by Amy Nelson

“Acting strangely” in public can result in being arrested and possibly charged with a crime, for the many people with mental illness who find themselves living on the street. But a Bellingham Municipal Court program to divert mentally ill detainees away from jail and into treatment has led to an impressive decline in crimes committed by participants.

In fact, over the first two years of the program, the rate of crimes committed by participants in the city’s Mental Health Court fell by 80 percent, Bellingham Municipal Court Commissioner Pete Smiley told the Bellingham City Council’s Justice Committee in late April.

“This is one of the most successful programs I’ve ever seen,” Smiley said. He referenced a Washington State University researcher who reviewed a similar program in King County and lauded the program’s success.

Smiley and program manager Linda Grant said cooperation among the court, law enforcement, and treatment and other resource providers, and an emphasis with participants on positive reinforcement along with accountability are the reasons.

The program was launched in 2015 and is part of the Bellingham Reduces Incarceration Challenge (BRIC) created in 2016.

It is one of four therapeutic jail alternatives programs in the county. Others are Whatcom County District Court’s similar mental health program, Whatcom County Superior Court’s Drug Court, and Bellingham Municipal Court’s Domestic Violence Court.

Such problem-solving courts are recognized as appropriate for many cases where traditional adversarial courts are not effective, Grant said.

Success by the Numbers
The evidence-based program tracks recidivism to measure success. The number of crimes charged decreased from 71 during the 2 years before entering the program to 14 in the 2 years following, Grant said.

The decrease in crimes charged ranges from 90 — 91 percent among those who completed all or some of the five phases of the program, compared to 50 percent among participants who started but did not successfully complete the program.

For those in a similar population who do not participate, the experience is nearly opposite. The recidivism rate among those individuals is nearly 100 percent.

“The reality is that most of the time, if people’s needs are not met, they are not going to cure themselves,” Smiley said. “People who have mental illness and a criminogenic mindset are going to continue that way unless there is serious intervention.”

Mental Health Court participants receive services including case management, medications, housing referrals, probation supervision and other care. After completing the program, criminal charges pending in mental health court are dismissed.

Benefits of the program for participants and the community are numerous:

• reduced crime, victimization, homelessness, incarceration, isolation and hospitalization

• increased engagement with the community, family reconciliation, mental and physical health, self-esteem and employment

Experiences in court change from negative to positive with fewer contacts with law enforcement.

Competent, Willing and Ready
Candidates for the program must demonstrate “serious and persistent mental illness,” suffering with such conditions as schizophrenia, bipolar disorder or depression, Grant said. Most are receiving Social Security disability benefits, she noted. But to qualify for Mental Health Court, participants must be legally competent, willing and ready.

How the person views the world, a sense of ownership of his or her own behavior, and whether there are impulse disorders or brain injuries that manifest in cognitive problems are part of the assessment. The first stage in treatment is pre-contemplation, when an individual is not yet motivated to consider changing. Next is contemplation, followed by readiness and then mid-change.

“Someone is not likely to be successful with the attitude that the rest of the world has the problem,” Grant said.

Those caught in criminogenic thinking, which tends to cause criminal and anti-social behavior, are not likely candidates. This affects anyone who is not good at cause-and-effect thinking or making good personal health choices; or who has a long-term pattern of a low sense of accountability, a lifelong habit of crime or association with people who commit crimes, or a low level of empathy, Grant said.

Frequent positive reinforcement and support from a team of professionals from various agencies in the community are hallmarks of the program.

For example, housing is a huge issue among this population, Grant said. So, the program partners with the Whatcom Homeless Service Center, to help address that need.

The program is not running at capacity, and the challenge is finding people who would benefit based on readiness and other criteria, Grant said.

Impacts of Overcrowding
In addition to providing more appropriate management for dealing with those who are arrested, the Mental Health Court and other jail diversion programs also help to alleviate overcrowding and other issues in Whatcom County’s jail.

At present, the first stop for individuals with mental illness is an often-crowded booking hall where their conditions are assessed without the benefit of privacy — a highly stressful environment that can trigger anxiety and behavior issues.

From there, due to lack of space in the Whatcom County jail, they may be sent to Yakima County to be housed until arraignment or trial. That move of inmates hours away from family, friends or other support renders them unable to attend treatment appointments.

The urgency around solving problems related to overcrowding and the need to deal appropriately with detainees is intensifying.

Even as Whatcom County prepares for the anticipated opening next year of a new 32-bed triage center to steer mentally ill detainees away from jail and into treatment, the American Civil Liberties Union has filed suit against the county’s jail and sheriff’s office for its treatment of inmates with opioid use disorder.

The suit asserts that denying medications to people suffering from opioid use disorder “singles out a particularly vulnerable group,” necessitating painful withdrawal and increasing the risks of relapse and death from overdose.
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Amy Nelson is a freelance journalist reporting on science, education, and public policy. She lives in Whatcom County.