In Crisis: Idaho Judge And Sheriff Explain Link Between Crime, Mental Illness

Oct 30, 2014

Idaho prisons, jails and courtrooms aren’t just parts of the criminal justice system. They also have been tasked with providing treatment to Idahoans with mental illness.

'WOW, THAT COULD HAPPEN TO ANYBODY'

Judge Michael Reardon started working at Ada County Mental Health Court seven years ago, in addition to his work as a family-law magistrate judge.

Reardon says the people in his courtroom are “by and large a pretty vulnerable population.” One of his goals is to demonstrate that a person with great authority is invested in their futures and wants to see them succeed.

He calls defendants by their first names. He knows their family tragedies and their pets’ quirks. During a recent hearing, he talked about guitar chords with one male participant, offered a second some pointers on fixing a bike flat, then gave a third eight hours of community service for misbehavior.

Q: What made you want to do this job?

A: I developed a sympathetic interest in it as a fairly young prosecutor in a robbery case I had.

The defendant was a fellow in his late 50s. He’d been a high school principal and a teacher, then he lost those jobs and ended up as a security guard at a campus or something like that. And all of a sudden, he’s finding a toy gun and a rubber mask and sticking up a bank in Boise.

In the presentence investigation, it was observed that he suffered from bipolar disorder. I remember very viscerally my response — at the time, I was sort of a gung-ho law-and-order prosecutor — thinking, “Wow. That could happen to anybody.”

He didn’t have anything to do with that chemical imbalance that went off in his brain. This is a guy who had a really successful life. And then he didn’t. From that point, I think I’ve always been sensitive to the issue of mental health and how it can change people’s lives.

Q: Why do people end up in your courtroom?

A: It seems obvious to me, maybe because I see it all the time. But people who have mental-health issues and don’t get the treatment tend to seek other ways of addressing what is wrong with them. I don’t know that they all recognize that they have schizophrenia or they’re depressed. But they know that methamphetamine makes them feel better if they’re depressed. Or they know that alcohol makes them forget about things. So they have a tendency to self-medicate.

And it is an almost universal truth that people in our population aren’t just mentally ill. They come to us with substance abuse issues.

Q: Why haven’t their mental illnesses been treated before they get to you?

A: Some of it is people don’t have the resources to access treatment.

Some of it is a lack of awareness. They know something is wrong; they don’t know what it is. Their Uncle Bob had the same thing and nobody ever figured out what that was.

Or they have been diagnosed. They have undergone some treatment in the past. It didn’t feel good to them, so they quit following the treatment.

One of the advantages of having somebody in a supervisory environment — some place where conditions can be placed on how they interact and what they’re supposed to do and what medications they take — is that we can enforce the behavior that we want them to carry forward.

The transformation that occurs in the course of the court’s four phases is: first they’re resistant, then they’re ambivalent, then they’re interested, and then they’re enthusiasts.

There’s a light that goes on for most folks someplace around Phase 3 that says, “Oh, wow, my life’s better. This stuff works. OK, now, how do I do that for myself?”

One thing mental health courts do really well is get folks in a routine that makes them appreciate how much treatment can help support their success.

Edited for clarity and length.

Ada County Sheriff Gary Raney being sworn in at a public reception Jan. 14, 2013. Many Idahoans held at the county jail have mental illnesses, Raney says. "We need to return Allumbaugh House to its original vision, or find another facility that helps the mentally ill before the crisis happens and someone becomes a victim," he says.
Credit Katherine Jones / Idaho Statesman

IDAHOANS WITH MENTAL ILLNESS 'SPIRAL' AND 'END UP IN JAIL'

Idaho prisons and jails aren’t just places for incarceration. They’re also mental-health providers.

The Ada County Jail, where several people interviewed for this series have spent time, has a psychiatrist and psychiatric nurse practitioner on call 24/7. The jail also employs three full-time licensed clinical social workers.

“The jail is a place where the community is protected from dangerous people, and some of those people have mental illness,” said Ada County Sheriff Gary Raney. “However, the majority of the mentally ill in the Ada County Jail are not dangerous and, if monitored, pose almost no risk.”

He said “the vast majority” of inmates who come into the jail with a mental illness are released with a treatment plan. But they have “little to no ongoing support” to help them continue their treatment, so they end up back in jail.

On any given day, about 6 percent of the Ada County Jail population has a “mental health chronic-care alert,” meaning the inmate has a severe or persistent mental illness, is not adapting psychologically to the jail or has made a serious suicide attempt in the jail.

The jail had 375 inmates with those issues in 2011, said sheriff’s spokesman Patrick Orr. Those inmates ended up having a much higher re-offense rate than average. About 75 percent were back in jail within two years — the highest recidivism rate of any group of offenders, Orr said.

By comparison, the re-offense rate for Idaho’s prisons over a three-year period is about 35 percent, according to the Idaho Department of Correction.

"In Crisis" is a collaboration between the Idaho Statesman and Boise State Public Radio.