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Tuesday, February 20, 2001 - Page updated at 12:00 AM

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Help, not punishment, for mentally ill: King County making a difference

Seattle Times staff reporter

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It was midmorning in the King County Mental Health Court and George Cox rocked nervously back and forth as the judge read documents detailing how he was caught trespassing and trying to damage property at a Port of Seattle pier.

"What's this thing you've got with boats?" asked District Court Judge Mark Chow, who presides over the mental-health court.

When Cox, who is bipolar and has extreme mood swings, couldn't explain, Chow handed down the sentence: Cox was to be held on $10,000 bail until he could be returned to Western State Hospital, where he had left without authorization. He was not to consume illegal drugs or alcohol.

He was to take his prescribed medication and "have no contact with any boats, ships and ocean liners," or Port of Seattle Terminals 25 and 30. "That means don't even walk there," Chow added.

Had Cox not been in mental-health court, he could have been out on the streets once more with no intervention until he broke the law again.

Cox's case is typical of those that come before the King County Mental Health Court - a sort of Mr. Rogers meets Sigmund Freud with a dash of Judge Judy.

The court began in 1999 as a way to decriminalize mental illness, get offenders treatment and in the process, decrease the likelihood of reoffending and improve community safety. Now the court, which is popular with defense attorneys and prosecutors alike, is a national model.

A University of Washington study last month praised the court, which in its first two years has served more than 500 seriously mentally ill offenders, most of them diagnosed as being psychotic or bipolar. About 50 percent were homeless and 80 percent also had substance-abuse problems.

The court has also served as a model for 100 similar courts to be built with federal funds authorized by President Clinton in November.

"It makes sense," said Chow. "This is a good court for the community, for the defendants and their families. ... A lot of people don't understand that if people are on medication, they can be functional."

Spurred by a 1997 slaying

The concept of a mental-health court was created after Dan Van Ho, a homeless mentally ill man with numerous misdemeanor convictions, was released from jail in 1997. Although an evaluating psychiatrist concluded that Van Ho was dangerous, he was released after serving his time. Within days, he killed a retired firefighter leaving a Mariners game.

Had a mental-health court been available, officials say, Van Ho most likely would have been detained after his misdemeanors and given the help he needed.

The King County Mental Health Court was designed by then-presiding District Court Judge Jim Cayce, who took a delegation from Seattle to Florida to study the first such court of its kind.

There are only 10 mental-health courts nationwide, including three in Washington: the King County Mental Health Court, Seattle's Mental Health Court and a similar court in Vancouver.

The defendants have varying degrees of illness. They are identified as possible candidates for the court by either the jail staff or by Suzy Rozalsky, a mental-health clinician, who picks the candidates from jail interviews. Participation is voluntary and open to those who have committed misdemeanors, which can range from simple assaults to creating public disturbances.

Those who go to the court are connected with mental-health services and, if necessary, with drug and alcohol treatment. They are closely monitored by the court and ordered to return frequently to make sure they are complying with the plan for treatment.

And they won't be released unless they have a home or an inpatient mental-health facility to go to. Should they fail to live up to the requirements, they can be sent back to the regular courts, and possibly to jail.

Safety is top consideration

Community safety, says Chow, is the court's top consideration. He believes the program accomplishes that by treating the illnesses that cause the crime.

The Mental Health Court operates out of the third-floor courtroom at the King County Courthouse and two days a week at the King County Jail.

Cox appeared last week. Even before he entered the courtroom, his case had been discussed by defense attorney Bob Bock, prosecutor Lisa Lawrence and Chow. They agreed the criminal-trespass charge would be dropped if Cox pleaded guilty to attempted malicious mischief - trying to dismantle a security camera in a guard's office while he was being detained.

"This is a unique court in that you do have to work together, and in working together we find we have a lot of interest in common," Lawrence said. The team meets several times a week to discuss cases.

From a defense attorney's viewpoint, Mental Health Court can be difficult. "You have to be ready to share more information than you would in other circumstances," where it would be considered a violation of attorney-client confidentiality, Bock said.

"There have been clients who couldn't even be talked to in jail that are now in the community and functioning well," said Bock, who like Lawrence handles all the Mental Health Court cases.

Addictions complicate cases

People with dual diagnoses of mental illness and alcohol or drug addiction are the hardest to place because most facilities will take one or the other, not someone with complex problems. "You can't just give them a pill and say goodbye," Chow said, because they need "wrap-around services."

Overall, he said, there is a critical need for more mental-health facilities, especially since the trend of the last few decades toward deinstitutionalizing the mentally ill has left many on the streets or "warehoused in jails" for lack of services.

`We now have our dad back'

For Cliff Quisenberry, the benefits of the Mental Health Court are immeasurable. The day his father was arrested for violating an anti-harassment order and sent to Mental Health Court was a "blessing in disguise," he said.

Quisenberry said over the years his father's quirks developed into full-blown paranoia. His relationship with his sons suffered and he eventually ended up in Mental Health Court. The court gave him structure and a treatment plan.

"The process was nonconfrontational" and now he's on medication and doing well, Quisenberry said.

Best of all, he added, "we now have our dad back."

Nancy Bartley can be reached at (206) 464-8522 or nbartley@seattletimes.com.

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