1. Presentation by: Hon. Stephen V. Manley Superior Court of California County of Santa Clara A Statewide Training for Local Mental Health Boards and Commissions April 21, 2012 Sheraton Hotel LAX Los Angeles, CA

2. - CAN THE COURTS ACHIEVE BETTER OUTCOMES? -AND CAN WE SIEZE THE OPPORTUNITIES UNDER REALIGNMENT ? THE PROMISE OF A NEW APPROACH TO MENTALLY ILL OFFENDERS IN CRIMINAL JUSTICE

3. OVERVIEW  Why has “Traditional” sentencing and supervision of the mentally ill in criminal justice failed us?  What is a new Model for Judges and Courts?  What role does a Mental Health Court and specialized supervision play?  What will be the effect of “realignment” on the effort to obtain better outcomes?

4. Bureau of Justice Assistance, 2009 Persons with Serious and Disabling Mental illness are Grossly Overrepresented in the Criminal Justice System  Three times as many men and two times as many women.  14% of jail, prison and supervision populations = 1 million Mentally ill offenders in jail or prison, on probation or parole in 2009.

5. Skeem, 2008; Louden and Skeem, 2010 They are Also Disproportionately Likely to Fail under Probation and Parole Supervision  Twice as Likely to fail, be revoked and sent back to prison within one year (52% to 62%)

6. Abram, Teplin and McClelland, 2010 Incarcerated Mentally Ill Offenders, regardless of Gender, have a Co-Occurring Substance Abuse Disorder  75% of all incarcerated mentally ill offenders abuse drugs and alcohol.

7. CRIME AND PUNISHMENT The Traditional Response Of the Courts

8. WHAT IS THE TRADITIONAL PURPOSE, ENVIRONMENT AND OUTCOME OF ALL SENTENCING?   PUNISHMENT

9. WHY?   WE USE THE “PAST” IN TRYING TO ADDRESS PRESENT CONDUCT AND DETER NEGATIVE CONDUCT IN THE FUTURE.   PUBLIC POLICY AND LAWS TRADITIONALLY HAVE BEEN WRITTEN TO EMPHASIZE PUNISHMENT.  WE BELIEVED THAT PUNISHMENT DETERS FUTURE CRIME AND LEADS TO BEHAVIOR CHANGE

10. What about Stigma?   The “moral” view of mentally ill and mentally challenged offenders

11. Mental Illness

12. Addiction

13. Mental Retardation

15. SELF PORTRAIT BY A MENTALLY ILL OFFENDER

16. How Does Stigma Appear in the Criminal Justice System?   Perception that these offenders are more prone to violence and “out of control” behavior   Incarceration to achieve social control   Very high level of Monitoring   Failure to acknowledge their functional inability to adhere to conditions of release

17. SINCE WE RELY HEAVILY ON PUNISHMENT, AND A HIGH LEVEL OF SUPERVISION FOR MENTALLY ILL OFFENDERS, DOES THIS MODEL REDUCE RECIDIVISM?

18. Criminal Sanctions versus Treatment -0.07 0.15 Reduced Recidivism Increased Recidivism CS -.07 (Number of Studies=30) Treatment.15 (Number of Studies=124) Edward J. Latessa, Ph.D., Center for Criminal Justice Research Division of Criminal Justice University of Cincinnati

19. PUBLIC SAFETY REALIGNMENT (AB 109/117)

20. Realignment Legislative Intent (PC sections 17.5, 3450, 6024 et. seq.)   Declaration: Commitment to reducing recidivism   General strategy: reinvest criminal justice resources to support community corrections programs and evidence-based practices (EBP) to improve public safety outcomes   Purpose: manage criminal justice populations more cost-effectively, reinvesting savings in evidence-based strategies that increase public safety while holding offenders accountable

21. Specific Strategies   Realign (1) low-level offenders and (2) post- release supervision of certain felons reentering the community from prison to local community corrections programs, strengthened through community-based punishment, EBP, improved supervision strategies, and enhanced secured capacity – – Introduction to the “NON’S”

22. Basic Structure   Changes place where sentence served for low level felons as defined who are sentenced or found in violation following release after October 1 (Jail rather than Prison)   Changes who supervises low level felony offenders on release (Probation rather than Parole)   Changes sentencing options for Judges as to low level felons   Makes Reentry Courts (PC 3015) and Mental Health Courts available for Probation referrals and Court referrals, as well as Parole referrals.

23. Definition of a “NON”   The felony offense must be one that has been designated by the Legislature to be punished by a jail sentence rather than a prison sentence regardless of the length of the sentence.   Exclusions:   Prior or current serious or violent felony conviction;   Required to Register as a sex offender under PC 290   Previously sentenced for aggravated theft

24. HOW IS CRIMINAL JUSTICE REALIGNMENT FUNDED?   Redirection of existing resources including a portion of sales tax and VLF, etc. to the Counties   $354 + Million in FY 2011-2012

25. Who Controls Realignment Funds at the Local Level?   Community Corrections Partnership Executive Committee   Chief Probation Officer, Sheriff, Police Chief, District Attorney, Public Defender, Presiding Judge, a County Department Designee   Board of Supervisors Must Approve the Plan

26. Impact of Realignment on Mentally Ill Offenders   23% Present Prison Inmates Mentally Ill   33% Present County Jail Inmates Mentally Ill   76% Mentally Ill Incarcerated Offenders Have Co-Occurring Substance Abuse Cal. Dep’t. of Corr. And Rehab., 2007 Annual Jail Profile Survey Report; 2007; BJA, U.S. Dept. of Justice, 2007

27. Data from a Reentry Court Working with Offenders Referred by Probation, Parole, and Judges hearing Revocation Calendars What do we Know About “Realigned” Mentally Ill Offenders as to their “Needs?”

28.  98% have a substance abuse issue.  70% of participants use methamphetamines as their primary drug.

29.  54% have a mental disorder.  35% had a mental health classification in prison (compared to 15% in the general parolee population[i]).[i] [i] California Department of Corrections and Rehabilitation, “2011 CDCR Adult Institutions Outcome Evaluation Report” (November, 2011), http://www.cdcr.ca.gov/Adult_Research_Branch/Research_Documents/ARB_FY_0607_Recidivism_Report_(11-23-11).pdf

30.  22% homeless upon entry

31.  85% of participants are at high risk for recidivating [i] [i] (compared to 53% of the general parolee population [ii] ). [ii] [i] [i] According to the California Static Risk Assessment Tool, an actuarial risk assessment tool used by CDCR to assess parolee risk of reconviction. [ii] [ii] California Department of Corrections and Rehabilitation, “ 2011 CDCR Adult Institutions Outcome Evaluation Report ” (November, 2011), http://www.cdcr.ca.gov/Adult_Research_Branch/Research_Documents/ARB_FY_0607_Recidivism_Report_(11-23-11).pdf http://www.cdcr.ca.gov/Adult_Research_Branch/Research_Documents/ARB_FY_0607_Recidivism_Report_(11-23-11).pdf

32. The Challenge   Most County Jails at Capacity and Overcrowded   Inadequate Treatment in Custody   No connection with community treatment

33. The Opportunity   Great Potential for “in-reach” mental health services and collaboration   Judges may consider community sentencing alternatives   Closer to Families and prior Services

34. What Can Be Accomplished at the Local Level   Assess and screen at the local level   Risk and Needs Assessments may be used by Judges   Pre-Release Planning for Successful Reentry into the Community   Specially trained Probation Officers   Utilize Mental Health and Reentry Courts

35. Will we Fund Treatment and Alternatives to Custody?   The success or failure of realignment will depend on how well counties invest their funding and how wisely Judges sentence mentally ill offenders   Does the funding only support Jail, Custody and Supervision Concerns, or are resources dedicated to treatment, supportive services, alternatives to incarceration and successful reentry?

36. Will the Courts Utilize Evidence Based Practices in Sentencing the Mentally Ill?   The Challenge of “Split Sentencing”   Example: Two years straight jail, or two years split between some jail followed by the balance of the two years in treatment and supervision?

37. WHAT THE COURTS CAN DO TO CHANGE AND LEAD THE WAY IN MAKING REALIGNMENT A SUCCESS

38. What has not worked is abandoned, and the Judge assumes a new role and the Court accepts responsibility!

39. WE RETURN TO GOALS THAT WE HAVE ABANDONED, AND RECOGNIZE THAT THE COURTS MUST LEAD: -OBTAIN BETTER OUTCOMES -ADDRESS THE NEEDS OF THE MENTALLY ILL OFFENDER

40. THE JUDGE MUST ACCEPT RESPONSIBILITY FOR OUTCOMES!

41. There are three Important Roles that a Judge must accept to reach the goal of better outcomes:  The Judge must be a convener  The Judge must be a motivator  The Judge must use practices that have been demonstrated to result in better outcomes (Evidence Based Sentencing and Monitoring)

42. A Judge Who brings treatment and services together and JOINS WITH THEM in a problem solving approach will obtain better results for offenders.

43. A Judge Who Spends 3 Minutes Talking to Each Client Motivates Change and Doubles Cost Savings Source: Marlowe, NPC Research 2010

44. TREATMENT WORKS AND IT IS AN EVIDENCE BASED PRACTICE!

45. MORE IMPORTANTLY -“COERCED COURT ORDERED TREATMENT” WORKS AS WELL AS VOLUNTARY TREATMENT!!

47. However, we Need to Address more than Treatment to reduce Recidivism of Mentally Ill Offenders  We must address the criminogenic risk factors for crime of each individual  Examples are Antisocial beliefs and behaviors, anger, impulsivity, antisocial and high risk peers

48. WHAT DOES ONE MENTAL HEALTH TREATMENT COURT LOOK LIKE? (How do we put these new concepts into practice?)

49. Serving nearly 2,300 defendants at any one time.

50. TARGET POPULATION THAT INCLUDES PAROLEES:   SERIOUSLY MENTALLY ILL; INCLUDE CO- OCCURRING DISORDERS;   THOSE FOUND INCOMPETENT;   LOW FUNCTIONING, AND MENTALLY CHALLENGED;   BRAIN INJURY (TBI);

51. BASIC OBJECTIVES  Recognize that treatment and services for the offender are essential.  Provide the treatment.  Motivate the offender to enter treatment and to stay in treatment.  Monitor the offender while he or she is in the community

52. JUDGES MUST THINK DIFFERENTLY:  The Judge must confront the “stigma”.  The Judge must “engage” the offender.  The Judge must build trust.  The Judge must learn new techniques to communicate.

53. WHO IS ON THE TEAM?   Judge   Three mental health specialists, three psychiatrists, substance abuse specialist, custody mental health, public health nurse, support staff   Two District Attorneys and Three Public Defenders   Specialized Probation Officers and Parole Agents and Liaison to the Board of Parole Hearings   Veterans Administration Staff   Community Case Managers

55. WHAT MAKES IT WORK?   Less confrontation/more gentleness, and unlimited patience!   Constantly reinforcing the need for positive behavior through frequent court appearances   Requirements are simple – include medications, stay in housing, and follow treatment program. SMALL STEPS ARE WHAT MATTER.   Lower the bar on definition of success!!

56. WHAT MAKES IT WORK!  Medications must start in jail and follow the defendant into community treatment without interruption.  Treatment must be immediately available on release.  Appropriate housing must be immediately available on release.  Drug Testing is essential.  IMMEDIATE intervention is necessary on decompensation.

57. What does Realignment Offer us?  An Opportunity to take these basic concepts and put them to work with one goal in mind: CREATE BETTER OUTCOMES FOR MENTALLY ILL OFFENDERS!!

58. DO THESE BASIC COLLABORATIVE PRINCIPLES WORK ?

59. Evaluation Results Santa Clara County MH Court ( SAMHSA Three Year Study )   Marked reduction in re-arrests, time in custody, and violations of probation and parole;   After six months of participation in the program, participants showed marked improvement in their mental health

60. Evaluation Results Four Collaborative Courts including Santa Clara County Superior Court (American Journal of Psychiatry)   18 months after graduation, 39% lower risk for being charged with any new offense for graduates   18 months after graduation, 54% lower risk of being charged with a violent crime for graduates

61. Number of prisoners whose most serious charge is a Felony - 2012: Drug : 654 17 % Vs Person (not sex):84223% Prop:35110% Sex:2607% DUI:702% Par. Viol:431% Oth Fel:78422% TOTAL JAIL POPULATION IN 1998: 4,333 TOTAL JAIL POPULATION IN 2012: 3,600 Number of prisoners whose most serious charge is a Felony - 1998: Drug:1345 31 % Vs Person (not sex):67115% Prop:3067% Sex:1904% DUI:692% Par. Viol:401% Oth Fel:77118%