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A CASE OF INSANITY

in congress - mental health courts
In November 2000, President Bill Clinton authorized the development of up to 100 pilot "mental health courts," modeled in part on an innovative Florida court that hears cases involving mentally ill defendants accused of non-violent offenses. Here's background on the legislation and its limitations, and a preview of what Congress may have in store for the current session.

In November 2000, U.S. President Bill Clinton signed into law America's Law Enforcement and Mental Health Project, a bipartisan bill introduced into Congress by two Ohio legislators -- Rep. Ted Strickland, a Democrat, and Sen. Mike DeWine, a Republican. The bill, which amended the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the creation of 100 pilot mental health courts, was introduced just months after the Justice Department released a report indicating that fully 16 percent of those incarcerated in the nation's prisons and jails have been identified as mentally ill.

"The problem is self-perpetuating and cyclical," explained Rep. Strickland at a June 2002 congressional hearing. "The prison environment has a devastating effect on the mentally ill and the mentally ill have a destabilizing effect on the prison environment."

Under the program, eligible offenders would be given "voluntary outpatient or inpatient mental health treatment in the least restrictive manner" as opposed to jail time. Only those offenders who have been charged with misdemeanors and non-violent offenses -- loitering or theft, for example -- are eligible to participate in the state and local mental health courts.

While the specific arrangements for each pilot program are left up to the state or local community, the Law Enforcement and Mental Health Project defines mental illness as "a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria within the most recent edition of the Diagnostic and Statistic Manual of Mental Disorders." It also dictates that "designated judges" will be the ones to determine, apparently after consulting with clinicians and/or legal advisers, whether or not a defendant is eligible to participate in mental health court.

America's Law Enforcement and Mental Health Project was signed into law nearly three years after Florida established the 17th Judicial Circuit Mental Health Court in Broward County, the nation's first such court. The Broward County court was established after a high-profile case involving 25-year-old Aaron Wynn, who had been in and out of area mental health facilities. In 1993, Wynn pushed an 85-year-old woman outside a supermarket in Fort Lauderdale. The woman's injuries resulted in her death, and Wynn was subsequently convicted of manslaughter. The case eventually led to a grand jury investigation of the state's mental health network, in which Florida's system was excoriated as ineffective and characterized as "a fragmented mental health system lacking in direction or leadership with little or no accountability to anyone."

The Florida legislature soon earmarked $1.5 million for the Broward County mental health court, which now handles approximately 1,000 cases a year according to Florida Bar News. Other mental health courts, modeled in part on the one in Broward County, have since been established in Washington state, California, and Alaska. Though there is no national model for mental health courts, the Justice Department reviewed the four "pioneer" mental health courts and determined that each program involved at least a judge, a prosecutor, a public defender, and some sort of mental-health services coordinator. [See this overview of the four "pioneer" programs]

Meanwhile, the U.S. Congress has appropriated only $4 million for the 100 pilot courts -- just $2.5 million more than Florida earmarked for one court. "Although this is not much money to work with," Rep. Strickland said at the June 2002 hearing, "the program will give communities who are struggling to contend with the problem of the mentally ill in the criminal justice system the initial resources they need."

Since the Justice Department found in July 1999 that the mentally ill were more likely than other offenders to have committed a violent offense, some maintain that the pilot courts, which would divert only non-violent offenders, are critically limited in their scope. Strickland concedes that the bill was just the beginning. "However successful, the mental health court initiative is a small piece of what is needed to address the problem of the mentally ill at all stages in the criminal justice system," he said.

To that end, Strickland, a psychologist, said that he plans to introduce more ambitious legislation soon. According to representatives from both Strickland's and DeWine's offices, the two legislators hope to introduce new bills in mid-October 2002. Characterized as expansions of the mental health courts legislation, the new proposals will leave it up to the local communities to decide whether or not violent offenders like Ralph Tortorici can be diverted to the mental health court system.


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