What Are Diversion Courts and How Do They Work?

 

The largest inpatient mental health facility in the nation is the Los Angeles County Jail. Think about that. It is not a hospital where treatment is the goal, but a facility to hold people for trial. A Severe and Persistent Mental Illness (SPMI) such as Schizophrenia can result in behaviors that are likely to get people arrested. While this is not everyone with the disease, it is enough to flood the jails. As a therapist, I don’t think this is the best option.

We are all aware of the war on drugs in this nation. Not only are many drugs illegal to possess, but people will engage in illegal activities to obtain them, such as theft, assault, and worse. Of course, the biggest drug causing problems is the legal one, alcohol, which can still lead to illegal violence or things such as drunk driving.

Treatment Courts special courts set up to address people with mental health and substance abuse issues. (There are also Veteran Courts with similar functions). Their goal is to get people out of the jails and prisons and back into the population as productive citizens. These are set up by the State either in felony or misdemeanor courts. These serve the individuals accused. Admission to the court is through a referral process, usually by the person’s attorney. Space is limited, so not everyone gets in. Screening is usually done around illness. Someone who does not appear to have an actual addiction or SPMI will not be accepted. Someone accused of significant violence would not be approved either. The goal was people caught for non-violent crimes. If you do not know, it is not hard for theft to be a felony. The person who is approved enters a guilty plea and they are sentenced to the court. It is voluntary. At any time, the person can withdraw from the court and get a normal sentence.

The court team is composed of care providers and court personnel. The head of the team, naturally, is the judge. Rounding out the court side is a probation officer, an assigned deputy, a public defender, someone from the DA’s office, and one to three other court personnel. The treatment side is usually lead by a case manager supervisor and representatives of the treatment organization. In our case, we had residential and day program reps there. The team would meet once a week to discuss clients, then court would be held for any clients who were due in front of the judge. Sometimes this meant someone was going from court back to jail for a limited time as a sanction. Both sides work together closely. Without this collaboration, it will not work. One judge I know called the court the “head” and the providers the “heart”.

The treatment was tailored to the individual’s needs. Usually there as some level of group and individual therapy. Often, clients were also on some sort of medications to help with symptoms. You would be amazed at the number of substance use disorders that are in part self-medication of other issues. Clients would be mandated to follow the treatment recommendations of the treatment team, but in any good treatment, the clients had some say. And again, this was all voluntary. At any time, the individual could withdraw from the program. For a felony court, that would mean more jail or prison time. Drug tests are conducted by the court at the courthouse and in visits in the field by court staff. Diluted screens are considered a positive as are refusal to produce a sample.

When I took over as CEO of my community organization, I started attending the Mental Health Court meetings. There was some friction between my staff and the Court staff. I was there to help settle things down. Personal friction is something we have all experienced at work. I am pleased to say in a couple of months, things were fine. I knew we had turned the corner when the probation officer was willing to let a client’s outburst slide, and my staff were adamant that there was a consequence. “Head” and “Heart” reversed, and everyone was a team.

Please ask me any questions you have below. I am happy to answer them.

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  1. Misthiocracy got drunk and Member
    Misthiocracy got drunk and
    @Misthiocracy

    Bryan G. Stephens: Someone who does not appear to have an actual addiction or SPMI will not be accepted.

    How is that ensured? It seems like the sort of criteria that skilled defense attorneys could get expanded again, and again, and again.

    • #1
  2. D.A. Venters Member
    D.A. Venters
    @DAVenters

    I could not agree more that we need more of this kind of thing in the court system.  It’s funny you posted this today, as just this morning I spent over an hour at a probation violation hearing making similar arguments for a client, so this exact thing has been on my mind today.  We don’t have this kind of court set up to address the kinds of problems my client from this morning has.  Thankfully, the judge recognized the issue – that traditional ideas of moral culpability and criminal justice just aren’t implicated with this person, that her problems are more akin to a medical condition – and we are putting things on hold to see if we can find an alternate solution. 

    The testimony of her mental health counselor, by the way, was instrumental in helping the judge understand the issue.  I saw your earlier post about being the president-elect of the state organization and meant to congratulate and thank you for doing this kind of good work.

    I hope this kind of court system reform takes off.

    • #2
  3. Stad Coolidge
    Stad
    @Stad

    I think this system of reform would work, but IFF (if and only if) there were zero leftists involved.  The left has demonstrated time and time again that they can take a perfectly functioning system and put enough garbage into the mix to bring everything crashing down in a heap of smoldering ruin.

    • #3
  4. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Misthiocracy got drunk and (View Comment):

    Bryan G. Stephens: Someone who does not appear to have an actual addiction or SPMI will not be accepted.

    How is that ensured? It seems like the sort of criteria that skilled defense attorneys could get expanded again, and again, and again.

    They don’t get to make that choice, the treatment team does. Defense attorneys to get to define what is and is not SPMI. That is left to Doctors. 

    • #4
  5. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    D.A. Venters (View Comment):

    I could not agree more that we need more of this kind of thing in the court system. It’s funny you posted this today, as just this morning I spent over an hour at a probation violation hearing making similar arguments for a client, so this exact thing has been on my mind today. We don’t have this kind of court set up to address the kinds of problems my client from this morning has. Thankfully, the judge recognized the issue – that traditional ideas of moral culpability and criminal justice just aren’t implicated with this person, that her problems are more akin to a medical condition – and we are putting things on hold to see if we can find an alternate solution.

    The testimony of her mental health counselor, by the way, was instrumental in helping the judge understand the issue. I saw your earlier post about being the president-elect of the state organization and meant to congratulate and thank you for doing this kind of good work.

    I hope this kind of court system reform takes off.

    I totally forgot to add that the DA’s office is involved. I am going to edit and add it.

    • #5
  6. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Stad (View Comment):

    I think this system of reform would work, but IFF (if and only if) there were zero leftists involved. The left has demonstrated time and time again that they can take a perfectly functioning system and put enough garbage into the mix to bring everything crashing down in a heap of smoldering ruin.

    Well, I have seen it work with people on both sides of the political spectrum involved. 

    • #6
  7. Gary Robbins Reagan
    Gary Robbins
    @GaryRobbins

    Thank you so much for posting on this.  I took a shot at it back in August 2018.  https://ricochet.com/541208/archives/recovery-courts/

    Bryan, you and I have more in common that we ever thought!  Thank you for your service.

    • #7
  8. Muleskinner, Weasel Wrangler Member
    Muleskinner, Weasel Wrangler
    @Muleskinner

    They seem to work very well in my state. I don’t recall the statistics for the drug court, but the re-arrest rates for those who complete the program are much lower than for those who go to prison. The rules are pretty tight for completing the program, and if I recall, somewhere around a quarter of those who are eligible and accepted into the program wash out. I go to church with the Public Defender here. He’s the most liberal person I routinely deal with, and he often says that the strict rules are one of the reasons the program is successful. 

    • #8
  9. Zafar Member
    Zafar
    @Zafar

    Very interesting article.

    How are these treatment programs funded?

    • #9
  10. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Zafar (View Comment):

    Very interesting article.

    How are these treatment programs funded?

    Usually State dollars. In GA Governor Deal pushed for it. He has a child in the industry and understood the need. 

    • #10
  11. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Muleskinner, Weasel Wrangler (View Comment):

    They seem to work very well in my state. I don’t recall the statistics for the drug court, but the re-arrest rates for those who complete the program are much lower than for those who go to prison. The rules are pretty tight for completing the program, and if I recall, somewhere around a quarter of those who are eligible and accepted into the program wash out. I go to church with the Public Defender here. He’s the most liberal person I routinely deal with, and he often says that the strict rules are one of the reasons the program is successful.

    Indeed. I have seen people who yelled and screamed at the judge hug her at graduation. It is an amazing transformation.

    • #11
  12. La Tapada Member
    La Tapada
    @LaTapada

    What if the person denies having any mental illness symptoms, but does have a mental illness and/or is exhibiting symptoms?

    I have a family member who became an alcoholic by self-medicating for bipolar disorder. Thank God she has been in recovery for over 6 years.

    I have another family member using street drugs and I believe he is self-medicating for bipolar as well (I’ve learned the symptoms and I see them in him.) But I think he would deny having them.

    • #12
  13. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    La Tapada (View Comment):

    What if the person denies having any mental illness symptoms, but does have a mental illness and/or is exhibiting symptoms?

    I have a family member who became an alcoholic by self-medicating for bipolar disorder. Thank God she has been in recovery for over 6 years.

    I have another family member using street drugs and I believe he is self-medicating for bipolar as well (I’ve learned the symptoms and I see them in him.) But I think he would deny having them.

    Well, if the person denies an illness they will not be seeking to enter into the diversion court. 

    • #13
  14. La Tapada Member
    La Tapada
    @LaTapada

    Bryan G. Stephens (View Comment):

    La Tapada (View Comment):

    What if the person denies having any mental illness symptoms, but does have a mental illness and/or is exhibiting symptoms?

    I have a family member who became an alcoholic by self-medicating for bipolar disorder. Thank God she has been in recovery for over 6 years.

    I have another family member using street drugs and I believe he is self-medicating for bipolar as well (I’ve learned the symptoms and I see them in him.) But I think he would deny having them.

    Well, if the person denies an illness they will not be seeking to enter into the diversion court.

    Thanks, Bryan. So the person in question has to request or be willing to apply for the diversion court.

    • #14
  15. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    La Tapada (View Comment):

    Bryan G. Stephens (View Comment):

    La Tapada (View Comment):

    What if the person denies having any mental illness symptoms, but does have a mental illness and/or is exhibiting symptoms?

    I have a family member who became an alcoholic by self-medicating for bipolar disorder. Thank God she has been in recovery for over 6 years.

    I have another family member using street drugs and I believe he is self-medicating for bipolar as well (I’ve learned the symptoms and I see them in him.) But I think he would deny having them.

    Well, if the person denies an illness they will not be seeking to enter into the diversion court.

    Thanks, Bryan. So the person in question has to request or be willing to apply for the diversion court.

    Yes. Now, usually, their lawyers are pushing it, but for many of these people, they don’t always listen well to their lawyers.

    • #15
  16. Zafar Member
    Zafar
    @Zafar

    They’ve reached the point when they make a decision – under duress or not. Before that it’s very hard to move people. 

    • #16
  17. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Zafar (View Comment):

    They’ve reached the point when they make a decision – under duress or not. Before that it’s very hard to move people.

    Indeed.

    • #17
  18. Jerry Giordano (Arizona Patrio… Member
    Jerry Giordano (Arizona Patrio…
    @ArizonaPatriot

    Bryan, I tend to be skeptical of this approach, but I’m not adverse to considering it. Do you know of any good empirical studies of the effectiveness of this type of diversion program?

    You have a tough job. It is hard for people to change their ways, myself included.

    • #18
  19. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Jerry Giordano (Arizona Patrio… (View Comment):

    Bryan, I tend to be skeptical of this approach, but I’m not adverse to considering it. Do you know of any good empirical studies of the effectiveness of this type of diversion program?

    You have a tough job. It is hard for people to change their ways, myself included.

    I don’t have such studies at my fingertips, no. They are out there. 

    What I do have is the low recidivism rate of the people who graduated from the courts. What you have to understand is that two years of treatment is powerful. That is the sort of time needed to for people to change. So much of what we do with substance use treatment is ultimately too short. People have to learn new skills and build new pathways. And please understand, this is me speaking in my expert opinion. I have worked almost three decades in the field. 

    I would be interested in your specific skepticism. If you don’t think two years or carrot and stick treatment is going to work, what treatment do you think can work?

    • #19
  20. Stad Coolidge
    Stad
    @Stad

    Bryan G. Stephens (View Comment):

    Stad (View Comment):

    I think this system of reform would work, but IFF (if and only if) there were zero leftists involved. The left has demonstrated time and time again that they can take a perfectly functioning system and put enough garbage into the mix to bring everything crashing down in a heap of smoldering ruin.

    Well, I have seen it work with people on both sides of the political spectrum involved.

    I’m not saying it can’t happen, but leftists eventually return to their roots – or the good leftists are replaced with bad ones . . .

    • #20
  21. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Stad (View Comment):

    Bryan G. Stephens (View Comment):

    Stad (View Comment):

    I think this system of reform would work, but IFF (if and only if) there were zero leftists involved. The left has demonstrated time and time again that they can take a perfectly functioning system and put enough garbage into the mix to bring everything crashing down in a heap of smoldering ruin.

    Well, I have seen it work with people on both sides of the political spectrum involved.

    I’m not saying it can’t happen, but leftists eventually return to their roots – or the good leftists are replaced with bad ones . . .

    If your argument is that all institutions fail eventually, then I agree. If your argument is that because that happens we should not set up institutions, then I disagree. 

     

    • #21
  22. Doug Watt Moderator
    Doug Watt
    @DougWatt

    As a former street cop I’m in favor of this type of approach. You are looking for the individuals that you can help to turn their lives around. It’s not always successful, but you have to remember that the goal is to save who you can.

    • #22
  23. Gary Robbins Reagan
    Gary Robbins
    @GaryRobbins

    Jerry Giordano (Arizona Patrio… (View Comment):

    Bryan, I tend to be skeptical of this approach, but I’m not adverse to considering it. Do you know of any good empirical studies of the effectiveness of this type of diversion program?

    You have a tough job. It is hard for people to change their ways, myself included.

    The Arizona county which has the most Recovery (Drug) Courts per capita is the very, very conservative Yavapai County.  (Every county wide official is a Republican.)  In Prescott they have 4 different courts, for DUI, Drugs other than DUI, Family (Dependency Cases), and Juvenile Offenders.  In the Verde Valley, there is a consolidated Recovery Court, which includes all of the above other than Juvenile Offenders.  

    • #23