Brittany Cannon found her dreams again.
For years, and what seemed like forever, they had been suffocating under the weight of severe depression and anxiety and the illegal drugs she’d been using to mask her illnesses.
A run-in with the law last year landed Cannon in front of Everett District Court Judge Tam Bui and the rest of the county’s mental health court team.
Cannon, who has been living with depression and anxiety since she was a kid, was given a choice and a chance. She was looking at a couple of misdemeanor charges and maybe a few days in jail, or she could spend the next year finding a path to recovery.
The 32-year-old mother was warned that she would be required to engage in mental health and chemical dependency treatment and be open about her progress and setbacks. She would have to regularly attend court hearings and check in weekly with the court liaison. She had to look for a job or enroll in school and volunteer in the community.
She also was told that she wouldn’t have to do it alone.
“I had felt hopeless. I didn’t think there was anywhere to go. I had been at such a low point. So I thought I’d give it a try. What did I have to lose?” Cannon said.
With guidance from the court liaison, a licensed mental health professional, Cannon finally found the right therapist. She also was in drug treatment and learning that much of her addiction was rooted in self-medicating her mental illness.
She started volunteering at an animal shelter and making plans to go to school.
“It felt like someone was holding my hand and helping me get strong again,” she said. “Instead of throwing me into the court system, I felt like a lot of people were in my corner.”
Two weeks ago Cannon became the ninth person to graduate from the county’s mental health court since it began in October 2012. The misdemeanors were dropped.
“My dream is back. I didn’t have it a year ago,” she said. “I was just trying to survive day-to-day. Now I have something to strive for and it’s because I’m stronger. I’m feeling a lot like myself.”
It’s too early to say what kind of long-term impact the mental health court may have on graduates like Cannon, or the criminal justice and healthcare systems, but a report looking at the program’s first two years hints at promise.
The data show a significant drop in calls to emergency medical services by people enrolled in the program. There also were significant reductions in the use of the county’s triage center and fewer arrests and days in jails for those people participating in the therapeutic court. Graduates found stable housing and employment. They were enrolled in school and continued to do volunteer work. Some repaired relationships with family.
Measuring outcomes
One of the primary goals of the program is to get people engaged in mental health services, Bui said.
“If they engage in treatment, there are going to be better outcomes,” she said.
In some instances that means a better quality of life for some of the community’s most vulnerable population.
“Many haven’t had support and are alone. They’ve burned bridges and people have given up on them,” court liaison Cary Peterson said. “When the judge acknowledges their efforts, their successes, you see them beaming for the first time. The court is literally changing people’s lives.”
Snohomish County’s mental health court is among the more than 300 in operation around the country. One of the first was launched in King County. There are few studies, however, on the long-term impact these courts have on recidivism.
One study published last year in the International Journal of Law and Psychiatry showed that participants who completed mental health court were less likely to be rearrested than those who didn’t finish the program.
Of the nine people who have graduated from the Snohomish County program, one has been charged with a new crime, Bui said.
The county also is examining additional markers to see what kind of impact the court could have in reducing participants’ use of other crisis systems, such as emergency medical services.
“The question becomes whether we were going to be shifting the problem around to other parts of the system,” said Robin Fenn, the research manager for Snohomish County Human Services.
She looked at the court’s first two years of operation. She and Bui released a summary report in September with their findings.
There were 103 people referred to and screened for eligibility for the program between May 1, 2012 and July 31, 2014. Only 21 were accepted.
The court is only open to people charged with misdemeanor offenses and participants must be diagnosed with a serious mental health disorder, such as schizophrenia, bipolar disorder, post-traumatic stress disorder, depression or anxiety. If they successfully complete the program, which typically takes a year, their criminal charges are dropped.
At the time of the report there were eight participants who had been enrolled in the court for at least a year. Fenn studied their involvement in the criminal justice system and crisis intervention before they were enrolled in mental health court versus after they opted in.
The data show an 80 percent drop in contact with emergency medical services, meaning there were fewer costly ambulance trips and unscheduled hospital visits. Fenn noted in the report that an average ambulance ride costs about $900 and a visit to an emergency room costs about $1,300. More than half of the 21 participants had publicly-funded insurance.
There also were significant reductions in visits to the county’s triage center, an alternate to jail or hospitalization for people in mental health crisis. There was a nearly 73 percent drop in bookings to the Snohomish County Jail among those studied.
The majority of the 21 participants were female, white and between the ages of 21 and 40. Nearly 30 percent were diagnosed with recurrent major depressive disorder and 23 percent were living with bipolar disorders.
Most are referred to the court by the Snohomish County Public Defender Association. The court is seeing more referrals coming from mental health professionals at the jail and from family, Bui said.
Prospective participants observe the court for at least four weeks before they opt into the program. During that time the team also is evaluating the participant and whether he is serious about recovery.
About one-third, or 32 people, who were believed to be eligible candidates refused to participate.
People often are reluctant about seeking mental health services, Peterson said. She works for Bridgeways, a non-profit mental health services provider. She has worked with mentally ill inmates in the county jail and also evaluated people for involuntary commitment.
Some have lived with mental illness for years and never sought help. They may never have had access to treatment and there continue to be strong stigmas and myths surrounding mental disorders, Peterson said.
At least 14 percent referred to the program were rejected by the deputy prosecutor. People with any significant violent criminal history aren’t accepted. The prosecutor’s office also rules out anyone charged with drunken driving or any sex offenses.
The most represented charges were fourth-degree assault, third-degree theft, criminal trespass and violating a protection order.
Bui said she thinks it has taken time for the prosecutor’s office to be more comfortable with the mental health court. The court team also has gone through numerous changes, including three different sets of deputy prosecutors and public defenders and a new liaison. It takes time to build trust among the players, Bui said.
“I have seen, observed and sensed a recognition and perhaps an acceptance that this is a viable way of approaching these cases,” the judge said. “I can only hope that over time with our tracking and constant tweaking we’ll expand the types of cases we accept and how we look at defendants.”
These often are complicated situations and “the layers need to be peeled back to get at the core of what’s going on,” Bui said.
Snohomish County deputy prosecutor Adam Cornell said he must see a clear correlation between the person’s mental health condition and their criminal behavior.
“Not every crime is a consequence of a person’s mental health condition,” Cornell said.
He also points out that people who are severely mentally ill may not be competent and therefore don’t qualify for the program.
Public defender Fred Moll said he’d like to see the court expanded to included people charged with some felony crimes. It’s these people that may benefit more from extra help and monitoring. They often have been revolving in and out of jail and the courts.
Bui said over time the team has become better at identifying those who are most appropriate for the program.
“My goal is to see more and more folks with tougher cases, who at first blush we may want to turn away, or the state is having reservations,” Bui said. “I think the more experience we gain we can take on those tougher cases and those people who are high utilizers of other systems. That’s where we’ll get the most bang for our buck.”
The court is funded in part by local sales tax already collected and specifically earmarked for substance abuse and mental health services. The county council this year approved about $260,000 for the program. That pays for the full-time liaison and part-time clerk. It covers a full-time deputy prosecutor position and some funding to the Office of Public Defense.
The mental health court continues to grow. It has added two more hearings a month, and now meets weekly.
Earlier this month several people were observing the court to decide if they were willing to put in the work.
Bui advised a woman in a jail jumper and shackles that she needed to meet with the mental health professionals at the jail or the team would be hard-pressed to let her into the program.
“It’s really up to you whether you accept it,” Bui said. “I’m giving you one final opportunity.”
Another man, attending his first hearing, shared his struggles of starting a new medication and managing the side effects. He works and goes to school full time. He sees a counselor at the local military veteran’s office.
“It’s been a rough road,” the man said.
The judge asked him to be patient.
Cannon said one of the true benefits of the program is the help she got navigating through the healthcare system. The court liaison had a list of mental health providers and was there to help her find housing and even find an eye doctor to get glasses.
“I didn’t feel like anyone was judging me and I didn’t get panicked coming to court,” Cannon said.
At her graduation ceremony, Cannon was given four stones inscribed with the words peace, family, hope and dream. In a way those are what she gained from the court, she said.
Her husband sees the changes. She is the mom she wants to be for her daughter.
Cannon looks at the future now with hope. She sees a career and maybe another child.
“I was lost and now I’m back,” she said.
Diana Hefley: 425-339-3463; hefley@heraldnet.com. Twitter: @dianahefley.
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