Image by Gordon Johnson from Pixabay

(10-19-20) A mother from Fairfax County, Va., recently sent me an email about her son who was about to be released from probation. In addition to having been diagnosed with a serious mental illness, this young man also is an alcoholic and was born with fetal alcohol spectrum disorder that he inherited from his birth mother. It is difficult for individuals to get treatment for a mental disorder. When you add an addiction, it becomes even harder and if an individual refuses help, there are even fewer options. I asked the mother to share her family’s story and I was stunned when I received a detailed account that dated back to her son’s birth. The mother and her husband have tried every possible program in Fairfax with limited success.  I am posting her account anonymously and with pseudonyms to protect the privacy of those involved.

Dear Pete.

Click to continue…

Judge Tina Snee of the Fairfax County General District Court speaks at first mental health docket graduation. Photo courtesy of Fairfax County Government.

(10-6-20)  I want to thank Fairfax County General District Judge Tina Snee for answering questions about the county’s mental health docket, which is an important part of the overall Diversion First program that was created to divert individuals with mental illnesses and addiction problems into treatment services rather than having them languish in jail and ultimately being released untreated. 

1. What made you agree to add a mental health docket to your already full schedule as a Fairfax County General District Judge?

I joined the bench in 2015 from a background of civil litigation.  It was my first immersion into the criminal justice system, and I was surprised at the number of defendants who presented, or charges reflected mental health and/or addiction issues. I was approached by Fairfax Court Services to see if I would be willing to work cross agency on the Fairfax County Diversion First Initiative.  We decided it would be beneficial to add a Behavioral Health Docket so we successfully petitioned the Virginia Supreme Court for approval of a Behavioral Health Docket and after its first year of operation can say it is a success.

All of us who work on Diversion First are doing it in addition to our busy schedules but we all receive a great deal of satisfaction seeing the benefits to individual defendants and the criminal justice system here in Fairfax.  

2. Some Virginia Judges oppose problem solving dockets – arguing that they require judges to become “social workers” or they argue defendants who come before them shouldn’t get special treatment simply because they have a mental disorder. How do you respond to those arguments?

The simple answer is I am trying to connect those on the docket to a “social worker” not be a social worker. I am still a Judge, and this is still the criminal justice system. The Fairfax County Mental Health Docket was approved by the Virginia Supreme Court and follows the structures implemented by the NADCP (National Association for Drug Court Professionals). NADCP provides a structured outline of the roles of each MH Docket team member (Judge, Prosecutor, Defense, Probation, Treatment). This outline clearly defines each team member’s role and duties – a sort of “stay in your lane” approach. The judge does not enter into a role of a “social worker.” The Judge hears the perspective of the team and requires participants to follow treatment recommendations.

At pre-court meetings, the team discusses each participant’s progress, to include challenges and successes that have occurred over the course of the past two weeks. We discuss possible treatment interventions, supervision adjustments, sanctions, and incentives. This allows us to have a discussion between everyone – treatment, supervision, defense, and prosecution – the judge ultimately decides if there will be a sanction or incentive issued. However, the judge does not determine the treatment intervention – treatment providers make that decision based on each individual’s treatment needs.

Click to continue…

Gary Ambrose, retired brigadier general, who lost his son to mental illness, speaks at Fairfax County Mental Health Docket graduation. Photo Courtesy of Fairfax County Government.

(10-15-20) This is the second in a three part series about Fairfax County’s mental health docket. Yesterday, I posted Washington Post Columnist Petula Dvorak’s profile of one of the first graduates from the docket program. Today, I look at the history behind the docket and statistics about those it helps.

More than a third of individuals with mental illnesses who participate in the Fairfax County’s mental health docket have been diagnosed with schizophrenia. More than half have drug and substance addictions and nearly half are homeless. The court helps link them with services so they can address those problems – as well as their criminal conduct.

I’ve been advocating for a mental health docket in my local county since 2008. Fairfax County finally submitted an application to the Virginia Supreme Court in January 2019 and launched its docket in July 2019, It held its first graduation ceremony earlier this month.  Fairfax General Court Judge Tina Snee issued completion certificates to three graduates with diagnosed mental illnesses who volunteered to participate in a rigorous treatment program instead of being punished through the traditional criminal justice system.

More than 350 mental health courts/dockets operate nationally. About two-thirds have been supervising cases since 2000. Studies have found that those who complete a court’s requirements tend to have lower rates of criminal activity and increased linkages to treatment services than defendants with mental illnesses who do not.

Judge Snee currently has eighteen participants under her supervision on her docket. Fairfax is one of eleven Virginia jurisdictions with a mental health docket, including one in Fairfax’s neighbor, Loudon County. The state also has approved a behavioral docket in Arlington. There are 95 counties in Virginia, so these dockets remain in a minority in our state.

Fairfax County also operates a Veteran’s Treatment Docket and a drug court. It was Judge Penney S. Azcarate who got support and approval in 2014 for a Veteran’s Treatment Docket. (Judge Azcarate served four years in the U.S. Marine Corps.) Judge Azcarate also oversees the Fairfax County Drug Court.  Judge Azcarate’s actions are what opened the door in the county’s judiciary for a mental health docket.

Sadly, the death of Natasha McKenna, an African American woman with a serious mental illness, who died in 2015 after being repeatedly stunned with a Taser at the Fairfax County’s Adult Detention Center, is what caused the county’s elected officials to get serious about diverting individuals with mental illnesses from jail into treatment. Sheriff Stacey A. Kincaid championed the effort to create a Diversion First program. Former Board of Supervisors Chairwoman Sharon Bulova and former Supervisor John Cook immediately jumped on board. Retired Air Force General Gary Ambrose, who lost his son to mental illness, was put in charge of bringing stakeholders together to develop the country’s Diversion First program. It was launched with great excitement the same year as McKenna’s death with tremendous support from a slew of groups, including fire fighters, local police departments, the Fairfax Falls Church Community Service Board (CSB), The Office of the Public Defender, The Office of the Commonwealth’s Attorney, Court Services/Probation, General District Court (GDC) Judges, GDC Clerk’s Office, Victims’ Services Section – Fairfax County Police Department, and the Fairfax County Sheriff’s Office. The county’s Diversion First program has been operating for five years and is the umbrella over which the mental health docket rests.

Click to continue…

(10-14-20) This is the first of three posts about the Fairfax County Mental Health docket, which recently held its first graduation ceremony. One of my favorite columnists, Petula Dvorak, attended the graduation and wrote about it for The Washington Post.

In one Virginia courtroom, a judge tries to stop a revolving door

By Petula Dvorak, The Washington Post

Click to continue…

(10-12-20) Ernie & Joe: Crisis Cops, a powerful documentary created for HBO, is now being made available for group screenings. If you belong to a chapter of the National Alliance on Mental Health, Mental Health America, or other mental health organizations or you are involved in police/judicial training and have not yet seen this film, you need too!

This superb documentary follows Ernie Stevens and Joe Smarro, two officers in the San Antonio, Texas, police department’s mental health unit, as they defuse potentially violent encounters with individuals in the midst of a mental health crisis and direct them into treatment instead of jail.

At a time when police violence, especially against individuals with mental illnesses, is making national headlines, it’s important to show that compassionate officers are working on our streets and effective diversion programs can be implemented.

Crisis Intervention Team training (the Memphis Model) is the most common de-escalation tool used in law enforcement. San Antonio trains all of its officers in its own crisis de-escalation training program, which differs slightly from the Memphis Model. All 2,191 officers on the force go through its CIT style training. At the time the film was made, there were 10 officers assigned to the department’s mental health team. Now, there are 20. The unit acts as in house experts in training officers and community first responders as well as being on-call to their fellow officers.

In an email, the film’s director, Jenifer McShane, told me: “An interesting by-product of making mental health training a priority within the department is that officer wellness is now a stronger focus and more officers are willing to approach the mental health officers with their own mental health struggles and seek treatment.” This is important because nationally in 2019, 228 current or former officers died by suicide, compared with 172 in 2018, setting a new high record.

As of last year, the University of Memphis Crisis Intervention Team Center reported 2,700 CIT programs were being offered in the United States. By comparison, there are 17,000 local and state law enforcement agencies.  Hopefully this powerful documentary will encourage those departments without de-escalation training to begin such training. As the film points out most police departments spend 60 hours in their academies on teaching officers how to use a gun but only 8 hours on mental health training. Yet, ninety-five percent of police officers go through their career without firing their weapon. Everyone of them who works on the streets deals with an individual in a mental health crisis.

Click to continue…

Dr. Dean Brooks allowed me to sit in his Hollywood chair from the set of One Flew Over The Cuckoo’s Nest during visit

(10-9-20) FROM MY FILES FRIDAY. I’ve been blessed in my life to work with many inspirational advocates. In May 2011, I wrote about Dr. Dean Brooks and his daughters. He died two years later. I think of him often and always with a smile.

The Cuckoo’s Nest Dr. Continues Speaking Out!

Dr. Dean Brooks has spent his adult life advocating for persons with mental illnesses. And he has not slowed down even though he now is 94 years-old and is living in an assistant living facility not far from the Oregon State Hospital in Salem that he used to oversee.

He first burst on the national stage when he appeared in the 1975  movie,  One Flew Over The Cuckoo’s Nest, as the hospital’s  chief psychiatrist, Dr. John Spivey, M.D.  It was a clever irony because Dr. Brooks was actually in charge of the hospital at the time of filming. In the movie, he can be seen interviewing Jack Nicholson to determine if he has an actual mental disorder or is faking it.

Click to continue…