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Mental Health Court & PRISM Center - October 2007
Lucy Wieland, Chief Judge of the Fourth Judicial District
October 10, 2007
October brings Mental Health Awareness Month with October 10 designated as World Mental Health Day. That seems like a perfect opportunity to discuss Hennepin County’s Criminal Mental Health Court and one of its latest endeavors — a new center called PRISM (Providing Resources and Integrating Services to the Mentally Ill).
Criminal Mental Health Court hears nonviolent misdemeanor, gross misdemeanor and felony cases involving defendants with serious mental illnesses such as schizophrenia and bipolar disorder, traumatic brain injuries or developmental disabilities. At any given time, more than 200 defendants are under some form of court supervision. In 2006, there were 340 new cases referred to this court. Its mission is to increase public safety by addressing the mental health needs of defendants. Its goals are to reduce repeat offenses, increase compliance with treatment, increase medication compliance, reduce emergency room visits and reduce hospital time.
People with mental illness can be helped by medication. Unfortunately, several factors may keep them from taking those medications. First, prior experience with the side-effects of certain medications may make them not want to take any others. This is especially true for people who have not tried the more modern medications that have been developed with less side-effects. Second, people have used alcohol and illegal drugs to medicate themselves and have become addicted to them. Third, people with mental illnesses such as schizophrenia, due to their disease, are unable to appreciate their continuous need for medication and stop taking it as soon as they begin to feel better. Finally, finding the right kind of medication and the appropriate dosage for a person involves a trial and error adjustment process between the patient and doctor that people with mental illness are not always equipped to undertake on their own.
Medication compliance decreases the chances that a defendant will commit another crime. In order to meet the challenge of keeping defendants on their medications, Hennepin County is in the process of opening the PRISM Center later this fall. Defendants under court supervision will be required to report to this new center on a daily basis and take their medication in front of a nurse. There will be a doctor present to make medication adjustments and there will be funds available to pay for the medications until government assistance or private insurance can take over.
The PRISM Center will also help overcome some of the logistical challenges defendants may encounter, including the shortage of psychiatrists in Minnesota, a lack of private health insurance and an inability to afford co-pay charges at the pharmacy. One consequence of these challenges is that, until now, the only alternative for some defendants has been to go to an emergency room or crisis center and wait to see a doctor. This alternative is not only more difficult for the defendant, but also costly to taxpayers.
Along with medical staff, court probation officers and social workers will also be present at the PRISM Center. If a defendant fails to report to take his daily medications, these workers will try to find him. The first goal of the center is to keep people stable on medication so that they do not fall back into the criminal justice system. The second goal is to help each defendant reach the point where they no longer need the support of the center. For this reason, social services addressing chemical dependency, housing and employment needs will also be available to the defendant at the center.
The PRISM Center is a pilot project. It is a recommendation of the Downtown Work Group, a group of business owners, law enforcement, county attorneys and mental health specialists created by the Hennepin County Board and chaired by Judge Richard Hopper, Fourth Judicial District Criminal Mental Health Court. During its first year of operation the center will only be available to a limited number of defendants selected by the court. If it proves successful, we hope to expand its capacity to serve a greater number of defendants in the Hennepin County criminal justice system.
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