Feature

An experimental mental health court in San Bernardino County, Calif., often can't keep up with the demand for services.

San Bernardino began its mental health court, Supervised Treatment After Release (STAR), last January. As with others of its type, the court places mentally ill criminal offenders in an intensive mental health treatment program instead of jail. But it's also unique because it's one of the few to handle predominantly nonviolent felony cases, and it requires participants to live in board-and-care facilities where they receive counseling, medications and supervision.

The county's public defender recommends defendants for the mental health court--most have been diagnosed with serious mental illness and are facing substantial jail time. The program was designed to last one year but participants may spend more or less time in the program, depending on their individual progress and how long it takes them to get back on their feet. They may also hold a job or go to school while in the program, depending on their abilities.

Broward County, Fla., established the country's first mental health court in 1997. But the San Bernardino court provides broad services to reach and rehabilitate a much higher proportion of criminal offenders. The clamor for those services was unforeseen.

"It's not unusual to turn someone away because there's no bed available at the board-and-care facility," says Pat Mueller, San Bernardino's deputy public defender.

The maximum number of participants at any given time is 25, says Mueller, but the need is greater. About 15 percent of the county's 5,000 inmates have been diagnosed with mental illnesses, says Jane Lawrence, interim chief administrator of San Bernardino's public defender's office. Most are repeat offenders who haven't received the necessary medication or treatment to help them be productive members of the community, she says.

STAR encourages the chronically mentally ill to receive treatment, says psychologist Ron Smith, PhD, clinic supervisor for San Bernardino's jail mental health services.

"Many have minor infractions," says Smith, "but they're arrested frequently and they're being placed in a jail environment where, because of the mental health resources available and the demand for these services, it's impossible to provide them with the best possible mental health care."

Instead of serving jail time, STAR participants receive court-ordered treatment that requires them to take daily medications, live in court-ordered residential setting and attend a forensic day rehabilitation program. They agree to stop using alcohol and illegal drugs and obey a curfew. Their progress is monitored by two clinicians from the county Department of Behavioral Health, and every three to six weeks they appear in court to discuss their progress with San Bernardino Superior Judge Patrick J. Morris. If participants violate curfew, fight with another resident or breach other court requirements, the court may restrict their freedom to leave the board-and-care facility, require them to perform community service work or remand them to jail for a short time.

Several participants are now preparing to leave the program, which has been in place for slightly more than a year. County officials say the program's effect on the mentally ill is striking.

"They are learning how to deal with their disease," says Morris. "They are learning the habits of responsibility--how to get up in the morning, have a wholesome breakfast and hold a job or go to school."

--L. RABASCA