Texas’ Mental Health Court Programs

Episode Notes

Transcript

Speaker 1:

Welcome to the State Bar of Texas podcast, your monthly source for conversations and curated content to improve your law practice with your host, Rocky Dhir.

Rocky Dhir:

Hello and welcome to the State Bar of Texas podcast. We have so many different types of courts, specialized courts. There’s civil courts, criminal courts, small claims courts, family courts, probate courts, immigration courts, workers’ compensation courts, you name it. My personal favorite. I got to tell you. Food courts though I’ve never made any money in food courts, I find the overhead just eats away at my profits. Sorry, I couldn’t resist. Okay. This is what I get to do as a host. All right. I get to have fun sometimes, but each of these types of courts serves an important purpose. Yes. Even food courts. Just kidding. Okay. Especially food courts. But one type of specialized court you might not be aware of is the mental health court. We have those in Texas. In a nutshell, they’re designed to help criminal defendants obtain treatment combined with judicial monitoring to achieve effectively two goals, better long-term mental health for the defendant and enhance safety for the community at large.

Brent Carr, Judge Brent Carr presided over criminal court number nine in Tarrant County for 32 years. During his tenure, he founded several programs in Tarrant County, including the RISE program designed for female felons who were involved in sex trafficking. Then there was the program Judge Carr established for homeless mentally ill persons. Judge Carr’s aim was to reduce recidivism and he succeeded. Now, judge Carr served as a jurist in residence for the Texas Judicial Commission on Mental Health, where he plays a key role on the commission’s specialty Courts advisory council who better to walk us through these mental health courts and what they do. So we’re very lucky to have him here today. Judge Carr, welcome to the podcast.

Judge Brent Carr:

Pleasure to be here.

Rocky Dhir:

Let’s talk first about your own experience as a criminal lawyer. As a criminal judge. I think you were a prosecutor at one point, right?

Judge Brent Carr:

Correct. I was a prosecutor for eight years and I’d pretty much done everything in the office I was ever going to do and I had an opportunity to run for this particular court. And as you mentioned, I served on the bench for 32 years, never had an opponent, which made it particularly enjoyable, but it also gave me the time and the luxury of being able to do something that I found out I really loved, which was to work with specialty court programs.

Rocky Dhir:

It’s interesting because some people think criminal courts should punish and others say they should reform. There’s this constant battle when people debate about criminal law. How do you thread that needle as a judge and even as a criminal lawyer, what was your philosophy on that?

Judge Brent Carr:

Well, they would pretty much tell you, and especially if they’ve ever been on probation, that being involved with one of these specialty court programs was probably more intensive than being on regular probation because we had a smaller group of people to work with. We paid close attention to their global needs to make sure that we had everything else in place, education, housing, relationships with family members, employment, and basically it was restructuring the entire person. And we did have several that over the years that were not successful. So of course they were returned to the regular justice system. But for the people in these programs, I would say it was probably more intense. It was not a get out of jail free card and we expected results and there were frequent compliance sessions to make sure that we were achieving agreed upon results.

Rocky Dhir:

As a judge though, how would you determine which defendants or whether a specific defendant belongs in a specialty court or even a diversion style program versus going through the more traditional justice system? What was your litmus test?

Judge Brent Carr:

Well, there are some lawyers and judges that have the right letters after their name, but something particularly judges have to come to realize is that you’re not an expert in everything. In fact, there are a lot of people in your community that do have the proper training. So I would rely heavily upon trained expert to conduct the evaluations of people who we were looking at for admission into the program. And once we determined that they met the criteria, and setting static criteria is very important because you just can’t have a program that can address the entire waterfront. But once we have an analysis performed by a qualified individual, then those that were admitted, then we had a very high successful completion rate and a very low long-term recidivism rate.

Rocky Dhir:

Was it only certain types of offenses that were eligible for these? Was it nonviolent offenses or did it depend on what happened to the victim? I mean, what was the balancing test for determining whether somebody belongs in one of these programs?

Judge Brent Carr:

I would say it’s all above. And so basically the focus is on higher risk, higher need individuals, and we would look at working with people where we could have a big impact on their performance in the community. So if you’re going to talk about dismissal and exp function as a reward, then the level of offense is going to generally be lower. If you’re talking about people where the goal is true integration back into the community as its own goal, then you’re going to be dealing with higher risk individuals. And if I could just briefly add here, is that even in some cases, assaultive offenses and things of that nature, we rather just stick our head in the sand and pretend like that everyone is just going to self-Correct. Or are we going to have much more intensive judicial monitoring to make sure that there is compliance with the terms of their rehabilitation program? And I think that any cursory examination of the results is going to show that the latter is much better in the long run.

Rocky Dhir:

Let’s talk for a second about the mental health courts in Texas. So first things first, foundationally, what is the Texas Judicial Commission on Mental Health?

Judge Brent Carr:

This is a novel development in the treatment of the mentally ill and people with intellectual disabilities in our justice system. Many states have modeled similar programs after what we’re doing in Texas, but it basically was established by a joint session of the Supreme Court of Texas and the Court of Criminal Appeals. According to Deep justice, heck, this is the first time that both courts had met on Banc to get behind a project where we are basically trying to use the authority of the justice system to produce better outcomes. So they established this commission. It’s located in Austin, Texas, in the Supreme Court building. It is staffed by a highly trained, competent group of individuals who have a lot of experience in running these type of agencies, and we bring together resources from all levels of the community and we are willing to go to each community, urban and rural in order to facilitate their development of programs that produces better results for the people with mental illness or intellectual disabilities in our communities.

Rocky Dhir:

I think I heard you say earlier that other states are following Texas. So does that mean we were the first ones to come up with a commission like this?

Judge Brent Carr:

I don’t know if we were the first ones, we were certainly going to be in the top five or less state develop this commission. But at many of our annual summit meetings, we have had people from other countries come and participate in our summit meetings because they’re interested in seeing and Texas being as large a state as it is, they’re interested in seeing pop down down to the top interaction of players at many different levels with all toward working toward the goal to improve outcomes for mentally ill in our system.

Rocky Dhir:

So we also need to talk about the Specialty Courts advisory Council where you play a very active role. Before we do that though, judge, we’re going to take a quick break here from one of our sponsors, and then when we come back we’re going to hear more about this council and then maybe talk a little bit more about these mental health courts. So stay tuned guys. We’ll be back in just a few minutes and we are back with Judge Brent Carr. We’re talking about Texas’s mental health courts, which honestly I got to tell you I didn’t know existed and now I’m learning a thing or two. So we’re going to learn this together. We just talked about the Texas Judicial Commission on Mental Health. Now within that commission, there’s a specialty courts advisory council. Judge, I know you’re very active in that. Tell us the role of that council and what you’re doing for it.

Judge Brent Carr:

Rocky, actually, this council, it’s a separate entity.

Rocky Dhir:

Oh, see I am learning things. This is what I’m talking about here. There you go. Yes,

Judge Brent Carr:

It has its own statutory authority. It is out of Governor Abbott’s office, and this is the group of individuals, again from across the state that make recommendations on how the governor’s pot of money, if you will, will be awarded to various specialty court programs around the state. So Texas right now has about over 250 specialty court programs, not just mental health. And if you’re a county of more than 200,000, you’re required to have both a substance abuse diversion program and a mental health program. Those are required by law. And so basically the legislature passes the appropriations bill, which determines how much money from general revenue will be applied to these programs. But about four years ago, they passed a law that said 1% of the alcoholic beverage tax that is collected in the state of Texas will now go into a special fund in order to fund these programs. Now, not to say we can fund every program, but I would say right now we have probably more available funding than at any other time I’ve been serving on the council, and that has been now about six. So when you go out and buy your next adult beverage, 1% of the tax that you’re paying is going to support these programs.

Rocky Dhir:

So when we talk about specialty courts, that’s not just mental health. There’s other categories within that. So I’m assuming is that family courts what all falls in the rubric?

Judge Brent Carr:

Family courts would be more divorces and things of that nature. A specialty court program, they have another name, it’s called Problem Solving Courts, and you basically pick the problem that you’re interested in working with. And let me just throw a hoorah out there for my colleagues. Judges do not get paid extra for monitoring these programs, but they are some really good work. And who doesn’t enjoy seeing people dig themselves out of a hole and go on to lead a productive life? So the main categories of programs that we have would be drugs by far or substance abuse by far the biggest mental health veterans. We have a group of courts that come out of the Child Protective Services arena, which is designed to hopefully reunite families with their children and get the parents primarily off of or deal with their substance abuse. We have people who’ve been involved in sex trafficking and all of these programs involve mental health to a degree.

And the women that I work with in the human trafficking here to four, they really receive little to no services, but we have had some just amazing results working with that population once we get ’em dried out. I even had one lady who went and obtained a PhD in social counseling work from Florida State University and we’ve had another of great achievements, but the Judicial Council on Mental health has really been a godsend and they are really doing some fantastic work in the area of mental health. But we have a lot of programs. I expect there’s going to be more programs. If I were king of the specialty court for a day, I would probably adopt this to be applied in many more areas than it currently is because it’s really about relationships that solve these problems. And the case workers truly get to know the participants, the judges get to know the participants, and the participants feel in most cases a need to respect the opportunity that they were given once we get them past their substance abuse and on a pathway to good mental health.

Rocky Dhir:

Now, government code chapter 1 25 is what governs how mental health courts are established. What are the requirements there?

Judge Brent Carr:

Well, first a few things that aren’t in the code. You’ve got to have a group of people that are dedicated to coming together and making the program work. Then at some point, if you are going to receive funding through the governor’s office, the Specialty Court Advisory Council, that process, then you have to give notice that you’re going to have a program, you have to provide a copy. It’s generally in the form of a commissioner court resolution where the commissioners are basically demonstrating in the open that they are going to be supportive of the project. You have to outline what your strategy is and you have to file all of this with the office support administration. It’s not a difficult process. And the Judicial Commission on Mental Health as well as the Office of Court Administration and Saam Houston State University Specialty Court Resource Center, they will all provide assistance to any jurisdiction that is seeking to establish a program in their area.

Rocky Dhir:

Judge, we need to talk about the actual mechanics of these courts and kind of how they work. Before we do that, we’re going to hear from one of our sponsors. So be thinking about that. And guys, we’re going to be back in just a few seconds and we’re going to continue talking about mental health courts with Judge Brent Carr. See you in just a few. And we are back talking about mental health courts in Texas with Judge Brent Carr. Now you might remember we were talking about how they’re formed, but what happens once you have a mental health court? What goes on with these? So judge, are they presided over by actual judges? I mean, what’s the mechanics? Once a criminal judge says, I want to take this defendant and put ’em into a mental health court, what’s the process from that point?

Judge Brent Carr:

Well, I do want to throw out just a very brief list of about four resources, which I’ll hopefully have a chance to do before we conclude here today. But let me first say that most of these specialty court programs, they’re patterned on what is referred to as the drug court model. And you can go to all rise org, which is a national organization. We’ve got now about 25 years of research into these programs. So this isn’t somebody just pulling an idea out of their where and saying, boy, this would be, yeah, hat that’s a good word, hat we’ll go with hat, pulling a program out of their hat. But let me just give you a standard model. So in the programs that I ran, we would meet at least twice a month where all of the participants would be required to come in and give an account of what they were doing with regard to their progress in the program.

The program is generally divided up into phases. There’s usually an orientation phase, which is getting someone exposed to their initial battery of resources, a maintenance phase to where we’re now making regular progress on whether it’s counseling or substance abuse or all of the above as we go through the program. And then we have the third phase, which is kind of the wrap up phase. Now, my women’s program with the people involved in sex trafficking, that was actually a six phase program because they were a much higher risk group. But for a standard program, I see typically three phases. And when we get to the last phase, we’re maybe reassessing the individual, see if there’s any loose ends. We need to tie up making sure that if they’re going to be capable of working or we need to work with them to obtain Medicaid or whatever else we need to work on to sustain them, we wrap all of that up.

So we are very complimentary of success. We have promotions, formal promotions, we have a graduation. And whereas I might be real proud of the last vacation I took, well a lot of these people in their life, what they have seen is a lot of negativity. And so this is a big deal for them. Now, for me as an elected judge, if I were to get a certificate for completing a drug program, well that probably means I’m going to have an opponent at the next election and so forth and so on. But for a lot of the folks that I’m dealing with in these programs, this is a big day in their life and they are proud and they bring their family members to see them being promoted to the various phases. And usually on a day of graduation, there might be a participant who brings as many as 10 or more people to finally watch them accomplish something positive in their life.

And many times it’s a very moving experience because we give each participant an opportunity to stand up and say how the program impacted their life. These programs typically range for a very low needs offender from about eight months to about 16 months, months. The one that I had with the women that program, if you finished in three years, you were setting the barn on fire. But every program has to deal with its own class a participant, and it’s not a race, it’s not a sprint to the finish line. It is assessing as we go along to make sure that we’re hitting all of the markers and we’re putting someone in a position to where they have their best chance of long-term success.

Rocky Dhir:

I guess what I’m trying to get at is the mechanics of it. So let’s say a defendant has been deemed eligible and the judge rules that this person will go through mental health court. It sounds like it’s more of a program, it’s not really, they’re coming back in front of a judge in a Courtroom, it sounds like maybe it’s a program and more of a group setting. What exactly happens in these mental health courts?

Judge Brent Carr:

It actually, they do come in front of a judge. Two meetings a month that I mentioned. Those are the court sessions. And so once someone has been accepted, then they meet with their case manager who establishes what their initial battery of resource involvement is going to be about every two weeks or twice a month on average. They show up in the Courtroom and they literally have to stand in front of the judge. And whether it’s good, bad, or ugly, they have to give an explanation of what progress that they’re making. And then we make adjustments as we go along. It’s not static and we don’t have immutable principles. If it looks like perhaps we need to add more resources in a certain area, then we will change their treatment plan. And everybody does have something called a treatment plan that is developed by qualified individuals, but we will adjust it as necessary. And you did pick up on one very important thing. A lot of people refer to these as specialty courts. Well, they’re really more of a docket. They are presided over by a judicial officer, but there’s not really a court that just deals with people in a mental health court program setting full-time. All of these judicial officers do other things in addition to running their dockets that basically we refer to as the mental health court.

Rocky Dhir:

So as a defendant, is your mental health judge the same as your criminal court judge or could it be different or how does that work?

Judge Brent Carr:

Most of the time it’s different. So once we’ve identified, particularly in an urban area, once we’ve identified a potential candidate, then we will transfer that case to the judge that’s over the program, and that judge will be responsible for their day-to-Day participation along with the rest of the team.

Rocky Dhir:

What’s the effectiveness of these mental health court programs in terms of recidivism, in terms of the success of the defendants who go through them? Do we have numbers on that?

Judge Brent Carr:

Yes, we do. The numbers basically are, if you’ve ever been arrested for anything, the chances of you getting rearrested for something is around 60%. We follow the graduates for as long as we can because at some point, once their record is expunged, I mean that means we destroy the record. So we have nothing else to follow. But over a two year follow-up period where we’re kind of keeping crack, then I would say that my veterans program, the recidivism rate was down around 8%. The mental health program, around 14%, the women’s program. But again, these were women who have been in drug use trauma for decades. And so our success numbers there for this very high risk group is about 50%. And that doesn’t sound as good as the other two groups, but that is an amazing number because when you have a group of people that basically had no exposure to resources and it was the true revolving door, they’re not threats to the community.

I kind of feel like a social worker with a rest power occasionally, and that’s not a bad combination, but once you use the Majesty, if you will, of the justice system to bring the horse to water, make them drink and make them take a drink, whether it’s going to trauma counseling, mental health counseling, substance abuse counseling, then we show some great results. So as a quick pitch, the resources I would throw out there a starting point. You’ve already heard me mention All rise.org, Saam. Houston State University has a program called the Specialty Court Resource Center, where they will assist with starting up a program and our moving into program evaluation, the Judicial Commission on Mental Health, which we’ve spent a fair amount of talking about. And Texas has its own group called the Texas Association of Specialty Courts Task, and we bring a lot of the national speakers to speak at that program.

And then the Judicial Commission on Mental Health also has its annual summit that occurs in fall. The registration is free. There are limited scholarships depending upon the funding that we have available to cover some other expenses, but usually you’re just out your transportation and hotel costs. So there’s a lot of help out there. This is no longer just a pike dream to where you’re just sitting there twiddling your thumbs, trying to figure out how to get started. There’s a lot of help out there for jurisdictions to get a program underway, and there’s a lot of very dedicated people that are waiting for the opportunity to serve. And I consult myself with several jurisdictions on a regular basis as a result of my Association with the Commission on mental health.

Rocky Dhir:

Wonderful. Well, judge Carr, we have reached the end of our time to talk about this topic, but this is important, and I hope those listening will start tapping into those resources. But judge, thank you so much for taking the time to educate us about the specialty courts, in particular, the mental health courts. This was illuminating. Thank you.

Judge Brent Carr:

Thank you very much for having me.

Rocky Dhir:

Absolutely. And of course, I want to thank you for tuning in, and I want to encourage you to stay safe and continue to be well. If you like what you heard today, please rate and review us, an Apple Podcast, Google podcast, or your favorite podcast app. Until next time, remember, life’s a journey, folks. I’m Rocky Dhir signing off.

Speaker 1:

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