New mental health court will track progress of outpatients

IOWA CITY — Johnson County will begin the first civil mental health court in the state to help people who were involuntarily committed with continuing their treatment and obtaining support to make the transition to living on their own in the community.

The Johnson County Attorney’s Office and the Abbe Center for Community Mental Health in Iowa City have led the establishment of the two-year pilot program with the assistance of many other advocates and mental health professionals, who will monitor and connect the outpatients with a team of providers. The first court date will be May 10. The working group for this program started in 2019.

Assistant Johnson County Attorney Lynn Rose explained more about the new specialty court to The Gazette.

Q: What is the goal of this specialty court?

A: To help participants stay out of the hospital and jail and remain on their own in the community. Typically, when people are released from hospitalization, they are given medications to help manage their mental health symptoms but some, because of those issues, don’t properly take the medications and may not complete follow-up treatments. The court will fill this gap.

Q: This court is similar to one of the other 39 specialty courts that exist in the state, which also set up treatment teams for the participants, but those individuals have committed criminal acts and are sent to a drug, OWI, domestic abuse, veterans or mental health — limited to four Northwest counties — court, instead of prison. So how does this court work?

A: The participants will be identified for the program only if they are outpatients who have a primary diagnosis of a mental illness. Those with criminal charges or convictions won’t be accepted in this program. Folks who find the most success in this type of “assisted outpatient treatment” are ones diagnosed with schizophrenia, bi-polar disorder, depressive disorders that lead to psychosis and psychosis.

This civil court is based on many other models in different states. Each of the courts similar to this in other states each have their own uniqueness. We made a site visit to one in Johnson County, Kansas, and also visited with professionals from two other courts in Ohio and Texas.

Q: What is the role of the judicial hospitalization referee?

A: A judicial hospitalization referee, who serves as the judge — authority of the court according to Iowa law — can order the participants to attend court once a week and a team of providers will be responsible for helping them maintain medication regimens, appointments for treatment and access other community services. The weekly court will help track their progress and adjustments can be made before something becomes a problem. This court also holds the providers responsible to ensure participants are receiving proper treatment and services.

Q: Who are the providers on the team?

A: The team includes the University of Iowa Hospitals and Clinics, Iowa City VA Hospital, Abbe Center, GuideLink Center, (National Alliance on Mental Illness), Shelter House and several mental health service agencies in the county.

The Mental Health/Disability Services of the East Central Region; Treatment Advocacy Center — national nonprofit that provides training, support and resources; Johnson County Sheriff’s Office; and the Iowa Judicial Branch also support the pilot program.

The judicial referee, Don Schroeder, an Iowa City lawyer, was hired last month and is an employee through the state judicial branch, but the position is paid for through the mental health region.

Carrie Crain, director of assisted outpatient treatment at the Abbe Center, will be the liaison between the court and participants and their care teams. Abbe Center also will hire a peer support individual for the team.

Q: How and when will this court start?

A: We will start out slow with about five participants. The referrals may come from psychologists/medical professionals, mental health service providers and law enforcement who may have had contact with some but realize they need treatment, not jail.

We asked the court clerk’s office to give us the outstanding outpatient commitments in Johnson County and there are currently 370. Some of those are in the Iowa Medical and Classification Center in Coralville, which wouldn’t be eligible for this program, but it’s a wildly underserved population. The team will continue to identify those appropriate for the program. We are hoping to have 10 to 12 participants by the end of the year.

Q: How long will a participant have to remain in court?

A: About 15 to 18 months for the best outcome, according to the health professionals

Q: Will the weekly court sessions be held at the Johnson County Courthouse, since this isn’t a criminal court?

A: No. The county is providing a conference area in the Johnson County Health and Human Services building, which will be better for the participants — less intimidating and stressful than making them go into a formal courthouse setting.

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