Advocate)

"The purpose is to try to get them out of this revolving door," said Judge Alan Zaunbrecher, who presides over the new court as well as Behavioral Health Court. "Most participants will have been hospitalized on numerous occasions."

Such outpatient treatment courts gained legislative support in Louisiana in 2008, after New Orleans police officer Nicola Cotton was fatally shot by a man who had struggled for decades with schizophrenia. The first Assistive Outpatient Court was created in New Orleans in 2018. Another followed in Baton Rouge.

The 22nd Judicial District's version was launched last month with a $3.5 million grant from the U.S. Substance Abuse and Mental Health Services Administration to cover its first three years of operation. The court will be able to handle 35 participants who will essentially have an organized treatment plan backed by a civil court order.

Participants will get a lot of support to stick with their treatment plan. The court has contracts with treatment groups but will also offer help with getting insurance, transportation to appointments and even things such as a mobile phone to ensure they are able to stay in communication.

The initiative fills a critical need in the community, said Nick Richard, executive director of the nonprofit National Alliance on Mental Illness's St. Tammany affiliate.

"They're on empty, past on empty. It's pure exhaustion," Richard said of families trying to get help for mentally ill loved ones. One father told Richard that if his son could just get arrested, he could then get into Behavioral Health Court, which also requires participants to comply with treatment.

"Imagine as a parent you've reached that point. Those are the phone calls I take," Richard said.

Eligibility rules are strict. Participants must be 18 or older with a history of mental illness and noncompliance with treatment that has resulted, in the previous three years, in at least two hospitalizations or one or more acts, attempts or threats of serious violent behavior toward themselves or others.

A participant enters through a petition to the court, typically filed by a health care provider, Zaunbrecher said. But the law also lets a relative or other concerned party to petition with the concurrence of the coroner.

So far, the court has one participant who entered by petition from a relative, Zaunbrecher said. "The dedication of the family to this person is just amazing," Zaunbrecher said.

Coroner Charles Preston said his office is working with an attorney for someone seeking a petition, the first it has handled under the new program.

Behavioral Health Court also includes court-ordered treatment. But those participants face the threat of jail if they don't comply with treatment.

That's not the case for Assistive Outpatient Treatment Court, Zaunbrecher said. There is no criminal proceeding and no specter of jail time or even contempt of court. The only downside for someone who doesn't follow the court's plan is that they likely will be hospitalized, he said.

But even without threat of jail, Richard said the court provides what he calls the "black robe effect," interaction with a judge on a weekly basis. "People don't hear positive words regularly from those in authority," Richard said. "The judge is huge in this."

The court has hired a director, licensed clinical social worker Wendy Griffith, who began in November. When the number of participants increases, there are plans to hire a program manager who will call every participant every day, Zaunbrecher said.

Arrest rates, emergency room visits and hospitalizations also will be tracked.

The hope, too, is that more consistency in care and medication will reduce suicides and homelessness, Griffith said.

"This is not one of these courts where if 100 go in, 80 are going to complete and graduate and be healthy, and we know it," Zaunbrecher said. "What we are trying to do is help one person, because if we help one, maybe we can help a second and then a third. We're going to keep trying."