District Court Judge Bonnie Mclean Amanda Myers, Project Director Problem Solving Court Coordinator

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1 District Court Judge Bonnie Mclean Amanda Myers, Project Director Problem Solving Court Coordinator

2 Our New Mission The 18th Judicial District Wellness Court (WC) is a problem solving court which diverts selected and limited dually-diagnosed defendants from prison. Defendants dually-diagnosed with a serious and persistent mental illness and substance use disorder are diverted into a specialized, judicially supervised, community based program that provides intensive case management and integrated co-occurring treatment. The goal of the WC is to reduce recidivism of offenders with co-occurring mental illness and substance use disorders in the criminal justice system, divert the mentally ill and substance dependent from prison, promote public safety, and improve quality of life for participants and their families with a cost effective, integrated continuum of care through community resources.

3 Making Connections The 18 th Judicial District restructuring began in October 2015 with the posting of a Request for Documented Quotes (RDQ). The Problem Solving Court Coordinator s (PSCC) Office reached out to the National Association of Drug Court Professionals (NADCP) for assistance and we were then directed to Dr. Steadman of Policy Research Associates. Dr. Steadman provided the PSCC Office with national research and resources for the restructuring of the Wellness Court. The PSCC Office also reached out to several stakeholders at the state level soliciting assistance and guidance for restructuring. These leaders were able to provide the research and support needed for the clinical restructuring.

4 San Francisco At the recommendation of Dr. Steadman, the PSCC, Problem Solving Court Judge, and Matt Vogl, (who at the time was the Director of the CU Depression Center), visited a nationally recognized Mental Health Court in San Francisco, CA.

5 Community Partners Upon return from San Francisco, Mr. Vogl was appointed the Executive Director of the National Behavioral Health Innovation Center (NBHIC). NBHIC now provides support and connections to evaluation, research, community connection and assistance with strategic planning. NBHIC recently compiled Program Components and Design: Best Practices for Mental Health Courts

6 Clinical Advisory Committee The Wellness Court Clinical Advisory Committee will support the Wellness Court Team by providing strategic guidance on achieving the court s mission statement and main objectives.

7 Target Population After further review of national and local research, it was noted that over 90% of Felony Mental Health Courts serve clients with a cooccurring, moderate or severe substance use disorder. Additionally, the substance use disorder often surfaced as a result of mental health symptomology and (until recently), a lack of access to healthcare services. Therefore, the Wellness Court has changed its target population recognizing this disparity. Currently, there are 21 clients in the Wellness Court and only 4% do not have a severe substance disorder. The remaining 4% have a moderate substance use disorder

8 Community Resources Wellness Court accepted prison re-entry clients: about 50% of Wellness Court clients had served time in prison - they were granted probation on Community Corrections Escape charges. Because these clients often had a lengthy Department of Corrections (DOC) sentence for failing to comply with parole, they were often revoked and sent back to DOC with sentences beyond their probation sentences. In Colorado, judicial districts have no jurisdiction over DOC or Parole clients making judicial oversight through Wellness Court for this population difficult at best. Based on local and state data, Wellness Court will now be a probation revocation model to deter community correction and prison sentences.

9 Education While evaluating Wellness Court, it was noted the term Serious and Persistent Mental Illness (SPMI) is often left to interpretation by the evaluating clinician. Some clinicians perceive only those with the top six diagnosis to be SPMI and others determine SPMI by the disruption caused by the mental illness. After further review of local and state data, Wellness Court has determined SPMI will be determined by the disruption caused by the mental illness.

10 Delivery After attendance at San Francisco s Mental Health Court and upon review of Dr. Steadman s research, Wellness Court phases were redesigned. Historically, the phases were designed as a drug court model with very specific timeframes and goals. Through research and observation, Mental Health Courts using a harm reduction model based on individual case plan goals have better outcomes than those who adhere to strict timelines. Therefore, the Wellness Court has restructured all phase systems to be driven by case plans and timeline guidelines set forth in policy, rather than in client handbooks.

11 Resources The Wellness Court has a 98% Medicaid enrollment rate leaving correctional treatment dollars to cover the cost of urinalysis testing, inpatient treatment stays, and sober supportive housing. For clients with higher acuity, Wellness Court, in collaboration with Dr. Brandon Mathews, State Director of Community Education Centers, are working to develop a 90 day sustainability unit focusing on mental health and substance use disorder treatment, medication management, community stabilization and integration. This pilot project will target 10 clients in year one, and depending on the outcomes, Wellness Court hopes to expand this program in year two to serve a greater number of clients.

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14 Who Defendant must be legally competent Documented Substance Use Disorder Meets DSM-V categories of Substance Use Disorder Moderate or Severe Documented Serious and Persistent Mental Illness such as but not limited to: Schizophrenia Psychotic disorders (Schizoaffective disorder) Bipolar Type I with Psychosis Post-Traumatic Stress Disorder Major Depression with a history of suicidality or psychosis Other Bipolar with a history of suicidality or psychosis Other - Mental Illness is clearly a barrier to addressing criminiogenic needs Co-occurring mental health and substance use disorder diagnoses have been untreated and can be linked to criminal justice system involvement and/or failure to comply with probation supervision The client is at risk of community corrections placement or prison Non-sex offense criminal history Assessed, screened, and approved by the WC Team Willing to actively participate in treatment plan (including medications) LSI-R score greater than or equal to 25 Must be charged with a felony and facing a probation revocation case within the 18 th Judicial District Capable of being supervised by the 18 th Judicial District Probation Department