Sunday, December 7, 2008

IT’S A GRAY AREA: Grappling with mental illness

IT’S A GRAY AREA: Grappling with mental illness - by Judge Jim Gray

Mental illness has been a part of the human experience for as long as mankind has walked the face of the earth. But within the last several years, medical and legal professionals have come a long way in understanding and being able to grapple successfully with these issues. In fact, there are some really good things that are happening in this area here in Orange County.


Today the largest mental health facility in most counties, including ours, is the local jail. This is mostly not intentional. But when mentally ill and often homeless people congregate and loiter in front of someone’s home or business playing their boom boxes too loudly, urinating in the flower beds or on the sidewalk, sleeping in doorways, or chasing people’s visitors and customers away, residents and business people have no recourse other than to call the police. On the first occasion the police usually take the offenders to a shelter or similar venue. If they keep returning, sometimes the police still drive these people to the city limits and tell them “not to come back.” It is illegal to do this, but it still happens. Otherwise, the police have no other viable choice than to take them to jail.


That is unfortunate because jail is not only the most expensive option, but also often inflicts untold damage upon these emotionally fragile people. But now when they are brought to jail in Orange County, they will be screened and, if the offenses are not particularly serious and they otherwise qualify, the mentally ill will be brought to the team at the Community Court.

Although Chief Justice George made the opening comments at the dedication ceremony at the new Community Court at 909 N. Main St. in Santa Ana on Friday, my dedicated and caring colleague Judge Wendy Lindley has been the leader behind this effort. She has gathered together people from the District Attorney’s Office, public defenders, Probation Department, Social Security, Health-care Agency, and Social Services, and they will work together to diagnose the problems of the homeless, mentally ill, and other people with a “dual diagnosis” of both mental disorders and illicit drug offenses who are generally “self-medicating” their symptoms. Then this team of professionals will pool their ideas and talents in putting together treatment plans backed by the powers of the courts, so that all of these defendants will have a chance to obtain and live at their highest performance level. This is a positive development that we can all be proud of! Thank you, Judge Lindley!


In addition, you should be aware of other resources in our county that are available to help with the problems of the mentally ill. If you need immediate help with a psychiatric emergency, you should call (714) 834-6900 and request assistance from the Centralized Assessment Team. Otherwise, if you need more generalized but non-emergency assistance, you should call Social Services’ Behavior Clinic at (714) 440-6767, or for dual-diagnosis patients you can call (714) 480-6660.


Studies show that only about one-third of the people with mental disorders in our country receive even “minimally adequate” care, and that percentage is far lower for those who are incarcerated or homeless. But it is not any more a crime to be mentally ill and need some psychotropic medication than it is to be diabetic and need insulin. It is often a chemical imbalance in a person’s brain that causes the problems, and medication can often be amazingly successful in helping people to live mostly normal lives.


That is not to say that there should not be safeguards to protect people from being forced unnecessarily to take psychotropic medications. Sometimes lazy medical doctors over-prescribe medications simply to keep their wards more “under control.” But in my years presiding over the Mental Health Calendar in the Superior Court, after hearing expert testimony and witnessing some truly unstable people, I have ordered that they take these medications, involuntarily if need be. And I have seen changes within seven to 10 days that were little short of amazing.


For example, the only time I have ever felt in physical danger as a judge was an occasion in which a man was testifying in my court in one of those hearings. And he was acting in such a truly bizarre and threatening fashion that I physically moved farther away from him. The experts said his records showed that he was a teaching tennis professional from another county who had stopped taking his “meds” while visiting relatives in Orange County. So I ordered that his medications be resumed, involuntarily if necessary.


Within about a week this man was back in my courtroom, and appeared to be perfectly fine. In his testimony he acknowledged that he had a mental disorder, and had forgotten to continue with his medications. And then once he had stopped, he fell into the mindset that he didn’t need them, and that led directly to his mental deterioration. But now that the meds were back in his system, things were fine, and we were joking about how I would never win Wimbledon, etc. And this instance was not at all unusual.


Without governmental and public support of programs like these, the mentally ill by default will hang out in public libraries, receive their medical treatment only in hospital emergency rooms, and be warehoused in county jails. So as you can see, ignoring mental health problems is much more expensive both in human as well as financial terms than addressing them directly. But we are doing pretty well here in Orange County, and I thought that you would like to know.

JAMES P. GRAY is a judge of the Orange County Superior Court, the author of Wearing the Robe – the Art and Responsibilities of Judging in Today’s Courts (Square One Press, 2008), and can be contacted at http://www.judgejimgray.com/ or at his blog at http://judgejamesgray.blogspot.com/

3 comments:

Agent Orange said...

Judge Jim Gray stated: "Without governmental and public support of programs like these, the mentally ill by default will hang out in public libraries, receive their medical treatment only in hospital emergency rooms, and be warehoused in county jails."

Judge, the Libertarianism and Liberalism are mutually exclusive doctrines therefore the Government has no business in determining anyones mental capacity. The issue of sanity is in the eye of a beholder, subject for a jury (NOT COURT) to be decided.

I would argue that there is more lunatics sitting on the OC Court bench than laying on the grass in front of the Court.

In the October 2008 Mayoral Candidate debate between me, Mayor Pulido, Councilwoman Martinez and Candidate Collins, I was asked the question: "What would you do for the homeless people? "
My answer was: "Nothing!".

As a true Libertarian, I believe that a role of the government should be limited to:

Protect the People;
Protect the Property;
Not to interfere in the Peoples pursuit of the happiness; and

only within the realm of a ZOO Socialistic Doctrine as stated by Jaroslava Moserová, MU Dr.Sc. (born 17 January 1930, Prague) who was a Czech senator, ambassador, presidential candidate, doctor, and translator:

"I usually use the comparison to a zoo. We lived like animals in a zoo, where we were sure of getting enough to eat, enough to drink, of having a roof over our heads, and of being relatively secure. And of course that our space was limited. Now, if you dissolve a zoo, it's always the predators who are the first to use the new freedom, while the more timid, defenseless animals have a tendency to hide in corners, and some of them may even think that it was better behind bars because they forget the stench and the loss of dignity."

Obviously, I have received only about 1000 votes but if elected the Santa Ana would be much safer place to live in than is now after my opponent promised usual politically correct crapola.

THE PEOPLE LIKE TO LIVE IN THE SOCIALISTIC ZOO!

Agent Orange said...

Judge,
On or about Friday, I have submitted the following comment which did not met your moderation standards.
Can you please point out what is wrong with my comment?
please use standa@merlin4x.com

-Stan


Judge Jim Gray stated: "Without governmental and public support of programs like these, the mentally ill by default will hang out in public libraries, receive their medical treatment only in hospital emergency rooms, and be warehoused in county jails."

Judge, the Libertarianism and Liberalism are mutually exclusive doctrines therefore the Government has no business in determining anyones mental capacity. The issue of sanity is in the eye of a beholder, subject for a jury (NOT COURT) to be decided.

I would argue that there is more lunatics sitting on the OC Court bench than laying on the grass in front of the Court.

In the October 2008 Mayoral Candidate debate between me, Mayor Pulido, Councilwoman Martinez and Candidate Collins, I was asked the question: "What would you do for the homeless people? "
My answer was: "Nothing!".

As a true Libertarian, I believe that a role of the government should be limited to:

Protect the People;
Protect the Property;
Not to interfere in the Peoples pursuit of the happiness; and

only within the realm of a ZOO Socialistic Doctrine as stated by Jaroslava Moserová, MU Dr.Sc. (born 17 January 1930, Prague) who was a Czech senator, ambassador, presidential candidate, doctor, and translator:

"I usually use the comparison to a zoo. We lived like animals in a zoo, where we were sure of getting enough to eat, enough to drink, of having a roof over our heads, and of being relatively secure. And of course that our space was limited. Now, if you dissolve a zoo, it's always the predators who are the first to use the new freedom, while the more timid, defenseless animals have a tendency to hide in corners, and some of them may even think that it was better behind bars because they forget the stench and the loss of dignity."

Obviously, I have received only about 1000 votes but if elected the Santa Ana would be much safer place to live in than is now after my opponent promised usual politically correct crapola.

THE PEOPLE LIKE TO LIVE IN THE SOCIALISTIC ZOO!

Marcos El Malo said...

This is an issue very close to me, as I am a sufferer and qualify for Social Security Disability because of it. It is also difficult to discuss openly, because I continue to have shame and guilt over it. How can I consider myself a conservative if I myself am supported on the government dole? Doesn't that make me a hypocrite?

It's also something that has made me leery of the LP and libertarians in general. How refreshing to encounter one who holds principles of liberty dearly, and yet is neither doctrinaire nor ideological inflexible.

I don't know if there is a subset of libertarians known as Practical Libertarians or Pragmatic Libertarians, but if there is, I think I might be more interested in joining the LP. Part of the turn off has been the fringe and the nut cases. However, the GOP seems to be falling under the control of its own fringe nut cases.