Underscoring our view that specialty courts are the wave of the future, we were eager to witness Judge Rosemary B. Minehan presiding over a session of Plymouth Mental Health Court. We’d heard that she is literally changing people’s lives with an innovative approach to a seemingly intractable problem, and we decided to visit in late December.
A Plymouth District Court judge for more than 20 years, Judge Minehan developed her plan for the Mental Health Court in 2010 after realizing that many of the cases she was seeing in the court room involved defendants with mental illness. The problem the Mental Health Court is designed to address can best be described like this: An individual with a mental illness such as PTSD, bipolar disorder, schizophrenia or depression is convicted of a misdemeanor or minor felony, and receives probation. Without treatment, the mental illness makes it difficult if not impossible for this individual to successfully complete probation, and move on.
Think about the old saw that when mental health services are not provided, the prison becomes the “default provider.” Untreated mental illness is likely to result in a cycle of frequent interactions with law enforcement, hospital emergency rooms, and the court.
Who are the participants at the Plymouth Mental Health Court? They are post adjudication defendants on probation. Represented by counsel, they sign an agreement requiring that they do 4 things: (1) Adhere to an evidence-based mental health treatment plan tailored to their needs, with arrangements to be made by one of the two social workers; (2) agree to stay free of alcohol or drugs; (3) come before the judge 3 times per month; and (4) fulfill any other conditions required by the terms of their probation.
Before going into the Court session, we talk with one of the social workers, Christopher Pike. Participants know they can call him if they are heading toward a crisis, or experiencing difficulty with compliance. If appropriate, he can arrange for their treatment protocol to be changed.
As each participant comes before her, Judge Minehan demonstrates empathy, compassion, but most of all, a commitment to holding the participant accountable for his behavior and helping him successfully complete his probation. “How are you?” she asks, addressing each one as Mr. or Ms. Two of them respond with “hanging in there,” and the judge says: “I know. This is a tough time of year. Everyone is pretending to be happy.”
Those who report that they are working get praise and encouragement from the judge. At the same time, she cautions a few to avoid the temptation of alcohol at family gatherings. She reminds one participant to avoid altercations with a neighbor, saying “You know if you lose your housing, everything falls apart. So the next time, just take a big breath.”
But it’s not all coaching. Judge Minehan queries both the social worker and a probation officer specifically assigned to the Mental Health Court about each participant’s compliance. In one instance, the judge requires that a new drug screen be performed. In another instance, the judge queries a participant about pain medication, and looks for documentation indicating it’s medically required for a specific condition.
Mental Health Court is labor intensive, as most participants are required to stay in the program for at least 6 months, and frequently more. Whereas a typical probationer in the District Court may have as little as 1 contact per month with a probation officer, a Mental Health Court participant may have daily contact with a probation officer.
The regular court appearances provide the opportunity for the social worker and the judge to recognize any change in a participant’s mental status, and intervene if necessary. Intervention could include anything from a psychiatric crisis evaluation, hospitalization, or other treatment options to stabilize the participant.
Judge Minehan has chaired the District Court Committee on Mental Health and Substance Abuse since 1998, has co-authored the Mass. Practice Book on Mental Health, and has extensive experience presiding over hearings involving civil commitment and the involuntary use of medication.
With some 15 participants at any one time, the Mental Health Court is funded by the Department of Mental Health. (Mental health courts can also be found at the BMC and in Springfield.)
We came away from our experience thinking this Mental Health Court is a beacon of hope and practicality, and encourage others to take notice.