Sep 26, 2013 "S.F. court offers path to treatment instead of jail"

S.F. court offers path to treatment instead of jail
By Fred J. Martin Jr.
Published September 19, 2013

San Francisco's Behavioral Health Court has facilitated the recovery of hundreds of clients over the past decade and more than 300 people have graduated to resume productive and successful lives. The court's clients come into the criminal justice system with a felony arrest but if a medical diagnosis reveals a severe mental illness, they are redirected from Superior Court to the Behavioral Health Court.

Jennifer Johnson, a deputy public defender who works with the Behavioral Health Court clients, said, "Creating a collaborative mental health court was a courageous step for San Francisco, and not easy to accomplish in the adversarial climate of the criminal justice system.

"The success of the program is proof that treatment is not only the humane solution for people with mental illness, but also one that benefits public safety, saves money and helps stop the revolving door of hospitalization, incarceration and homelessness."

The court provides individualized treatment for each client who agrees to accept community-based mental health treatment, accept prescribed medical care and cooperate with the probation officer and forensic case manager. Those who complete their program are honored at a graduation ceremony conducted by the judge, who congratulates and releases them, sometimes after erasing criminal charges.

J.P., a court graduate, lived on the streets for more than two decades hearing voices, using and selling drugs, and cycling in and out of jail before landing in the Behavioral Health Court. With the help of his intensive case management team, he learned to manage his symptoms of schizophrenia and post-traumatic stress disorder. J.P. has been clean and sober for five years and only comes to the Hall of Justice to accompany other clients as a peer counselor.

Another graduate, M.A., left her native country 13 years ago because she was rejected by her family and ostracized by a community that did not understand her bipolar disorder. Without access to treatment in San Francisco, she started using drugs and working as a prostitute. She tried to commit suicide multiple times before her last attempt brought her into the criminal justice system. After three years in treatment, she has reunited with her children, is working, has not been arrested, and has not attempted suicide.

The program provides detoxification, therapy and treatment to equip clients to cope with their mental illness, a physically based illness that reduces their functionality.

Superior Court Judge Kay Tsenin created the Behavioral Health Court with the modest goal of helping 10 to 20 people incarcerated for showing signs of untreated mental illness. Ten years later, the court has 150 clients and is a fully integrated part of San Francisco's criminal justice system.

San Francisco's Behavioral Health Court - one of hundreds of such courts nationwide - has been the subject of numerous studies. Recent findings illustrate the value of the court in decriminalizing mental illness, reducing violence and prioritizing spending of precious mental health resources.

Of the four courts studied, the San Francisco court serves the highest percentage of clients with schizophrenia, who most often had committed crimes against people rather than property. San Francisco's program resulted in the largest decrease in re-arrests compared to the treatment-as-usual control groups, 39 percent compared to 7 percent.

Supporters are planning a celebration on Oct. 16 at the St. Francis Yacht Club to recognize the court's accomplishments. Event organizers hope to start a citywide initiative to guide decision-makers on developments at the intersection of mental health and law.

Fred J. Martin Jr., a retired Bank of America senior vice president, has worked on mental health issues for a decade.

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