Attorney Scott Johnson has seen some of the faces of mental illness.
The prosecutor-turned-defense lawyer has represented about a dozen severely mentally ill clients charged with crimes since going into private practice four years ago.
None of them had the resources to afford treatment, and there's no public agency that can fill the need. They keep committing crimes because they've become mentally unstable and can't manage their disorder or related substance abuse.
Johnson says it's time that something is done, and he's not alone.
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Tri-City prosecutors, judges, top cops and mental health advocates have long considered the need for a mental health court, but the struggle has been in finding a way to pay for it. They propose using part of a 0.3 percent criminal justice sales tax in Benton County.
County commissioners are scheduled Tuesday to discuss putting the request on this fall's primary election ballot.
If passed by voters, a person shopping in the county would pay three cents on a $10 purchase.
The tax, which would end after 10 years, could bring in an estimated $9.2 million a year for law enforcement, legal and judicial personnel and programs for overall public safety.
Along with mental health court, the money would pay for prevention and intervention services -- like getting more officers on the road to combat gangs and drugs -- but not so-called brick and mortar building projects.
Benton County would get 60 percent of the money to divide among its departments and agencies, while the rest would go to the county's four cities based on population.
Mental health court would be fully funded out of the county's portion of the sales tax revenue.
The ultimate goal of a mental health court is to keep more people out of jail and resolve the underlying causes of their criminal or other inappropriate behavior.
Some call it "therapeutic justice."
The concept has been around for decades. In Washington, there are 11 mental health courts operating in 10 counties.
A defendant with a misdemeanor or gross misdemeanor offense would go through a specialized screening to determine if they have a major mental disorder and if their criminal behavior is linked to the illness.
A person who also has a substance-abuse problem would be accepted as long as the mental health diagnosis is primary.
Participation in the program is voluntary.
A mental health court team closely monitors the participant's progress with a private treatment provider, while helping them find reliable housing and jobs so in the end they have a stable foundation, can get their lives back and become a productive members of society.
Johnson recalled a former client, a Tri-City man with a lengthy record of exposing himself to girls and women and failing to register as a sex offender. The only recourse for police was to lock him up each time he committed a crime.
If the guy had been able to participate in a therapeutic court at some point through the years, and had a case manager to see him through treatment, then maybe he'd be better handling his illness now instead of ignoring orders to stay out of city parks, Johnson said.
Johnson recognizes that taxpayers may get tired of hearing about yet another program, but said there would be eventual benefits and cost savings to the counties, cities and ultimately the public.
He also knows there is no guarantee that a person will keep taking medications or attending treatment programs after they've technically graduated.
"You just have to accept the fact that mental health court, even if somebody makes it all the way through, it doesn't cure the mental illness," Johnson said. "You can hope you've helped the person effectively manage their mental illness."
What would it cost?
A rough estimate puts the initial costs for the program and diversion at $600,000 a year, though savings are expected down the road from fewer arrests, incarcerations and criminal cases.
That number includes additional prosecution and defense costs, along with court and staff time needed to track each participant's progress for up to two years while getting community-based treatment.
"I think it will be cheaper in the long run," said Benton County Prosecutor Andy Miller.
He acknowledges the idea could be a tough sell, because the commissioners need to balance the budget every year or two years, and can't necessarily look at whether the investment will pay back in five or six years.
Voters rejected a criminal justice sales tax -- which would have included money for a mental health court -- in 2007 and 2008. And the federal Department of Justice turned down a grant request last year.
District Court Judge Joe Burrowes is in favor of removing mentally ill people from the jail system and getting them appropriate care, but he questions if the costs outweigh the benefit.
"It's frustrating for me and other judges to see a person who appears to be having mental health issues in the jail, and I can't provide the resources. ... I can order a lot to be done, but the resources either are not available or the funding is not there or they're just overworked," Burrowes said.
"And I sometimes get concerned about the revolving door because we do have those that continually trespass, continually go to a place they shouldn't go, and it's all because of mental illness," he said.
If the tax initiative goes to the voters and passes, Benton County District Court would need to assess just how many people truly need this type of program and the availability of treatment, Burrowes said.
Johnson believes sales tax funding might not be necessary if officials do some creative belt tightening and have the will to get it done, he said.
As an example, Johnson would be willing to take $10 an hour off his homicide public defender contract for a period of time if he knew it would help kick-start the specialty court, he said.
"I think it's urgent enough where I think we say, 'What cuts can we make? What sacrifices?' " Johnson said.
'Mission creep' at jail
Of the 600 inmates in the Benton County jail on an average day, about 100 are dealing with some kind of mental illness, Sheriff Steve Keane said.
More than a dozen have significant issues or are suicidal, which means they can't be held with other inmates and must be watched constantly.
The jail is experiencing a "mission creep" from a criminal justice institution to one that's increasingly faced with mental health and medical cases, Keane said.
Gordon Bopp, board president of National Alliance on Mental Illness of Washington, says many inmates with mental illness and/or substance abuse disorders also are disabled, poor and homeless.
"They are kept in our local jails because our community does not have a community mental health care center where they can be properly diagnosed, treated and given the tools for effective re-entry into our communities," Bopp said in a November letter to the county commissioners.
Bopp and his wife, Nan, are longtime active leaders of NAMI's Tri-City affiliate.
He argues those inmates should only be handled in the criminal justice system when it can be proven that a person's illness was not a factor in committing a crime.
Mental health treatment facilities or court-ordered assisted outpatient treatment are the best options, Bopp said.
"Mental illness is not a crime, and for these individuals, no amount of punishment can cure their medical conditions," he said. "In fact, such practices seriously set back and complicate their pathways to wellness and recovery."
'What can we do now?'
The prosecutor's office has been seeing more minor cases of mental illness, and more people using mental health as a defense for crimes, Miller said.
As it stands now, when law enforcement arrests someone with a mental illness or clear mental health issues, they must book them into the jail on a criminal investigative hold unless they have a medical need that requires treatment at a hospital.
"Everybody is wondering why is this person in the court system and kind of scratching their head, 'What can we do now?' I think we are seeing more of that than we used to," Miller said.
In some cases, Miller has tried a de facto mental health court approach, he said. A judge continues the case or defers the sentence, and the person's treatment progress is monitored by prosecutors for a certain length of time.
Sometimes people need motivation and reinforcement to get into treatment, Miller said. With mental health court, a case is dismissed once all conditions and goals are completed. That's helpful to people whose eligibility for treatment could be threatened if they're reliant on government money.
Miller told the Herald that the success of Benton County's juvenile and adult drug courts during the past 10 years, with a large number of the graduates remaining sober and drug-free, has made him and other officials want to look even more at setting up a mental health court.
"I think the general frustration in the law enforcement community is that we don't have enough tools and resources to deal with people who have mental health problems in the criminal justice system. I certainly agree with that, and more so as time goes on," he said.
"I also think that we get a lot of people with mental health issues that go on becoming repeat offenders in the criminal justice system, and I don't know that any of us feel comfortable that we're accomplishing a lot by recycling them."