Mental health court fosters collaboration

Joe Buckner is chief district court judge in Orange and Chatham counties.

The everyday horror of mental illness affects us all, even if we're free of affliction, even if our family has escaped it.

Unrecognized and untreated, you see its victims on the park benches, rifling through the trash bins, muttering on the street. In extreme cases, the effect is a school shooting or suicide.

In Orange County, we realized that mental illness was costing our community public and private resources. Our criminal courts were where the mentally ill collided with the law.

That's why in 2000 we launched a special mental health court. Born from hope and hunch, the court brought together prosecutors, public defenders, law enforcement, jailers, probation officers and others to find a new way to address this population's needs.

Now, with the right community services, the petty offender who is hearing voices is put on the right medication. A counselor connects him with a job service, gets him off illicit drugs, helps him find somewhere to live. Success means he doesn't reoffend and we don't see him in court again.

Mental health reform has hindered us. Some of the people in need of residential care aren't getting it and are cycling back through our dockets and jail. One former participant has been recommitted to our mental hospital 13 times in two months. Our local provider has closed shop, leaving us few referral options.

Before I was a judge, I knew little about mental health and substance abuse care. Now I do. At least 85 percent of our repeat offenders have a substance abuse or mental health issue.

Repeat offenders victimize their families, other citizens and businesses again and again.

The costs come from repeated 911 calls, averaging 18 for every arrest, officer injury during arrests, emergency room visits, jail time, emergency medical help, calls on adult care services from social services and more.

The human misery index is high. The mentally ill suffer disproportionately from homelessness, hunger, addiction, abuse and suicide. Those with no place to go find a somewhere: university libraries, retail businesses and railroad tracks, with periodic stops in jail and mental hospitals.

Although the people in court represent a small percentage of the mentally ill, we need the same approach to caring for them. The decisions must stay local but must involve all stakeholders.

We should let local groups handling the needs of the mentally ill choose the services they wish to fund through in-house positions, contractors or a blend of both.

We need consistent community case management with people who are trained and feel a calling to help.

Losing taxpayer money to repeated crisis management and private money to community nuisances can be reduced. Public and private stakeholders can partner with case managers and the mentally ill they treat.

Local stakeholders must commit to making the short- and long-term outcomes as positive as possible.

With all community players at the table, all our counties in North Carolina can succeed even if the delivery of services varies in our one hundred counties.