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STEPHEN V. MANLEY, JUDGE, MENTAL HEALTH TREATMENT COURT, SANTA CLARA COUNTY,
CALIFORNIA



Stephen V. Manley is a Superior Court judge in Santa Clara County. He has served
on the bench for over 25 years. He was a founder of the Drug Treatment Court in
Santa Clara County as well as the Santa Clara County Mental Health Treatment
Court. In January 2005 he spoke with the Center for Court Innovation’s Carolyn
Turgeon about his work.

How do you view mental health courts and drug courts, and the relationship
between them?
I was finding that drug courts excluded clients who were mentally ill or dually
diagnosed, and had co-occurring disorders. Why? Because these defendants were
too difficult to work with. This is years ago. And I said, well now we’re taking
the neediest people, the people most in need of structured treatment and all of
our resources, and we’re excluding them from drug courts, and this is wrong.

I’ve worked with mental health clients for years and I know our traditional
method is to ignore them. We either cycle them through quickly or we give them
long sentences. There’s a stigma with the mentally ill that they are more
dangerous, which is not true. Some are, some are not. They are, however, far
more difficult to work with. It makes absolutely no sense in my view to
warehouse someone who is mentally ill and release them into the community with
no services, when we know they will be rearrested again and go right back into
jail.

So I went to war with—or had discussions with—mental health [officials in my
county] and we changed things. And now in my courthouse we have a whole mental
health team. And we force mental health providers to take mentally ill clients
who are criminal justice clients, most of whom are not charged with serious
offenses.

In what ways are the drug courts and mental health courts different?
I think they have to be very separate courts. In a drug court we use incentives
and sanctions to motivate clients. With the mentally ill it is totally
different.

Sanctions, for example, do not work with a mentally ill person unless they have
significance. So I very seldom use sanctions. This morning I had a client who is
very challenged intellectually. To him, jail is a reward. He likes it. Homeless
people like it in the winter. What good does it do me to put people in jail for
a sanction when they don’t even understand what I’m talking about?

So number one, you’ve got to change all the rules. That does not mean you don’t
use drug court principles. It doesn’t mean that you do not use sanctions in the
appropriate case. But it does mean you have to think it through and know that
you’re applying the sanctions to the right person.

Number two, you have to lower the bar of expectations. Our expectations in drug
court are far too high for mentally ill people to meet. Eighty percent of
mentally ill people are substance abusers. They substitute street drugs for
mental health medication because they often find in the short run they work
better. And they’re also easier to get. I always look at what the presenting
factor is that is making it impossible for a client to function in the
community, and work on that first. Once we get that going then we work on the
substance abuse. And if we’re working on the substance abuse, we’re not working
on total abstinence, we’re working on reduction. With people with dementia, you
can only expect so much.

I received a probation report yesterday that I thought was one of the funniest
that I’ve received in a long time. It had two sentences. “The defendant appears
to have a short attention span. He has missed all five of his drug tests.”
Mentally ill people don’t remember! If you want to give them a drug test, give
it to them immediately, when they’re in the courtroom. Send them outside to the
bathroom and have them drug tested, but don’t expect them to remember three
weeks from now that they were supposed to go see someone.

Success is small things: clients who are able to function, who learn how to take
the bus, who learn to find a place to live that is somewhat permanent, who are
able to get social security or their disability reinstated. I have different
expectations and goals for every group of clients.

Do you think that any judge could work in a mental health court?
I do not believe that just any judge could walk in and preside over a mental
health court. A judge has to be committed, very patient, and willing to accept
criticism from clients. Because mentally ill people are very honest. They will
tell you almost everything and they will tell you what is and isn’t working and
what they want—if you ever bother to listen to them. Trying to meet the needs of
these clients is an incredible challenge. It takes a real team and that’s why
drug court principles work so well. There is no court that requires a more
sophisticated and committed team than mental health.

We have, for example, mental health caseworkers in the courthouse every day, so
when clients are decompensating on the street they can come here to get help.
Now that isn’t the way it should be. They should be able to go to a mental heath
clinic! But they don’t exist and they don’t welcome them and they close their
cases. So we have to change the paradigm and that’s what mental health court is
really about: changing the whole way you approach the mentally ill in the
courts.

What we fail to advocate or even recognize is that the mentally ill are a large
percentage of our criminal justice population, our family population, and our
dependency population. There are too many of them in our system because no one
else wants them, and it’s easier to put them in jail than to try to deal with
them in the community.

The other problem is, there’s such a stigma around mental illness that no one
wants to reveal it. Therefore we often don’t know what the problem is and we’re
treating it the wrong way. We treat it as a drug problem when it’s really both a
drug problem and a mental health problem. You’ve got to have very good
assessments, treatment placements, and monitoring done by both mental health and
drug and alcohol specialists. You have to make them work together, and that’s
where the judge can be an agent of change. This is the greatest barrier to
success, other than resources: getting these two disciplines to work together.
They’re separate turfs, separate rules, separate processes, procedures, goals.

In mental health court you also have the issue of medication, which never comes
up in a drug court. In a drug court the judge orders people to do things. With
medications it’s entirely different because, number one, in most states the law
doesn’t permit you to order people to take medications, and, number two, even if
you could order it that doesn’t mean they’ll take them. You have to convince
them to take medication because if you cannot stabilize a client you cannot put
them back into the community. And so that takes very intense work by a whole lot
of people.

 

September 2005
Areas of Focus
Treatment Courts
Related Content
 * Veterans Treatment Court Strategic Planning
 * Fact Sheet: Brooklyn Mental Health Court
 * Criminal Justice Interventions for Offenders with Mental Illness: Evaluation
   of Mental Health Courts in Bronx and Brooklyn, New York
 * Predictors of Program Compliance and Re-arrest in the Brooklyn Mental Health
   Court
 * Emphasizing the Harms

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