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February 23, 2013

Dual drug and mental health court assists recovery

MILLEDGEVILLE — The Baldwin County Adult Treatment Court Collaborative (ATCC) serves the community by addressing individuals with substance abuse, mental health or co-occurring disorders that have committed a crime. This joint judicial, law enforcement and treatment service program improves public safety and community health by rehabilitating participants into productive citizens.

“I think we are all learning how to work together with a community-based program that we've really never had. It's been a tremendous link between the jail, the courts, and River Edge,” Sheriff Bill Massee said. “We hope to help more and more families as it progresses. Baldwin County really needed the mental health component in the ATCC.”

The substance abuse court covering the eight-county Ocmulgee Judicial Circuit expanded to include mental health thanks to a three year Substance Abuse and Mental Health Services Administration (SAMHSA) grant awarded in Sept. 2011. Funding equals just under $400,000 per year for the award period.

State funding of $95,000 and a portion of Drug and Alcohol Treatment county fines and fees contribute as well. The SAMHSA money primarily backs treatment services not judicial operations.

Baldwin County, in association with River Edge Behavioral Health Center, was one of just 11 applicants receiving the SAMHSA funding nationally.

ATCC project director Amy Michaud said part of the grant is data collection to prove these accountability courts are worth the money.

Evaluators analyze an individual's change from the entry survey compared to several months within the treatment process.

The enhanced drug court is considered a pilot combination of both substance abuse and mental issues.

“That's the pilot project to see whether this braided funding has better outcomes than the existing courts,” Michaud said.

Mental health patients don't pay for their treatment, while substance abusers are assessed a fee.

“We don't hinder progress because they are unable to make their payments,” Michaud said.

No violent or sex offenders make the cut. Candidates are evaluated on a case-by-case basis.

The average program lasts 18 to 24 months depending on individual need. Participants have frequent court appearances, random drug screenings, counseling and medication management over the course of the voluntary three-phase intervention.

Programming isn't easy by any stretch. Most individuals have never operated in such a rigid, strict environment.

Prior to the mental health court addition, the drug court already had 25 people signed up. Patients served since Feb. 1 last year total 101 on both sides.

Six patients obtained GEDs. ATCC graduated 12 over the last year and maintains a 90 percent retention rate.

The treatment court spurred 70 individuals to employment since inception.

“The goal is to make sure this person is employed, housed and a productive citizen,” the ATCC coordinator said.

Michaud said 80 percent of enrollees have dual or co-occurring diagnoses. 

A strong legal incentive exists though Ocmulgee Judicial Circuit District Attorney Fred Bright understands the difficulty surrounding these issues.

People can leave the program at any time. Most are staring down serious prison time if they don't graduate.

“If a patient successfully completes the court, they'll graduate and their charges will be dismissed,” Bright said. “If you flunk out, your case is prosecuted on the regular criminal system.”

Georgia Gov. Nathan Deal's 2013 fiscal year budget allocated $9 million to state drug court programs for treatment services and drug testing. Other circuits are establishing their accountability courts.

“There are a lot of resources going into these drug and mental health courts. It's clear that's the new trend,” Bright said.

Baldwin County has become the standard for efficient operations. The Ocmulgee DA credits Judge Hulane George for pushing the SAMHSA grant and getting the ATCC finalized.

River Edge was and continues to be the main component of the program's success. From full-scale treatment and counseling support to shelter plus care housing, the center runs the engine.

Shannon Harvey, River Edge CEO, commended Judge George and Massee's foresight and commitment to treatment versus punishment. 

River Edge enjoys the collaborative partnerships.

“We are so delighted because we know treatment is effective and recovery is to be expected. Mental illnesses and addictions are chronic health conditions from which people can and do recover everyday. We are excited to be part of that,” Harvey said.

The ATCC contributes to reduce county jail expenditures for housing and medicating a certain population that isn't well served by correctional settings. 

Astounding jail and emergency room visits for mental health related reasons after the Central State Hospital closings were alarming. Six-month-old statistics tallied 580 prior arrests for ATCC participants in Baldwin County alone.

“That's probably the reason we were funded because there was such a crisis in our community,” Michaud said.

Jail staff flags individuals fitting the treatment court profile minimizing days spent incarcerated. The Sheriff's Department frequently refers to the treatment court.

County jail health services administrator Beth Eubanks said it's nice to have another mental health related option, considering the drug abuse side was the court focus from 2003 until the recent setup change. Though a challenging severely ill population often refuses the voluntary court, Eubanks likes where the program is headed mentioning the wonderful work being done.

“For a certain population this is a good thing. It's necessary,” Eubanks said. “Whether we like it or not, we are part of public mental health. You can't separate law enforcement and the jail from mental health anymore.”

Michaud said River Edge's partnership since 2010 couldn't be more valuable. Along with Eubanks, the ATCC coordinator agrees mental health care would be lost minus the relationship.

“River Edge is the biggest piece. Without the integrated treatment they offer, this court wouldn't exist,” Michaud said. “At the end of the day recovery and wellness is where we are trying to lead our people and community. If you don't have strong treatment services and leadership, then you aren't going to be successful.”

Bright said the accountability court does a nice job helping remove the community tax burden through rehabilitation. 

Considering state funding volatility, finding alternative sustainability for the ATCC after the SAMHSA grant period ends is imperative. The circuit applied for a separate Bureau of Justice Assistance grant to boost judicial coordination. 

The size exploded while the staff hasn't. Bright could use another assistant district attorney bolstering ATCC operations as well.

Family investment and community safety remain accountability court focal points. The team hopes to serve 150 by Sept. 30.

“From the day we initiated the program until today, we've come a long way. I don't know that any one court or program will alleviate all the problems in Baldwin County,” Massee said. “We look at it this way if we have 100 problems and can solve 10 of them to help 10 families, we are doing what's necessary.”

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