New MU study tackles mental health court engagement
BOONE COUNTY - People with mental health problems are overrepresented in the U.S. criminal justice system, according to a new MU study. This inequality inspired one MU social worker to look at the courts responsible for helping those people, and what makes them successful.
Kelli Canada, a social worker at MedZou Community Health Clinic, said the problem began back in the 1950s and 1960s with a movement to shut down institutions that treated and housed those with mental illnesses.
"People were moving from these institutions into the community. It sounds like a great plan, and it was in theory," Canada said. "But the problem is, was that money that was supporting those institutions wasn't shifted to the community. So we were left with a lot of people who had very serious needs and not enough community support."
Canada said without this community support, the U.S. saw an increase in people with mental illnesses ending up in the criminal justice system, and not being able to get out.
"We know that people with mental illnesses don't do well in the criminal justice system. They don't do well in jail. They don't do well in prison," she said.
Mental health courts were designed to give criminal offenders a voluntary option to seek treatment for their condition. Participants are required to go through assessments and regular monitoring during their time in the program to ensure they stay on track, in exchange for access to resources and treatment for their illness.
The courts seek to provide mentally ill offenders with what they need in order to get and stay out of the criminal justice system.
"We do see that there's reduction in criminal recidivism, and we do see that for some of those people there's more treatment access than they had prior, but what we don't really understand is why," Canada said.
Canada's research focused on answering that very question: what makes a mental health court successful?
Canada found that one of the biggest factors in determining a mental heath court's ability to help its participants is its access to services. She said if a community doesn't have the services necessary, there's no way a mental health court can be successful.
"I don't just mean mental health services, I mean comprehensive services," Canada explained. "So, mental health, substance abuse, vocational training, job placement training, so we can help people understand how to build a resume and look for jobs."
Canada's research also looked at the role the mental health court "team" played in participants' success.
"It's not just the court side, it's the treatment providers, and they all work together to try to develop a plan for that individual," Canada said.
She found that courts with the best success engaged in the rehabilitation process every step along the way. This means all individuals involved - social workers, judges, attorneys, therapists - were aware of the offender's mental health problem and how to deal with it.
"They really felt that the process was fair. They really felt like they had a chance to tell their story and that people were actually listening to that story," Canada said. "They talked a lot about trust in their team, which we don't always hear that, we don't always hear people trusting the judge."
The mental health court in mid-Missouri is a facet of the Boone County Alternative Sentencing Center. The first mental health court was held on April 22, 2003.
According to a 2015 report from the Boone County Mental Health Court, criminal offenders in Boone County who were mentally ill often spent unnecessary time in jail before the court’s creation. The report said many of them became repeat offenders due to a lack of access to treatment services.
Mikala Houchins, a behavioral health caseworker with Burrell Behavioral Health, said she tries to make sure those who are mentally ill in the criminal justice system know they are not alone, and not without resources.
"They are just not aware of everything out there that is available to help them," Houchins said. "They think they're alone and that they're kind of stuck with what they have."
Burrell caseworkers and therapists work with participants in the Boone County Alternative Sentencing Courts as part of their treatment and to provide access to services in the area.
Houchins said the job of the "team" is to ensure their participants have access to anything they might need in order to facilitate the rehabilitation process, whether it be transportation, food, work or education.
"So many clients are not able to advocate for themselves. They realize that there is a better way to do things instead of maybe selling drugs or doing drugs to cope with things," Houchins said. "Our program offers them a lot as far as stability for their mental health by getting them health care, mental health care, things like that, and getting them connected."
Houchins said the team that works with the Boone County Mental Health Court is lucky, in that many of them have a background in mental health, and those who don't are always willing to get the training necessary to be more successful in working with the court participants.
"That is also kind of my piece in that team, is to say, okay so some symptoms of that mental health disorder is this, and so we need to take that into consideration as to maybe why this client is acting this way or why they are having some issues in that area," she said. "Not everybody is a therapist or in mental health."
Both Canada and Houchins agreed it is very important that the mental health court program is a group effort among the offender, the team and the community, to make sure participants are able to sustain treatment in the long run.
"As we create these court programs, because we are seeing so many people with mental illnesses in the system, we have to have that same initiative in the community to make sure that there's enough services and that we are well-funding our mental health system and really pushing for that collaborative care," Canada said.
"That's just something we tell them even when they enter into the program is use your team, that's why we're here," Houchins said.