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The Honolulu Advertiser

Posted on: Sunday, June 19, 2005

Program treats troubled inmates

By Ken Kobayashi
Advertiser Courts Writer

Tony suffers from schizophrenia. He's defrauded the state of welfare benefits and committed credit card fraud. He was one of an estimated hundreds of inmates in Hawai'i afflicted with mental illness, but not severe enough to warrant an insanity acquittal and commitment to the state hospital.

OAHU'S MENTAL HEALTH COURT

The goal is to divert nonviolent seriously mentally ill criminal defendants from jail or prison to treatment. The hope is that it would help reduce the chances of them committing future crimes and help them become mentally healthy individuals. In addition, it would free up expensive prison bed space.

The pilot program is for O'ahu residents 18 or older. They must:

• Be suffering from serious mental illness ranging from schizophrenia to bipolar and post-traumatic stress disorders.

• Have a minimal history of violence.

• Agree to participate.

Their charges cannot include sexual offenses or violence.

Source: State Judiciary

But instead of completing his sentence, Tony was taken out of prison last month and now lives in a one-bedroom Honolulu apartment as the first participant in a pilot program to establish the state's first Mental Health Court.

If he graduates from the program that will run for about a year and involves intensive monitoring and treatment, Tony won't have to serve any prison time.

And if the pilot program succeeds, judiciary officials believe as many as a couple of hundred individuals annually could end up in the program aimed at diverting mentally ill nonviolent criminal defendants from jails and prison and into treatment.

Similar to drug court for nonviolent criminal drug addicts, the goal is to cut down the "revolving door" syndrome of the mentally ill, which includes many homeless, going in and out of prison.

The program is aimed at providing them treatment not available behind bars rather than having them take up expensive prison bed-space and risk that they will be released only to commit future crimes because of their illness. In addition, the program is designed to help those individuals recover and become mentally healthy members of the community.

Circuit Judge Marcia Waldorf, who first learned about mental health courts during a visit to Seattle in 1999, is the point person for the two-year pilot program now in its second year. It's financed by $231,000 in federal money and $57,750 in matching money. The pilot program was expected to have about 30 participants.

"Probably most people would recognize that people with mental illness ... don't really belong in prison," said Waldorf, who is also O'ahu's drug court judge. "If you're satisfied that they can be treated successfully and thus remain out of prison, that's, I think, what most people would want to see happen."

Although the court would handle only defendants in criminal courts, Waldorf said it might be worth considering in the future expansion of the program to defendants acquitted by reason of insanity and committed to the Hawai'i State Hospital. The facility also faces a "revolving door" problem of conditionally releasing patients who get in trouble and then have to be recommitted, such as the man who has been in and out of the state hospital since 1979 in connection with a car-theft case.

About 100 mental health courts have been set up around the country. Waldorf said the judiciary was able to adopt some of the best features in setting up the pilot program here.

The city Prosecutor's Office and state Public Defender's Office have agreed to participate. The program also has the support of the Department of Health, which helps screen applicants and provides services.

The program recently got its first participant, Tony, whose last name isn't being used for this article at the request of the court, which fears the disclosure might jeopardize his therapy.

Tony, 46, who has a history of hearing voices as far back as 1997, has been in psychiatric facilities in the past. But he's also been in and out of prison because of two criminal cases. In 1997, he used another man's credit card. And in 1998 and 1999, he defrauded the state of about $8,300 in public assistance funds.

He was arrested in March when prosecutors sought to revoke his probation and was at the O'ahu Community Correctional Center awaiting resentencing when he was accepted in the pilot program last month.

As a result, he lives alone in his apartment, but is intensely monitored by a probation officer as well as a case worker from the Institute of Human Services. Tony also has had to return each Wednesday to Judge Waldorf, who talks to him about how he's doing and any problems he's facing.

Tony appeared in Waldorf's courtroom Wednesday, dressed in shorts and a T-shirt and wearing rubber slippers.

"So how are you?" Waldorf asks, opening a conversational dialogue.

"I'm fine, Your Honor," Tony replies.

Tony talks about getting a futon to sleep on and about adjustments to his medication.

"The voices have increased," he says. "They're very angry, more angry than before. It's involuntary. I'm not sure what to do."

"How are you responding?" the judge asks.

"I'm not answering the voices, and that's been working," Tony says.

Waldorf congratulates Tony about completing the first phase of the program, which means he now has to return to court once every two weeks.

"I would like to shake your hand," the judge says. "Good for you."

The courtroom gallery of program officials and others applaud, which is part of the therapy to underscore his progress. Tony goes to the bench and shakes the judge's hand.

Stanley Perpignan, IHS case manager assigned to Tony who has been at the group's shelter in the past, later said the difference between now and when Tony was on probation for his criminal cases is that there is much closer monitoring.

Perpignan sees Tony sometimes two or three times a week and coordinates services such as food and shelter and also makes sure he sees his doctor and takes medication. "You name it, we do it," Perpignan said.

Tony also can turn to other people — his probation officer, the judge and mental health court officials, Perpignan said. "Sometimes it's hard to cope if he doesn't have someone to call."

Although Tony sometimes talks to himself and isn't ready to get a job, he is not and has not shown any signs of violence, Perpignan said. Tony spends his days at home, visits the beach or library, watches television.

Tony, amiable and polite, said he joined the program to see if it could help him. "So far, it's been very helpful," he said.

He plans on graduating from the program and has been staying out of trouble, he said.

"I was on crystal methamphetamine before," he said. "No more crystal methamphetamine. Sometime I feel urges. I just say no."

What does he do with the voices?

"I just ignore them."

And the future?

"I see myself working, being someone that society wants to see out there."

Waldorf said the judiciary will be seeking more federal money for a third year of the pilot program and may eventually ask the state Legislature and others for support.

"The whole idea is to have the (seriously mentally ill) people that are in the system not in prison, where that's possible," she said.

Reach Ken Kobayashi at kkobayashi@honoluluadvertiser.com or 525-8030.