Family Mental Health in Collaborative Courts: The community feedback period for this project began on 8/8/18 and ended on 10/6/18

What is the problem that needs to be addressed? Please describe how it is related to mental health.

The problem: The OC Collaborative Courts do not have access to a formalized integrated service array and mental health services system for children and families of court participants. Collaborative Courts monitor, evaluate and report on what specific services received that provided the best long term outcomes for the participant and their families in comparison to participants that do not access or utilize the family services. But to function effectively, courts must also hold the system accountable for responding to the needs of children. If treatment has a family dimension, collaborative courts must raise the bar on their capacity to serve families with mental health and other coordinated services.

“Collaborative court programs are specialized court tracks that combine judicial supervision with rigorously monitored rehabilitation services. They include integrated treatment and social services, strict oversight and accountability, a team approach to decision-making, and frequent interaction between the judicial officer and the participants. Collaborative courts increase public safety and save money by stopping the revolving door of incarceration and re-arrest for many offenders. They also provide profound human and social benefits. The Orange County Collaborative Courts, which began in 1995 with one Drug Court at the Central Justice Center, have expanded to include a variety of programs based on the Drug Court model at five Justice Centers. As a result of these programs, thousands of County residents have been rehabilitated: addicted criminal offenders transformed into responsible taxpayers; repeat offense drunk drivers changed into dedicated advocates of sobriety; deeply troubled combat veterans helped to re-integrate into society; mentally ill offenders now leading stable, productive lives; homeless people given the tools they need to regain their self-sufficiency; at-risk youth steered from the path of delinquent behavior; reformed parents proud to have had drug-free babies. In addition to changing the lives of criminal offenders and dramatically reducing their rate of recidivism, the adult and juvenile programs have saved more than $120.6 million through the avoidance of more than 852,848 custody bed days.” www.occourts.org/directory/collaborative-courts/reports/2016_Annual_Report.pdf

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?

Court decisions can affect relationships with children. 60-75% of participants in adult drug courts have at least one minor child. Focusing Only on Parent’s Recovery Without Addressing Needs of Children Can threaten the parent’s ability to achieve and sustain recovery, and establish a healthy relationship with their children, thus risking:

  • Occurrence/Recurrence of maltreatment
  • Entry/Re-entry into child welfare system and out of-home care
  • Relapse and sustained sobriety
  • Additional substance exposed infants
  • Additional exposure to trauma for child/family
  • Prolonged and recurring impact on child well-being

Homeless Services. Approximately 39 percent of people who are homeless have a mental disorder, and an estimated 50 percent of adults with serious mental illnesses who are homeless have a co-occurring substance abuse disorder (U.S. DHHS, 1999b; Lehman and Cordray, 1993; Ridgely & Dixon, 1993; Fisher and Breakey, 1991). Because individuals who are homeless are far less likely to use the traditional systems for receiving care (Burt et al., 1999), a broad range of community programs has emerged to address their substance abuse, mental health, housing and social support needs.

  • The Criminal Justice System. Epidemiological studies show the use of drugs or alcohol by people with untreated serious mental illnesses increases their potential for violent behaviors (IOM, 1999). One analysis suggests that substance abuse, psychotic symptoms, lack of contact with specialized community mental health services, and poor adherence to medication are all associated with greater risk of adult life-time violence (Swartz et al., 1998).
    Orange County can learn:
  • The numbers of children and families connected to the court participants in the OC Collaborative Courts
  • The needs of those families
  • The services provided to those families what produce the best long term outcomes
  • The cost savings of providing those services

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?

National experience documents that Drug Courts that provided parenting classes had 65% greater reductions in criminal recidivism and 52% greater cost savings than Drug Courts that did not provide parenting classes. But there is no County or State that has a program for all of their Collaborative Courts to have a formalized array of services including integrated mental health services system for children and families of court participants that is measured with outcomes and services. (Carey, S.M., Mackin, J.R., & Finigan, M.W. (2012). What works? The 10 key components of Drug Court: Research-based best practices. Drug Court Review.)

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.

By addressing the service needs and for court participants families in all collaborative courts, it can have a dramatic effect on the long outcomes for the court participants. If not, it can threaten parent’s ability to achieve and sustain recovery, and establish a healthy relationship with their children, thus risking:

  • Occurrence/Recurrence of maltreatment
  • Entry/Re-entry into child welfare system and out of-home care
  • Relapse and sustained sobriety
  • Additional substance exposed infants
  • Additional exposure to trauma for child/family
  • Prolonged and recurring impact on child well-being

Serving the whole family accomplishes:

  • Cost Savings
  • Decrease recidivism-Offenders with more family contact are less likely to be arrested or incarcerated again
  • Savings for courts and county
  • Engage community- Family assessment tools can capture family strengths as well as needs
  • Highlight your leveraged funds for sustainability-
  • 2nd generational trauma and prevention
  • Recovery for both parent and child occurs in the context of family

There is a role that judicial leaders have in ensuring that participants in their drug court are connected to child and family-based services and resources knowing that 60-75% of participants in adult drug courts have at least one minor child.

This project could also utilize the existing federal funding options for these services for sustained funding that goes beyond grant availability and make this part of the project outcomes – to show how other funding methods could sustain the project past the period of the MHSA grant.

Homeless Services. Approximately 39 percent of people who are homeless have a mental disorder, and an estimated 50 percent of adults with serious mental illnesses who are homeless have a co-occurring substance abuse disorder (U.S. DHHS, 1999b; Lehman and Cordray, 1993; Ridgely & Dixon, 1993; Fisher and Breakey, 1991). Because individuals who are homeless are far less likely to use the traditional systems for receiving care (Burt et al., 1999), a broad range of community programs has emerged to address their substance abuse, mental health, housing and social support needs.

The Criminal Justice System. Epidemiological studies show the use of drugs or alcohol by people with untreated serious mental illnesses increases their potential for violent behaviors (IOM, 1999). One analysis suggests that substance abuse, psychotic symptoms, lack of contact with specialized community mental health services, and poor adherence to medication are all associated with greater risk of adult life-time violence (Swartz et al., 1998).

What is the project idea? Please describe how this project will operate.

All collaborative courts are family courts if their clients include parents and children. Many clients have legal matters involving juvenile delinquency, dependency, family, and domestic violence matters. This project can offer judicial leaders and legal professionals working in adult drug courts practical strategies and solution on how to work with parents who are involved in collaborative courts Collaborative courts should pay greater attention to children and families and why cross-system collaboration and communication are critical for family safety and recovery.

There are strategies and techniques to integrate family into court and treatment process including:

  • Definition of family-inclusive vs. exclusive
  • Family group conference
  • What are social and economic needs
  • Child-family outcomes critical: can families work with parents
  • How families work with court
  • Find opportunities for team members to have conversations with members of families
  • Review records and assessments with family members
  • Observations/Home visits
  • Family Functioning Instruments: open ended questions, strength based

The courts could formalize the referral and follow-up to outside agencies with children’s services; include child and family-serving agencies on the courts collaborative team; mobilizing and linking to new resources from other agencies that already serve children and families; ensure that court information systems including tracking of family members.

A MHSA INN project with the OC Collaborative courts that includes assessing family strengths and needs as part of assessment process during the first 2- 4 weeks in court and include as part of court plan; understanding and measuring the court’s decisions that impact the child(ren) as well as the parent, even though the court may never see the children; add questions about child(ren) and family status into the court process; advocate for a family-centered approach (family-based treatment, parenting classes, ensure that parent has opportunity to express concerns about parenting a child and track participants who are parents and the progress of children.

A function of this coordination staff for the collaborative courts would be continuing surveillance of all available information about grants, as well as opportunities for redirection of current resources which are typically more substantial

Additional Information

Family issues are one of most commonly identified criminogenic factors (Bonta et al., 2008)

  • Family interventions are one of most effective methods to reduce offender recidivism (Lipsey et al., 2010)
  • Inadequate family support, family problems and family disruption contribute to offending (Salisbury & Van Voorhis, 2009; Wareham, Dembo & Poythress, 2009)
  • Attachment to children reduces violations (Visher, 2013)
  • Meta-analyses show that family interventions reduce recidivism (Farrington & Welsh, 2003; Woodfenden, Williams & Peat, 2002)
    Families are powerful informal agents of control
  • Families often help the offender in addressing issues such as housing and employment (Young, Taxman & Byrne, 2002)
  • Family involvement results in better employment and reduced drug use (Visher, La Vigne & Travis, 2002)
  • Offenders with more family contact are less likely to be arrested again or reincarcerated (LaVigne, Visher, & Castro, 2004; Martinez and Christian, 2009)

Service coordination for court populations involves exchanges of information and individuals across agency boundaries. The boundaries can be within the courts themselves (e.g., juvenile courts, family courts, criminal courts) or within large executive branch agencies (e.g., divisions of health, mental health, income assistance, or children’s services). The boundaries can also be those among courts, executive agencies, and not-for-profit service providers. A case-level coordinator could overcome the problems resulting a lack of.

Centralized access to a service network. The effectiveness of individuals and teams that provide case-level service coordination is directly related to what they know about the range and quality of available services. The maze of local service providers and available programs can be daunting even to those familiar with the service community. A central resource is needed to provide current information about services available in a jurisdiction to help ensure timely access to and delivery of appropriate services. The central resource can take different forms: printed, electronic, human, or some combination. ww.ncjrs.gov/pdffiles1/bja/196945.pdf

June 7, 2018

6 comments

How is this idea different from LA county’s SHIELDS program?

SHELDS is a model program and has received several federal funding awards. The Los Angeles screening and assessment system linked to the Department of Children and Families, and their use of family treatment courts is different from Orange County’s; Orange County remains the largest jurisdiction in the country without family treatment courts linked to child welfare.

Who would do the family assessments for the courts?

This could be done possibly by nonprofit providers, by additional court staff, or by out-stationed staff from SSA/HCA with the funding and coordination of the INN grant. In adult drug courts that have added family services in other jurisdictions, various approaches have been adopted in other jurisdictions. See https://www.ndci.org/wp-content/uploads/2016/05/Transitioning-to-a-Family-Centered-Approach.pdf

Is the focus of this project a system change within all of the collaborative courts or only within specific collaborative court(s)?

That would be a decision to be made by the governance leadership of the courts. The project could benefit each collaborative court if that court chose to adopt its methods of screening, assessment, and integrated data systems that respond to the needs of children affected by the charges against their parents and the treatment services they receive. The INN grant would be able to guide other collaborative courts to gain knowledge about what service needs of the court participants families have the greatest effect on the long outcomes for the court participants and achieve the parent’s ability to achieve and sustain recovery, and establish a healthy relationship with their children.

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