Sherri Crock is the mental health court liaison for the Athens County Municipal Court Substance Abusing/Mentally Ill (SAMI) Court, which is designed to divert individuals with dual disorders of mental illness and substance abuse from incarceration by providing intensive community treatment and supervision. She spoke with Carolyn Turgeon of the Center for Court Innovation about the program.
How did the Athens County Municipal Court Substance Abusing/Mentally Ill Court come about?
I’ll give you some history. Athens County was one of the recipients for the original mental health court grants that went out in 2003. We were one of 24 across the country, and we ran this program in three counties. It wasn’t as successful in Hocking and Vinton counties because the population we were targeting to serve did not exist in large enough numbers. However, in Athens County the program went like gangbusters. We had plenty of business. And what we were finding through our two-year tenure was that a lot of the individuals we were accepting into our program not only had a mental health condition but a co-occurring substance abuse issue as well.
It made sense to target individuals with co-occurring disorders so that we could provide them with better services and hopefully better outcomes. Toward that end we decided that we would apply for a grant for a SAMI court, which is a problem-solving criminal justice initiative. And we were awarded the grant.
We decided to use the IDDT (integrated dual disorder treatment) model, or the Dartmouth New Hampshire model, which is designed to address mental health and substance abuse issues at the same time. Historically in the mental health and substance abuse treatment arenas, if someone had dual disorders they would go to their mental health provider and be told they couldn’t be treated until they’re sober, and then they would go to their substance abuse treatment provider and be told that the couldn’t be treated until they’re psychiatrically stable. This really sent the client into a tailspin.
When did the program start?
It started in December 2005. We ran mental health court until the end of November and then we started calling it SAMI court. I wrote provisions in the grant allowing us to take folks with straight mental health issues because that was important to the judge, but generally now we are taking folks that have dual disorders.
What have the challenges been so far?
One challenge has been getting the word out there that our population target has changed a little bit. This has been quite an evolution. It’s been almost like a revolution in a way. I was a one-woman show for the first two years, just me working with the judge, and now I have a staff. So hiring a staff and getting them trained has been a challenge.
Was it difficult to persuade stakeholders of the necessity of a dual disorder court?
Everybody seems to be on board with it. Now what we need to do is educate them about what it truly means to have a dual disorder court. So that’s another challenge that we have and one that I’m going to start addressing.
Usually when I explain what we’re doing through community education we get more business. The court and other court players—defense attorneys, the public defender, the county and city prosecutors, etc.—start thinking, “maybe the SAMI court team or maybe Sherri can help us with this problem.” A defendant may not necessarily be eligible for SAMI court but now a practitioner might ask me to take a look at that defendant and make a treatment recommendation, which might guide the court in sentencing options.
How does the screening process work?
We have a probation officer who has gone through Crisis Intervention Team or CIT raining for law enforcement officers, training that teaches them how to deal with individuals with mental illness in the field in an effort to deescalate them and hopefully avoid arrest. He runs probation for our program through the court, and is very adept at flagging cases in arraignment. He is available to meet with people and gauge whether or not they might be interested in the program, he knows a lot of the attorneys in town, and he’s also a good ambassador and is able to shepherd cases into our program. I used to do that and I don’t have time to do that anymore, so he’s kind of picked up the slack and it’s enormously helpful.
And generally the judge knows whom to send into the court. It’s a busy court but it’s also a small community. It’s one courtroom on a municipal court level. We do have a Court of Common Pleas which is a higher criminal court, but we do not offer services in that court at this time.
Is it a goal to do that eventually?
Yes it is.. We have talked about that for a year and those conversations continue. We’re dealing with misdemeanors now, but eventually we’d like to get these services to all offenders in the community who need them. There are plenty of folk we’d like to serve who have low-level felony charges and we currently can’t help them in the Court of Common Pleas.. In some cases we can talk to the county prosecutor about either reducing the charges or dismissing them without prejudice, but that’s not so common.
Has it been a challenge to get the mental health providers working with drug treatment providers?
You know what? No, and I’ll tell you why. We are unique here, in the sense that we have a very good collaboration between the mental health provider, for whom I work, and the court. The ideal is to have the roles very well defined, and the judge here is very comfortable in his role. Legally he decides what cases are appropriate for folks entering our program, and we decide whether or not the potential candidate meets eligibility requirements
And what staff did you hire in the last few months?
We hired two case managers, one of which is also an LPN, and that is in keeping with our IDDT model. We have on a consultation basis a psychiatrist and an RN. They have other functions so they’re not specifically assigned to us and we don’t need them to be. There’s myself. We have a counselor who does both individual and group counseling. We also have a probation officer dedicated to us by the court.
What generally happens to the people who come into the program? How long do they stay in?
That depends solely on them. I have some people who have gotten through in nine months, I have some people who have been in the program up to two years. That depends on how well they do with their treatment and whether or not they re-offend. It depends on a lot of factors.
Have you had many successes so far?
Well it’s funny. A lot of the folks we have now have participated in the mental health court program, and there are some folks who have taken well to the increase in monitoring. We had a lady who, with the mental health court program, didn’t do well because she needed some assistance that I simply couldn’t give her. Once she had a case manager in place, someone who could help her with getting housing and child care and getting her transportation needs worked out and her benefit situation worked out, she soared. So in that way we have seen quite a bit of improvement. And we’ve also seen the opposite: we have a gentleman now who’s balking at the idea of having a probation officer show up at his door on an almost daily basis. He hides from the case manager and he doesn’t come to his appointments. So we’ve seen both extremes.
Do you link clients to services other than mental health or substance abuse treatment?
We do. The nice thing is that recently our [state-funded] alcohol drug addiction and recovery board received some money from the state and because they’re a very progressive and intelligent board, they earmarked some money for housing and we’ve been able to tap into that. This has helped our folks tremendously, because otherwise we’d be looking at a very long waiting list. There is a shortage of housing, there’s a shortage of money, and these folks are disenfranchised. As it stands, we’ve been able to put at least five people in housing who normally would have had to wait significant periods of time.
What are your future plans?
We want to expand the program, expand the population and the municipal court realm until we feel confident and comfortable with what we’re doing, and then hopefully expand to the Court of Common Pleas. And that has been broached and discussed before with our advisory board and with others in the community.
We’re the only one in the state that’s doing this at a municipal level, as far as I know. Butler County, Ohio, is doing this on the felony level and the Court of Common Pleas. Our model is loosely based on them. When we conceived of this idea we spent a day in court with them, we talked with them, and they were very helpful. They follow the IDDT model to the letter and I think have had some pretty good success with it. And they’ve even published. I don’t know if we’ll get that far, but I do know that because we’re in such a unique area in Ohio—we’re rural yet we’re also home to one of the few state mental hospitals—we have a high population of individuals who meet these criteria. People that come here for hospitalization often stay, and then they offend, and they become homeless. And we as a community need to have a function to deal with that problem, and this is our solution for that.
April 2006