He is the judge for the Allegheny County [Penn.] Mental Health Court. He has been a judge in the county's Criminal Division since 1994 and is a former prosecutor. This is the edited transcript of an interview conducted on July 3, 2008.
- The court's team approach
- The growing trend of mental health courts
- Changing the stereotypes of a courtroom
- What's the outlook for Bennie Anthony?
How did you decide to work with this court?
Judge Joseph James [of the Court of Common Pleas] approached me about taking over responsibility for Mental Health Court when Judge Robert [Colville] was appointed to the Superior Court. ... I wasn't sure how I felt about it [at] first. ... But I must say now, it's been the most rewarding thing that I've done as a judge. You see major changes in people's lives and are able to participate, in most instances, in a positive fashion in helping people.
Were you surprised to see what it can do? What's been the personal progression?
... I have been surprised about the way Mental Health Court has changed people's lives and about the relatively low recidivism rate in Mental Health Court. I've seen visible changes in people, and that probably was the most surprising thing for me, being able to detect by just simply looking at a person whether or not they're on their medication or whether or not we have the issue of ... substance abuse kicking in, as opposed to people that are on their meds and clean and sober. ...
Was it a shift from a punitive model to rehabilitation and treatment?
Supervising Mental Health Court was unlike any judging that I've ever done before. And I'm sure, for any other judge that's in a specialty court, ... we're used to a system that is a vertical system, where the judge is making that decision after hearing arguments by both parties. Mental Health Court is really a horizontal system, where a judge gives up a lot of the authority that that person has in recognizing that other members of this team may be in a better position to make decisions or to make suggestions regarding how we can affect someone that is in Mental Health Court. ...
Who are the team members? How is the court configured?
There are members from Justice Related Services. They are the forensic workers, the people that are helping the mentally ill population. There are probation officers that are specialized probation officers that are making sure that they're complying with the rules and regulations of probation. And then we'll often have various providers come in and participate in our meetings to determine what is the best possible solution to a problem or to reinforce what is taking place in a positive way in someone's life.
A public defender as well?
There is also a public defender and a district attorney that are part of Mental Health Court. The public defender is protecting the rights of their client, and the district attorney, in a sense, acts as the gatekeeper in that they have a large amount of control over what cases are accepted into Mental Health Court.
Is that an unlikely alliance?
The Mental Health Court meetings are much less adversarial than you would expect to see. And I think a large part of it is the team has developed trust. That's very, very important in the Mental Health Court team, that each party trust that the other party is going to be truthful with them, regarding the good and the bad things about what is taking place.
For example, we know that if a person is missing their treatment meetings, the Justice Related Services people will tell probation: "Look, they haven't been making their meetings. We may need to do something to hold their feet to the fire." By the same token, if probation is being told that the client is not fulfilling some aspect of their probation, Justice Related Services then has the opportunity to fix what is wrong. The same way with the district attorney and the public defender. They recognize that the public defender is not going to try and put in cases or refer cases that are inappropriate for Mental Health Court, and that the district attorney is going to work with the public defender in terms of cases that, under certain guidelines, would not normally be accepted into Mental Health Court.
You're the central figure still? Most decisions still rest with you?
The judge in Mental Health Court has ultimately the last call. Someone has to be able to do that. We often arrive at a consensus. When that can be done, that's great. But if we can't arrive at a consensus, I go back to my traditional role as a judge and make a decision, and we move on. I do my best to be as thoughtful as I can, but ultimately I make the decision. I hope I make the right decision.
Where does it get complicated? What are your challenges day to day?
For a judge in Mental Health Court, some of the toughest challenges are dealing with individuals that, while they are trying, they perhaps have an inability to be able to succeed. ...
By "inability," you mean they keep coming in with the same thing over and over again?
I think some of the most difficult cases for a judge in Mental Health Court are when people that keep coming back for having left a program, or keep coming back for having perhaps committed another crime, albeit generally minor offenses, trying to get the message across to them.
I'll give you an example. Today we had a woman that was walking down the hall in between our sessions, during our luncheon session, and we know that she had been using. She had been clean for a long time, but a couple of weeks ago in a session told me that "I messed up," that "I'd used again." So we asked her to stay so that we could assess her and perhaps have her go to a drug program on Monday. And she asked me if she was going to be put in jail. I said: "No, we're not going to put you in jail. We want you to go to the program on Monday. But you must promise me that you cannot and will not use between now and Monday." She promised me on her children that she would not use, and then when court started at 1:30, she was nowhere to be found. And unfortunately, we had to issue a warrant for her. ...
When she promised you, did you think she'd honor the promise?
When she promised me that she would return at 1:30 and promised me on her children that she would not use until she was in the program on Monday, I was at first encouraged by that promise, and the fact that two weeks earlier she had said to me, "Judge, I messed up; I made a mistake; I used," I was encouraged by that. But when she did not show up after making that promise within the hour, I knew that her situation was desperate, and I knew that perhaps in a funny way it turns out the best for her, because we'll get her off the street, we'll get her clean again to where she was. She was clean for a good year. And [we'll] try and change her, try and turn her life around, and as a consequence, her family's life will be better during that time.
Do people in your court have unlimited chances? Does it become hard for you to strike that balance and give them one more chance?
The balance between deciding when to remove someone from Mental Health Court or to give them chances, it's a difficult decision to make. We've found that the revolving door, or the arrest and release, hasn't worked. And we've found that in Mental Health Court, with the recidivism rate being a lot lower, that you have to give people more chances. And there are times -- and the times are few for me -- where I've been fed up and say, "OK, we have to remove you from the court." We try and become involved with more sanctions that bring them back to the court. And I've found that with more touches [the contact a person has] with Mental Health Court, the longer we're able to keep them on the straight and narrow. ...
Addiction aside, what issues do you deal with with the mentally ill? What do you see day to day?
The biggest challenge in terms of the mentally ill population in Mental Health Court has been when they're not on their medication. That probably is the biggest issue that we see. And it's so apparent when someone is not on their medication that you need to take action, take action quickly. ...
Often, the mentally ill population will start to feel better, and they'll be on their medication for a while, and they'll think that they're doing OK. They'll then try and get a job, and they'll start to place the job and the importance of that job ahead of their own health. And we have to sometimes rein those individuals in and reinforce with them: "Look, it's great that you're working, but you have to go through treatment. You have to take your medication, or else you'll fall back into a situation where you'll commit another crime and maybe be placed in jail again."
What are the requirements for staying in your program?
In order to remain in the Mental Health Court program, and ultimately to graduate, you need to put together a series of positive reviews where you're doing what's being asked of you. You're meeting with your probation officer. You're going to treatment. You're not involved in committing any other criminal offenses or other infractions. And the more positive reviews that you have, the closer you get to graduation. We typically go between 50 to 75 percent of the time that they're on probation, if you have those positive reviews, then we'll graduate them from Mental Health Court, and their probation will be terminated. ...
Within your profession, how does your role differ from other judges'?
In terms of the demeanor or the personality of a judge in Mental Health Court, there are certain characteristics that I think that you need to have. One of them is that you need to recognize that you are part ... of a larger team that's going to be making a decision. ...
Some clients have told me that they feel that they belong to an organization, and "Thank you for letting me be a part of this organization." So I've found that being more low-key, being more forgiving, being more understanding of what would be otherwise infractions that would result in incarceration has actually worked. ...
How is your work viewed by other judges? Do they understand what you do? Are you educating them that it does work?
Among the judges of this court, I've become the mental health advocate, and I've gone to other judges on occasions when they have a detainer on a person and asked them: "Look, we have this person in Mental Health Court. We think we have a plan. We think this plan might work to the betterment of this individual and society as a whole. Would you consider lifting your detainer and having the person supervised by Mental Health Court, or deferring your detainer to our Mental Health Court plan?" And it's been unanimously received. ...
Quite frankly, Mental Health Court probation is more difficult for a person to complete than regular probation. They have more requirements in order to complete their probation. And that's sometimes the most difficult part to get across to the public. ... We require you to come to court maybe every two weeks, maybe every 30 days, every 60 days, to show that you're on the right track. So society is actually better protected when a person is in Mental Health Court, because we really are keeping an eye on the individual more often than if they were just on regular probation, reporting once a month.
A lot of it also seems to be engagement with people. They know they're being watched by a number of team members, and they're not anonymous.
I believe that it's a very, very important part of Mental Health Court, and that is, the team, if you watch during the in-chambers discussions, knows a lot about all of the clients. They know the idiosyncrasies of the client. They know what's going on in that client's life, personally, professionally. And that's a very important factor in being able to supervise people in the court, because when you demonstrate all these people that are watching them, when you demonstrate your knowledge of what's going on in their lives, they step back and say: "Wow, how do they know all this much about me? And why do they care so much about me?" ... And it makes them care about themselves more, makes them want to do the right thing, do the positive thing to stay in Mental Health Court and ultimately graduate.
If not for this court program, what would have happened to all these people?
I think if not for Mental Health Court, a lot of people would be in the "catch and release" situation. They'd commit an offense, they would go to jail, maybe spend a week or two in jail, perhaps be released on bond; and then, without the extra supervision -- finding a place for them to reside, making sure they're on their medication -- they'll commit another crime, and they'll be in that revolving door in the criminal justice system, where for that period of time their life is one of unhappiness; their family's life is one of unhappiness; society's paying the dollars in order to keep them incarcerated. No one wins.
Why are there so few mental health courts nationwide?
I believe that the trend of mental health courts nationwide is increasing because people are realizing that it does work. We were fortunate here in Allegheny County because the Rand Corporation did their study, and it shows that the Mental Health Court saved our taxpayers $3.8 million over two years. ...
I guess the trend, at least [in] the state of Pennsylvania -- and I'm hoping across the country -- is for counties, states or whatever the entity is to adopt more mental health court programs. In Pennsylvania, there's an effort by our Supreme Court to have some form of mental health intervention from the first part of the intercept ultimately to Mental Health Court or the last part of the intercept in each of our counties. I'm a member of the Pennsylvania Commission on Crime and Delinquency, and just last month we awarded funds for the starting of seven or eight other mental health courts across the state of Pennsylvania.
People are seeing that it works. They're seeing that it works in terms of recidivism, seeing that it works in terms of saving money. It's not only the right thing to do now; it's the right thing to do and it saves money, so that the local authorities, the elected leaders, can go to the taxpayers, say, "This is what we're going to do, and we're going to save you money, and we're going to be helping people and their families."
The taxpayers are going to be paying dollars to have the people incarcerated, and families will be broken apart; that's the consequence. And that's what has been going on, in many instances, in these people's lives. I've had people say, "[This is] the first time in a year I've been clean." We had a woman say: "I never thought I would live to be 50, let alone be 51. And I would never think that I would have a job. Now I have a job." It just works wonders. ...
Do you see more programs like this in the years ahead? Is your program being modeled in other places?
I hope that this is a trend, and I think it is a trend. And I could speak for Pennsylvania, where there are a larger number of counties that are setting up mental health court programs. We've been the host to between six and seven other counties that have come here and observed the proceeding. We're also the host of a court from Washington, D.C., that came to observe the proceedings. Our goal would someday to be one of the learning centers for mental health courts in the country, but I'm not sure when and if that will happen. We would welcome it if possible. ...
For this population, it must change the stereotypes of whatever their experience had been inside courtrooms.
I think we're attempting to change the stereotypical feeling that people have when they walk into a courtroom. ... It's OK to admit that you've used drugs, because we're going to attempt to deal with that problem as opposed to throwing you automatically in jail. And the word gets out. ...
But we still hold somewhat of a hammer over their head in terms of, "You may ultimately end up going to jail." And that's happened. ... And when it happens, there are other people in the courtroom. If I'm going to incarcerate someone because I have no choice, I do it usually at the beginning of the session so other people in the courtroom see: "This may ultimately happen to you. It's not a free ride for everyone that's here, and we expect something of you." ...
And conversely with the successes?
We like to have our graduations at the very beginning of the session so that people that are in the courtroom that have positive hearings can see: "This is where I can ultimately end up. I can be graduating." ... And the people with the negative reviews see that they can end up in that place also. I try and tell the people ... [that] many of the graduates have had negative reviews in the past; they've just gotten past their negative reviews. So anyone in the court can make it. ...
For the severely mentally ill, what kinds of charges bring them in again and again?
Many of the charges that we see in Mental Health Court involve retail theft. ... There's usually, along with that, a [drug] possession charge, because there might be a dual diagnosis there. We often have charges that are ... burglaries or criminal trespasses, because ... many of the mentally ill population are homeless and may be staying in an abandoned home. ... We'll also see some ... simple assault or altercations with the police. There are very few crimes which are excluded automatically from Mental Health Court. ...
We've now begun accepting driving-under-the-influence cases in Mental Health Court if we can attach a particular [mental health] issue for them. ... Up until recently, they were not acceptable. ... Originally there were no felonies. Now they accept felonies also. So with a recognition that it's working, we're allowing more cases in and hoping that for each time period we stave off a time bomb. ...
What's the relationship with the police department in terms of your work?
Amy [McNicholas Kroll, director of Justice Related Services,] is doing a great job in educating and training the police to deal with the mentally ill population from the CIT [Crisis Intervention Training], where it has the police officers, as part of their training, wearing earphones where they're hearing voices so that they can recognize what a person is going through when they arrive at the scene as a first responder, and be able to deal with it differently than they would normally. ...
[Tell us about the in-chambers meetings.]
The information that we obtain at those in-chambers meetings is invaluable. As you can see, the knowledge that each of the team members have -- as late as what the person did yesterday, as having talked to them on the phone last night -- is important because it tells us where a person is in their life: "So-and-so had not been using. Now they've used twice. What do we need to do in order to be able to put that person back on the right track?"...
Do those in-chambers meetings get lively?
... They haven't come to the point where they're shouting matches, but they can be quite lively, and people can be very emphatic in the position and the point that they're taking.
And it helps you to hear all that, to figure out where you are?
It's extremely helpful because it gives me a perspective. And sometimes I lose perspective because I've been known to be perhaps more on the side of the person with the mental illness, and sometimes a district attorney's office or probation will bring me back and say, "Remember, Judge, you said the last time that if they don't come in, we're going to have to issue that warrant?" That provides me with the perspective that I need, and I might say, "Oh, yeah, you're right, you're right." ... It's an invaluable resource. ...
Is there resentment that special resources are dedicated to the mentally ill?
We're always looking for more resources for Mental Health Court, and we haven't come across really a feeling from the public that those are unnecessary resources. My biggest belief is, they don't understand the plight of those with mental illness, and that while some of these crimes at first might look like they're intentional, they're not intentionally committed. They're committed as a result of that mental illness from which often the people have no control. And our goal is to try and, as best we can, control them through the plan so that they can continue to live within the expectations of the rest of society. I believe education is really the key. ...
Why should anybody in the general public care about what's happening to the mentally ill in terms of jails and prison? Why should it matter?
Well, they're human beings. They're your fellow citizens. Their lives are just as important to them and to their families as our lives are to us. They unfortunately were either born or something happened that they developed an illness over which, in many instances, they have no control, or struggle to control. Why should they be treated differently than the rest of us? Why should we consider someone that has mental illness any different than someone who has high blood pressure, who has diabetes? It's an illness.
We have years and decades of criminalizing that. So we have growing evidence, and that hasn't been particularly successful.
Right. The evidence is there. I always point to, just locally here, our recidivism rate in our Rand study. I mean, it should be in and of itself something that the public should say: "Wow. Look, this is working. This is helping those people, and it's helping us as a result of that. As taxpayers, we're not shelling out all of the dollars." ...
Tell me what that evidence is in terms of recidivism and costs.
The recidivism rate in Mental Health Court is now, I believe, about 14 percent, which is much less than the average recidivism rate, which is in I think the high 60s or the low 70s. So, one, we aren't having people that are reoffending and thereby causing the taxpayers to have to fund their stay in the jail.
And the Rand study demonstrated that after a two-year period of time, our local citizens, our taxpayers, saved $3.8 million as a result of the people going through Mental Health Court and Mental Health Court probation as opposed to how they would be traditionally treated. ...
[What are] your impressions of Bennie Anthony today and how he's doing?
Bennie Anthony is doing well. That his case was generally unremarkable to me is a good thing, because it means he's doing all he needs to be doing. He's complying with this service plan; he's attending treatment; he's doing all that is expected of him. ... As soon as he stood up [today], I knew that this man was doing well and that this man had to be completely different from the person that had been referred to Mental Health Court. ...
Given his history, spending much of his adult life in jails, what would be the best case scenario for Bennie? What will happen within your program?
... We'll continue to monitor him. We'll step back the number of times he has to come to the court until he completes a portion of his probation, and we will then be able to graduate him with an understanding that if he wishes to return to the court at any time, once you've graduated, just want to come in, if you feel it's a part of family, part of community, that you can do that.
I'm not surprised by the transition on his part. The types of cases that you've described [him being involved in], those are relatively minor kind of cases. Perhaps there was not necessarily an understanding of what's going on with him, so it was easier for the police to just take him and put him in jail rather than to attempt to deal with the situation as we're going through now. I don't know a lot about his history beyond his Pittsburgh experience, but those kind of cases, those kind of crimes, I think we can clearly change with what we have going on for him in this court, the level of services that forensics is prepared to provide for him.
I see a bright future for him. I really do. The kind of crimes are relatively minor. They're annoying for the people that were around when he was loitering, but they're not the kind of crimes that we [won't] be able to impart to Bennie, "This is what you need to do; this is what you don't need to do," and perhaps maybe give him a sense of worth and value that he may not have had in the past.
Is staying on his medication voluntary now, or is it a requirement for staying in the program?
That's a fine line. He's volunteered to be part of the program, and in volunteering to be part of the program, he signed off on a service plan. A service plan is part of the condition of his probation. So under probation, he would be required to take his medication. So his failure to take his medication could be considered a probation violation, and we could then be able to, if he doesn't take his medication, take some proactive steps toward getting him to take the medication. But there are a lot of steps in between that we can deal with before we have to say: "You're in violation of your probation. You have to take this medication."
How important is early release as an incentive for somebody like Bennie? Is that a big part of leverage?
Yes and no. Early release is sometimes a big part of leverage for some people that want to be away from the criminal justice system. In some instances it's not, because we have people that we were ready to graduate that haven't wanted to graduate because they feel a sense of and a part of a different community that they didn't feel part of before. It really depends on the person, depends on spending more time with him to see what really one of his goals is. If his goal is to be rid of the criminal justice system that we are, then ... early release will be leverage. If the stability that this is providing him is more important to him, then I don't think that there's really any leverage with early release, and he may go a little deeper into the program than we may have planned for him. ...