Mental health court strives to lower jail population

David Statum and Mike Lewis

STAFF WRITER jordan scott The Coffee County Mental Health Court program helps to keep those with identified mental health issues out of jail, according to Mike Lewis, director of the Coffee County Drug Court, which oversees the pro

David Statum and Mike Lewis

gram. “The participants are people who have jobs, who have families and are productive, he said. “A lot of them have children, they take care of their homes and they drive. It’s just because of an issue that they’ve ended up in the court system and the best way to help them is to try to intervene and see what we can do to help them not repeat that behavior.” Participants are identified by those in the legal system and must have a mental health diagnosis before being allowed to participate in the mental health court program. Coffee County General Sessions, Juvenile Judge and Drug Court Judge Tim Brock presides over mental health court once a week. “Every week they’ll stand up in front of Judge Brock and he’ll ask them how they’re doing,” said Lewis. “Some weeks everyone’s happy but there are other weeks where it’s one meltdown after the other. “Judge Brock has said that drug court and mental health court are the two hardest courts he presides over, not because the people are difficult but because he knows his words carry a lot of weight when he’s talking to them.” According to Lewis, Brock holds each participant responsible for keeping their appointments with doctors and psychologists, taking their prescribed medications, and contacting case manager David Statum every day. “They’re not real hard requirements but they’re things that tend to work with the participants because it’s an ongoing accountability,” said Lewis. “There’s somebody on the other end of the phone who cares about them.” According to Statum, the conversations with the court vary in length and topic. “The ultimate goal of this program is that the participants get the skills they need to live productive lives,” he said. “We have some incredible participants in the program and they just need somebody to champion for them and to be an advocate for them, to be kind. “A mental illness is very taboo but it’s a physical illness just the same as any other physical illness, but because it’s so taboo it’s something we shy away from.” Statum continued, “When we do that, people don’t get the help they need. What we’ve found is that when we’re able to surround folks with services that they’re able to get tools that they need to be able to live happy and successful lives.” What is mental health court? The program varies in length for each participant depending on need and probation period. “The time of the program is not specific,” said Brock. “We can’t keep them any longer than their period of probation but we really want for them to get stable and stay stable, so that drives how long we keep them.” On average, 11 to 15 people participate in the mental health court program at one time. Statum is the only case manager. “We could totally handle more participants. I don’t know that we have a max case load at this point,” said Statum. “We have great resources that we’re implementing.” According to Lewis, the mental health court was running on a grant from the state in its first three years. In its fourth year of operation, the Coffee County Drug Court is strapped for funds. “We would love to expand the program but we’re strapped for funds,” said Lewis. “In order to keep our core programs running we had to eliminate a position this summer. “We shifted funds over and put them toward things like mental health court. The more overlap between our programs the better as far as resources.” Identifying the need for mental health services Coffee County Mayor Gary Cordell asked the Coffee County Jail Operations and Oversight Committee on Oct. 5 to consider split-ting into separate groups to better address two needs of the county: employee retention within the sheriff’s department and population oversight at the jail. One component of the population oversight group would be to discuss mental health issues within the jail population. “It’s not illegal to be crazy,” said Gary Benefield. “Putting the mentally ill in jail is a disservice to the individual as well as the tax payers.” Having less people in jail is less costly to tax payers and keeping the jail population down makes it less likely that a new pod will need to be built at the new jail. The new county jail can hold up to 400 inmates. According to Lewis, no tax dollars are expended on programs under the drug court umbrella. “There’s definitely a problem in Tennessee and other states where mentally ill patients end up in county jails,” said Sheriff Steve Graves. “We’re not trained to take care of mental illnesses. It would be good for them and their families to have access to support and services. “If this program has a positive impact on jail recidivism then we should see about expanding the pro-gram.” Brock and Statum both said that they think the mental health court program is a great help to the sheriff’s department. “I think the sheriff’s department is glad that we’re doing this because there are a lot of folks incarcerated that have mental illness and it’s a difficult thing for the sheriff to deal with, with the limitations he has,” said Brock. “He doesn’t have access to mental health treatment, counseling and things like that.” “Medications are problematic in jail too. I think they’re glad we’re taking some responsibility for those things because that’s a difficult thing to do in a jail setting,” he continued. “It’s better for these participants and it’s better for everyone that we do it here as long as there’s no danger to anyone.” Statum said, “It’s ideal if the mental illness can be treated rather than diverted to jail. The jail is not ideally suited to meet folks’ mental health needs.” “People are becoming aware that our mental health systems are really lacking,” he continued. “We need to find ways to support people and help people who are going through difficult times.” Mental health and drug use in jail At an informal meeting of the jail operations and oversight committee on Monday, Aug. 31, Coffee County Public Defender John Nicoll expressed concern that his clients were being taken off of necessary medications by the new county jail doctor. “The doctor, in my opinion, is unfortunately taking some of these people off medication that they probably need to be on because of their mental health history and their mental health issues,” said Nicoll. “I’ve raised this concern to Sheriff Graves. We’ve talked about it. Some of this is out of his control because of the doctor who is in there and his determination.” The county awarded Quality Correctional Health Care (QCHC) with a contract to operate the medical facility at the new jail. Dr. Johnny Bates, founder and CEO of QCHC, addressed Nicoll’s concerns to the Coffee County Purchasing Commission on Tuesday, Sept. 1 without the public defender’s presence. “There’s certain drugs that I don’t allow in jail that are often prescribed,” he explained. “Have you ever heard the people complaining say, ‘I didn’t get my blood pressure medicine or I didn’t get my eye drops?’ It’s always, ‘I didn’t get my psychotropic meds.’ Well there’s a good reason for that.” Bates passed out a number of articles and medical journals to the purchasing commission members supporting his reasoning. “Wellbutrin, which is a drug commonly used for depression, is the number one choice of drug by meth addicts. It is snorted and it can cause seizures,” he explained. “One of the things that happens is inmates will feign a psych diagnosis. They get these drugs and then they can trade them like commissary. The drugs that are abused the most are Wellbutrin, Seroquel and Neurontin. “We have 44 jail contracts now. None of these drugs have been allowed in any of these facilities and we have not had the first issue. We have a lot of complaints, lots of mothers calling and a lot of people irritated, but we haven’t had any issues.” Jail medical administrator Valerie Uselton, RN, defended the doctor’s process. “Dr. Bates doesn’t just take them off their meds, he sees them and he explains to them exactly what he’s explaining to you all about potential for abuse,” she said. “He listens to them.” Bates explained that he tapers inmates off of medications and gives them a washout period before starting them on a different medication. “Some people aren’t bipolar, they’re just on too many medications at one time,” he said. “They get misdiagnosed with a bipolar disorder when really they have a substance abuse disorder.” According to Bates, QCHC always performs drug screenings before making these decisions. “We’re number one in drug screenings in the country,” he said. Lewis understands that people with drug addiction problems and those with mental health conditions must be treated differently. “We do some drug testing with our mental health court participants but not nearly as much as we do with our drug court folks,” he said. “They’re really on completely different ends of the spectrum. “We don’t want our Drug Court people to take any medication, but we want our mental health court people to take their medication because it’s important.” Coffee County Drug Court encompasses drug court, mental health court, the recovery academy for at-risk youth and probation supervision for multiple DUI offender. “Once you get people on the right track and get their needs met, regardless of which program they’re in, they can soar,” said Statum. For more information about Coffee County Drug Court and its programs visit www.cctndrugcourt.org, call 723-3051 or stop by the office at 604 College St. in Manchester.