Background story from the Philadelphia Inquirer, 2001:
Sunday, August 05, 2001
‘Cookies’ a sweet deal for mentally ill
By Charley Gillespie
The Associated Press
AKRON — Incentives such as ballgame tickets or a free manicure are helping the state’s first Mental Health Court keep people out of jail.
Ohio and seven other states are testing a theory that token rewards and positive reinforcement can change mentally ill offenders’ behavior and keep them taking their medicine.
The court opened in January and has allowed 54 offenders to avoid or leave jail. Its goal is to serve 100 people by year’s end.
“We have open beds in the mental health units in the Summit County Jail for the first time since the jail opened in 1989,” said Akron Municipal Judge Elinore Marsh Stormer, who oversees the Mental Health Court. “We also have reduced the number of people committed to state mental institutions.”
In Mental Health Court, defendants plead no contest to misdemeanor charges and enter a two-year treatment program. They are monitored by a probation officer and regularly appear before Judge Stormer.
Charges are dropped with successful completion of the program.
In Ohio, the counties around Columbus and Cincinnati are considering Mental Health Courts, the judge said. In Butler County, a Substance Abusing Mentally Ill program involves putting mentally ill drug court offenders into a special program similar to a mental health court.
Most courts — especially in rural areas — don’t have a strong mental health system in their community to help offenders, Ohio Supreme Court Justice Evelyn Stratton said. Without such support, people with mental illnesses often get arrested for minor crimes, she said.
Judge Stormer said she pushed for the specialized court because most mentally ill would take their medications if urged to do so.
Tammy Lucas, 40, of Akron said she knew she had a mental illness when she was 13 and eventually was diagnosed as manic depressive. She says she became addicted to alcohol and crack cocaine while trying to deal with her symptoms.
Ms. Lucas said she spent half of 1999 in a coma after taking 28 sleeping pills. Last December, she again attempted suicide.
Before her last suicide attempt, Ms. Lucas was arrested on drug possession and solicitation charges. When she went to court in April, Judge Stormer invited her into the program.
Ms. Lucas says Judge Stormer treats her more like a friend than a criminal, as long as she keeps taking her medicine and attending group therapy sessions.
Ms. Lucas says the difference between Ohio’s program and others is that case managers work with her and the defendants.
Judge Stormer offers many different incentives, or “cookies,” to keep offenders inspired. A defendant recently was promised a free manicure to keep taking medication and meet with her case worker.
“It costs $10 to get someone a gift certificate to get her nails done. So if that is really meaningful and really motivating for her, we get her one,” Judge Stormer said.
“You get them tickets to go to the movies or take everybody to a baseball game. It’s really not what the item is that makes a difference ... it is the recognition and public approval.”
Those who miss meetings or don’t take their medicine face sanctions including community service, house arrest, time in a halfway house or even jail.
Not all make it through the program.
A program member charged with unruly conduct and criminal trespassing was sent to prison after pushing a police officer.
“I don’t excuse his behavior, but I am not sure we couldn’t have helped him prevent some of that behavior,” the judge said.
Judge Stormer says most people in the program likely won’t commit another crime partly because of the commitment of the court’s case managers.
“They are taking them to appointments. If they need to be seen every day, they are seen every day,” she said.
No they won't. Most meds have side effects patients do not want to deal with and will choose alcohol and other drugs over their prescribed meds. The prescribed meds also makes the patient feel normal and thus enforcing in their minds they really do not need the meds.