Corrected 2/8/08: In an earlier version of this story, the name of Judge John Zottola was misspelled.
PITTSBURGH—Judge John Zottola's courtroom often feels more like a kindergarten award ceremony than part of the criminal justice system. Every Thursday on the fifth floor of a Romanesque-style courthouse, defendants shuffle to a podium to receive compliments, encouragement, and applause, whether it's for sticking to their treatment, wearing a nice outfit, or staying clean and sober. Even defendants who've slipped up on probation are unlikely to be thrown back in jail. Instead, most face a stern but kind warning, along with orders for more rigorous treatment or reporting schedules. "Don't make me look bad," Zottola tells them.
A soft touch is hardly standard for judges. But this is the Allegheny County Mental Health Court, an alternative to traditional criminal court, and it is precisely that sort of approach that has helped keep more and more mentally ill offenders out of jail. "Some people say, 'Is warm and fuzzy appropriate for the criminal justice system?'" says Zottola, a former county prosecutor. "But it really works."
For years, courts have treated the mentally ill with the same dispassion accorded any other defendant. The results have been devastating. More than twice as many people with mental illness live in prisons as in state mental hospitals. When they are confined to tiny cells, their conditions often worsen, increasing their propensity to act out. As a result, the mentally ill face disproportionately harsher discipline than do other inmates behind bars. A 2003 Human Rights Watch report said there were "deep-rooted patterns of neglect, mistreatment and even cavalier disregard for the well-being" of mentally ill inmates.
Trade-off. That attitude is slowly starting to change. Spurred by growing prison populations and high levels of recidivism, mental health courts now number about 175 nationwide. The premise is simple: Instead of being sentenced to jail or standard probation, defend-ants in mental health court are diverted to treatment programs and remain under regular supervision for a fixed length of time. After going through the Pittsburgh court, which started in 2001, only 10 percent of 223 graduates were rearrested, far below the 68 percent national average for all defendants.
"There are people who are mentally ill who do dangerous and violent things who should not be getting a pass because they are mentally ill," says Douglas Brawley, chief assistant for the mental health court in Broward County, Fla. "But many of the crimes, when you look at them, are manifestations of their mental illness."
Participation in the Pittsburgh program is voluntary. Only a handful of eligible defendants turn it down each year, usually because of the possibility of longer periods of court supervision or long waits for a bed in a treatment facility. While the program accepts those facing misdemeanor and felony charges, it bars sex offenders and most violent criminals. In exchange for their guilty pleas, defendants are put on probation and given a treatment plan. They also receive two months' rent and $200 for new clothing.
When she first appeared in Zottola's court, Tina Haddix was, to say the least, troubled. Now 35, Haddix had begun drinking at age 12 and was addicted to crack cocaine by her early 20s. Combined with untreated bipolar disorder and depression, her addiction only worsened. Haddix began stealing to feed her habit and soon found herself in jail. In 2005, Haddix was caught forging the checks of her parents and other elderly people. Facing more serious charges, she pleaded guilty to misdemeanor theft and signed up for mental health court.
After a few months in residential treatment, Haddix moved to a halfway house for a year, then signed a lease for her own apartment. During her two years on probation, Haddix never slipped up. By the time she graduated from the court last fall, she had gotten financial aid to take classes to become a drug and alcohol counselor. She says she is certain about where she would be without the mental health court: "Dead or out on the street."
Not all mental health courts have been as successful as the court in Pittsburgh or the courts in San Francisco and Broward County, where studies have also pointed to lower recidivism rates. Different courts use different treatment facilities. They also apply different sanctions. Some judges see jail time as fair punishment for breaking treatment; others say jail is counterproductive. A number of courts will take felony cases, while others restrict participation to those accused of misdemeanors. "What's unclear is for whom and under what circumstances mental health courts work," says Henry Steadman, the director of Policy Research Associates, who is running the first national study of mental health courts. (Even in Pittsburgh, of the 481 people who have enrolled in the court, 47 have been thrown out or left.)
The courts have sparked criticism by some mental health experts. First, they worry that the courts criminalize the mentally ill because most force defendants to plead guilty in order to receive treatment. (A few will erase charges altogether if treatment is successful.) Second, critics are concerned that the courts divert limited treatment resources from the general community to those with criminal records. "Nobody talks about the trade-offs," says Joseph De Raismes, vice president for public policy for Mental Health America, an advocacy group. "Nobody talks about whether three or four needy people didn't get into treatment."
Addiction. The choices inside court aren't always easy either. During a recent session, Zottola heard the difficult case of Jeffrey Woods, who at age 48 had spent more of his life inside the criminal justice system than outside it. He was raised by a single mother as one of 13 children. Arrested at 17 for stealing from a jewelry store, Woods says he fell into drug dealing for most of his 20s and soon became his own best client. The addiction was heightened by his untreated mental illness: schizoaffective disorder, which had led to a number of suicide attempts. In 1992, he was sent to prison for a decade.
Released in 2003, Woods tried to turn his life around. He fell in love and began to reacquaint himself with his teenage son. But soon, he says, "my urge and needs came back." In 2004 he was arrested again for stealing, but this time, he was offered a way to avoid jail: the mental health court.
Since joining the program, Woods has been charged with four new offenses, including felony theft charges. After his arrest last fall for stealing a $400 watch, he stopped checking in with his probation officer and his therapist. Prosecutor Heather Kelly wanted him thrown out of the program.
Woods, aware that he was on thin ice, had made a pre-emptive strike by sending the judge a Christmas card. He had also begun showing up for therapy and arrived at court early, clean, and sober. It wasn't perfect, but it was progress. Zottola warned Woods that he was getting close to jail time again. "You have to try to straighten some of this stuff out," the judge said. "I'm ready," Woods assured him, announcing his efforts to enroll in culinary school.
The judge ordered Woods to report for weekly drug tests and to check in regularly with his probation officers. "I have a lot of faith in you," he told the defendant, while reminding him that jail still loomed.
After the hearing, Woods said he feared returning to jail largely because it would cost him his fiancée . But he believes the mental health court has made a difference. "It helps me realize you do have choices in life," he says. Yet he says he's never quite sure what the next moment will hold. When he's off medication, he says, trouble lurks. Last winter he walked out of mental health court, only to be arrested hours later for shoplifting a pair of gloves.
Still, Woods counts himself lucky. He's nearly 50—an age, he says, that his father never reached.