\n\t<\/iframe>\n<\/p>\nGAINESVILLE, Ga. \u2014 In early December, Donald Brown stood nervously in the Hall County Courthouse, concerned he\u2019d be sent back to jail.<\/p>\nThe 55-year-old struggles with depression, addiction, and suicidal thoughts. He worried a judge would terminate him from a special diversion program meant to keep people with mental illness from being incarcerated. He was failing to keep up with the program\u2019s onerous work and community service requirements.<\/p>\n\u201cI\u2019m kind of scared. I feel kind of defeated,\u201d Brown said.<\/p>\nLast year, Brown threatened to take his life with a gun and his family called 911 seeking help, he said. The police arrived, and Brown was arrested and charged with a felony of firearm possession.<\/p>\nAfter months in jail, Brown was offered access to the Health Empowerment Linkage and Possibilities, or HELP, Court. If he pleaded guilty, he\u2019d be connected to services and avoid prison time. But if he didn\u2019t complete the program, he\u2019d possibly face incarceration.<\/p>\n\u201cIt\u2019s almost like coercion,\u201d Brown said. \u201c\u2018Here, sign these papers and get out of jail.\u2019 I feel like I could have been dealt with a lot better.\u201d<\/p>\nAdvocates, attorneys, clinicians, and researchers said courts such as the one Brown is navigating can struggle to live up to their promise. The diversion programs, they said, are often expensive and resource-intensive, and serve fewer than 1% of the more than 2 million people who have a serious mental illness and are booked into U.S. jails each year.<\/p>\nPeople can feel pressured to take plea deals and enter the courts, seeing the programs as the only route to get care or avoid prison time. The courts are selective, due in part to political pressures on elected judges and prosecutors. Participants must often meet strict requirements that critics say aren\u2019t treatment-focused, such as regular hearings and drug screenings.<\/p>\nAnd there is a lack of conclusive evidence on whether the courts help participants long-term. Some legal experts, like Lea Johnston, a professor of law at the University of Florida, worry the programs distract from more meaningful investments in mental health resources.<\/p>\nJails and prisons are not the place for individuals with mental disorders, she said. \u201cBut I\u2019m also not sure that mental health court is the solution.\u201d<\/p>\n<div class=\"wp-block block--newsletter \" data-type=\"kaiser-health-news\/newsletter\" data-align=\"center\" style=\"\">\n<h4 class=\"newsletter__title\">\n\t\t<a href=\"https:\/\/kffhealthnews.org\/email\/\"> \n\t\t\tEmail Sign-Up\t\t<\/a> \n\t<\/h4>\n\n\t\tSubscribe to KFF Health News’ free Morning Briefing.\t<\/p>\n<\/div>\nThe country\u2019s <a href=\"https:\/\/www.17th.flcourts.org\/11-mental-health-county-court\/\">first mental health court<\/a> was established in Broward County, Florida, in 1997, \u201cas a way to promote recovery and mental health wellness and avoid criminalizing mental health problems.\u201d The model was replicated with millions in funding from such federal agencies as the <a href=\"https:\/\/www.samhsa.gov\/grants\/grant-announcements\/sm-14-009\">Substance Abuse and Mental Health Services Administration<\/a> and the <a href=\"https:\/\/bja.ojp.gov\/program\/mental-health-courts-program\/overview\">Department of Justice<\/a>.<\/p>\nMore than 650 adult and juvenile mental health courts were operational as of 2022, according to the <a href=\"https:\/\/ntcrc.org\/\">National Treatment Court Resource Center<\/a>. There\u2019s no set way to run them. Generally, participants receive treatment plans and get linked to services. Judges and mental health clinicians oversee their progress.<\/p>\nResearchers from the center found little evidence that the courts improve participants\u2019 mental health or keep them out of the criminal justice system. \u201cFew studies \u2026 assess longer-term impacts\u201d of the programs \u201cbeyond one year after program exit,\u201d said a <a href=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2023\/11\/PCP_MentalHealthCourts_Brief_2022_DigitalRelease.pdf\">2022 policy brief<\/a> on mental health courts.<\/p>\nThe courts work best when paired with investments in services such as clinical treatment, recovery programs, and housing and employment opportunities, said Kristen DeVall, the center\u2019s co-director.<\/p>\n\u201cIf all of these other supports aren\u2019t invested in, then it\u2019s kind of a wash,\u201d she said.<\/p>\nThe courts should be seen as \u201cone intervention in that larger system,\u201d DeVall said, not \u201cthe only resource to serve folks with mental health needs\u201d who get caught up in the criminal justice system.<\/p>\nResource limitations can also increase the pressures to apply for mental health court programs, said Lisa M. Wayne, executive director of the National Association of Criminal Defense Lawyers. People seeking help might not feel they have alternatives.<\/p>\n\u201cIt\u2019s not going to be people who can afford mental health intervention. It\u2019s poor people, marginalized folks,\u201d she said.<\/p>\nOther court skeptics wonder about the larger costs of the programs.<\/p>\nIn <a href=\"https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=3100302\">a study<\/a> of a mental health court in Pennsylvania, Johnston and a University of Florida colleague found participants were sentenced to longer time under government supervision than if they\u2019d gone through the regular criminal justice system.<\/p>\n\u201cThe bigger problem is they\u2019re taking attention away from more important solutions that we should be investing in, like community mental health care,\u201d Johnston said.<\/p>\nWhen Melissa Vergara\u2019s oldest son, Mychael Difrancisco, was arrested on felony gun charges in Queens in May 2021, she thought he would be an ideal candidate for the New York City borough\u2019s mental health court because of his diagnosis of autism spectrum disorder and other behavioral health conditions.<\/p>\nShe estimated she spent tens of thousands of dollars to prepare Difrancisco\u2019s case for consideration. Meanwhile, her son sat in jail on Rikers Island, where she said he was assaulted multiple times and had to get half a finger amputated after it was caught in a cell door.<\/p>\nIn the end, his case was denied diversion into mental health court. Difrancisco, 22, is serving a prison sentence that could be as long as four years and six months.<\/p>\n\u201cThere\u2019s no real urgency to help people with mental health struggles,\u201d Vergara said.<\/p>\nCritics worry such high bars to entry can lead the programs to exclude people who could benefit the most. Some courts don\u2019t allow those accused of violent or sexual crimes to participate. Prosecutors and judges can face pressure from constituents that may lead them to block individuals accused of high-profile offenses.<\/p>\nAnd judges often aren\u2019t trained to make decisions about participants\u2019 care, said Raji Edayathumangalam, senior policy social worker with New York County Defender Services.<\/p>\n\u201cIt\u2019s inappropriate,\u201d she said. \u201cWe\u2019re all licensed to practice in our different professions for a reason. I can\u2019t show up to do a hernia operation just because I read about it or sat next to a hernia surgeon.\u201d<\/p>\nMental health courts can be overly focused on requirements such as drug testing, medication compliance, and completing workbook assignments, rather than progress toward recovery and clinical improvement, Edayathumangalam said.<\/p>\nCompleting the programs can leave some participants with clean criminal records. But failing to meet a program\u2019s requirements can trigger penalties \u2014 including incarceration.<\/p>\nDuring a recent hearing in the Clayton County Behavioral Health Accountability Court in suburban Atlanta, one woman left the courtroom in tears when Judge Shana Rooks Malone ordered her to report to jail for a seven-day stay for \u201cbeing dishonest\u201d about whether she was taking court-required medication.<\/p>\nIt was her sixth infraction in the program \u2014 previous consequences included written assignments and \u201cbench duty,\u201d in which participants must sit and think about their participation in the program.<\/p>\n\u201cI don\u2019t like to incarcerate,\u201d Malone said. \u201cThat particular participant has had some challenges. I\u2019m rooting for her. But all the smaller penalties haven\u2019t worked.\u201d<\/p>\nStill, other participants praised Malone and her program. And, in general, some say such diversion programs provide a much-needed lifeline.<\/p>\nMichael Hobby, 32, of Gainesville was addicted to heroin and fentanyl when he was arrested for drug possession in August 2021. After entry into the HELP Court program, he got sober, started taking medication for anxiety and depression, and built a stable life.<\/p>\n\u201cI didn\u2019t know where to reach out for help,\u201d he said. \u201cI got put in handcuffs, and it saved my life.\u201d<\/p>\nEven as Donald Brown awaited his fate, he said he had started taking medication to manage his depression and has stayed sober because of HELP Court.<\/p>\n\u201cI\u2019ve learned a new way of life. Instead of getting high, I\u2019m learning to feel things now,\u201d he said.<\/p>\nBrown avoided jail that early December day. A hearing to decide his fate could happen in the next few weeks. But even if he\u2019s allowed to remain in the program, Brown said, he\u2019s worried it\u2019s only a matter of time before he falls out of compliance.<\/p>\n\u201cTo try to improve myself and get locked up for it is just a kick in the gut,\u201d he said. \u201cI tried really hard.\u201d<\/p>\nKFF Health News senior correspondent Fred Clasen-Kelly contributed to this report.<\/em><\/em><\/p>\n<aside class=\"meta-authors meta\">\n\n\t\t\t\t\t\t\t\t\t\t\tSam Whitehead: <\/span> \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/kffhealthnews.org\/news\/article\/mental-health-courts-promise-reduce-incarceration\/mailto:swhitehead@kff.org\">swhitehead@kff.org<\/a>,\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/twitter.com\/sclaudwhitehead\" target=\"_blank\" rel=\"noopener\"> \n\t\t\t\t\t\t\t@sclaudwhitehead<\/a>\n\t\t\t\t\t\t\t\t\t<\/p>\n<\/aside>\n<section class=\"block--category-tag-list \">\n<div class=\"category-tag-list__content-wrapper\">\n<h3 class=\"block--category-tag-list__title\">\n\t\t\t\tRelated Topics\t\t\t<\/h3>\n\t\t\t\t<a class=\"category-tag-list__contact-link\" href=\"https:\/\/kffhealthnews.org\/contact-us\/\"> \n\t\t\tContact Us\t\t<\/a> \n\t\t<a class=\"category-tag-list__tip-link\" href=\"https:\/\/kffhealthnews.org\/tips\/\"> \n\t\t\tSubmit a Story Tip\t\t<\/a>\n\t<\/div>\n<\/section><\/div>\n<script async src=\"\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"GAINESVILLE, Ga. \u2014 In early December, Donald Brown stood nervously in the Hall County Courthouse, concerned he\u2019d be sent back to jail. The 55-year-old struggles with depression, addiction, and suicidal thoughts. He worried a judge would terminate him from a special diversion program meant to keep people with mental illness from being incarcerated. He was […]<\/p>\n","protected":false},"author":1,"featured_media":2196,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-2195","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health"],"_links":{"self":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/2195","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2195"}],"version-history":[{"count":1,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/2195\/revisions"}],"predecessor-version":[{"id":2197,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/posts\/2195\/revisions\/2197"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=\/wp\/v2\/media\/2196"}],"wp:attachment":[{"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2195"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthynewsusa.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}