A meaningful collaboration

Pioneering Mental Health Court Clinic trains students to represent a vulnerable population

By Katherine Hedland Hansen

Russell Kurth advises Rule 9 intern Meg Giske during a hearing at the Seattle Municipal Health Court. Behind Kurth is city prosecutor Andrea Chin.

Seated at the counsel table, a young defender gently questions her client, a homeless and mentally ill man who has been arrested for trespassing.

She asks him if he knows why he was arrested, why he's in court and if he understands the process. Clad in a red jail jumpsuit, shackled at the wrists, his long, unkempt hair tucked behind his ears, he tries to answer.

"I was removed from the property," the man replies, as the judge watches, listens and takes note of the man's demeanor as well as his answers.

"Do you know what that's called?" asks Megan Giske, a third-year student at Seattle University School of Law appearing in court as a Rule 9 intern.

"Um, removal?" he guesses, becoming slightly frustrated and agitated at the questions.

Sensing the client's mood, Giske calms and reassures her client: "You doing OK? You're doing a good job."

The client continues, explaining that he was sitting under an awning in front of a business in downtown Seattle.

"Why were you there?" Giske asks.

"Just trying to stay out of the rain," he replies with a sad shrug.

After a few more questions, the judge says he has enough information to conclude that the client, who was previously declared incompetent to stand trial, cannot assist in his own defense. The charges are dismissed, and he will be detained until mental health professionals evaluate whether he can be released or if he needs in-patient treatment. Social workers will try to connect him with housing.

This client is just one of the thousands of mentally ill people who come through the criminal justice system every year. As courts throughout the state and the country struggle with how to deal with mentally ill criminal offenders, Seattle University School of Law has started a groundbreaking clinic to train and inspire lawyers to work with this vulnerable population. Giske is part of the first group of students to have the opportunity to participate.

The Mental Health Court Clinic at the Ronald A. Peterson Law Clinic is believed to be the first of its kind in the country. Through an innovative partnership with Associated Counsel for the Accused (ACA), students get first-hand experience representing clients in Seattle Municipal Mental Health Court.

"Mentally ill people spend seven times longer in jail than others because the system doesn't know what to do with them," said Russell Kurth, an experienced mental health court practitioner at ACA and a Distinguished Practitioner in Residence at the law school who teaches the new clinic.  "How can we make the system better? How do we help the legal system deal with the mentally ill?"

Students and graduates want to help find an answer to that question, and to help the mentally ill individuals who find themselves in court.

"In the Mental Health Court Clinic, I gained practical experience in everything from criminal procedure to client counseling," Giske said. "But most importantly, I learned how to advocate for a very unique population."

She previously spent a summer as a Public Interest Law Foundation intern for the Northwest Justice Project working on public benefits cases and was involved in community outreach projects targeted at homeless and at-risk youth. She hopes to continue working with the Mental Health Court. That's just what the law school hoped for when it started the clinic.

"We need more astute, knowledgeable people going into this field to give a voice to those who have none," said Karen Murray, municipal court supervisor for the Associated Counsel for the Accused and a 1991 graduate of the law school. "It's humbling to know that we as attorneys can do so much if we use what we have learned in the right way, and with passion and not for personal gain."

A court that people run to  

Seattle Mental Health Court was the first municipal court of its kind in the country. Now in its 11th year, it is recognized as one of the leading and highest volume courts in the country dedicated solely to criminal cases involving mentally ill defendants. It is one of the few that operates as a both a competency and a therapeutic court, protecting the rights of incompetent clients to not be prosecuted and offering those deemed competent assistance with housing, treatment, chemical dependency and other services. Prosecutors, defense attorneys, social workers, police and others work together to design a program of support and supervision that meets the goals of improving the quality of life for each client, protecting public safety and reducing system costs.

"We are more successful at achieving these goals when we work together," Kurth said.

"Clients have a group of people who care about them and are trying to help them navigate through life. That simple fact makes all the difference. A lot of these cases are a failure of our society to take care of its downtrodden."
Russell Kurth, Distinguished Practitioner in Residence

Instead of simply locking people up, the Mental Health Court helps get to the root of the problem. For instance, nearly 80 percent have drug or alcohol addiction in addition to a mental illness. Most have no transportation, and many are homeless.

Through the court, attorneys, social workers, psychologists and others direct clients who are amenable to treatment, counseling, housing and other benefits. Programs linked to the court have immediate beds for substance abuse treatment, spots in transitional housing, access to mental health care and other services. The Seattle Police Department has a crisis intervention team with officers specially trained to look for signs of mental illness, two of whom work directly with the court - also a first in the nation.  

Even with the services it offers, Kurth said the court's early intervention saves the city, county and social services agencies an estimated $1 million per year. He said it's an effective, if still limited, response to a significant social problem.  As the number of inpatient hospital beds for the mentally ill in the country has decreased from 550,000 in the 1970s to fewer than 50,000 today, the nation's correctional system has been overwhelmed by the resulting untreated mental illness. The Department of Justice reported that in 2007, 64 percent of people incarcerated in local jails had a mental illness.  The numbers for state (56 percent) and federal (45 percent) facilities are only slightly less alarming.

There were no mental health courts before 1997, but there are now more than 200, including others in Washington. While Kurth has made this his life's work, he envisions a day when people with mental illnesses will receive the treatment and care they need in the community and in hospitals before they ever see a jail cell or courtroom.

"The increase in mental health courts is a good thing," Kurth said. "On the other hand, they should not be needed to the extent they are. Morally, financially and in the interest of public safety, we must learn to care for our mentally ill before they are incarcerated."

Those who stay with the court program for two years have an 83 percent reduction in criminal behavior, Kurth said.

"We don't want people to run away," he said. "We're a court that we want people to run to."

Collaboration and compassion

In harmony with the collaborative spirit of the court, the law school requires students interested in the clinic to first complete the course in Law, Policy, and Mental Health taught by adjunct professor Mike Finkle, who was the lead Mental Health Court prosecutor for the Office of the Seattle City Attorney and was recently appointed a King County District Court Judge.

Before his judicial appointment, Finkle spent 24 years as a prosecutor. When he began working in the Mental Health Court 12 years ago he saw the benefits of a collaborative, rather than an adversarial, court for these cases involving often fragile people.

Though it's collaborative, defense attorneys still zealously advocate for their client, and prosecutors work in the interest of the community.

"The goal of the court was always to protect public safety by addressing the unmet needs of the mentally ill," Finkle said. "Russell and I didn't always agree on the 'how,' but we did always agree that Mental Health Court was the right place for these cases."

Jessica Mullan '09 is a fellow with the Mental Health Court Clinic. After representing juvenile clients in the law school's Youth Advocacy Clinic, she spent her final semester as an extern with ACA working with Kurth in the Mental Health Court. She found the court's approach so rewarding that she volunteered with ACA after taking the bar exam and before she was offered the fellowship.  She serves as a role model to the clinic students as a member of the court team and someone who appreciates this alternative form of practice.

Clinic student and Rule 9 intern Nick Allen talks with a client.

"It makes so much sense to have a collaborative court," Mullan said.

That collaboration extends to scholarly and professional presentations as well. Finkle, Kurth and Mullan coauthored an article about competency courts for the journal Behavioral Sciences and the Law, and Kurth and Finkle have given numerous joint presentations around the country. In addition to educating, they hope to encourage other jurisdictions to follow their lead.

Kurth was drawn to this assignment because of his personal experience with his sister. She was diagnosed with bipolar disorder and Munchausen by proxy syndrome, in which a parent will fabricate or induce symptoms or illness in a child in order to gain attention and sympathy. His parents have custody of his nephew.

Though he is estranged from his sister, his experience made him more comfortable dealing with mental illness and more determined to seek solutions for those who suffer.

"Mental illness changed the landscape of our family," Kurth said. "I tried to help my sister and I couldn't, but I had to help her son. I'd like to lessen the impacts on other families."

Chris Browning and his wife, Liz, know well the pain that mental illness can cause a family, and the difference a mental health court can make. After years of struggling to deal with their son's schizophrenia, they met Kurth when he was appointed to represent their son after he was accused of assault. Kurth's efforts diverted their son from jail and helped him get the treatment he needed.

"It was a life-saving turning point for our son," Chris Browning said.

The clinic is funded in part by grants from his family's foundation, the Val A. Browning Charitable Foundation, and the Nesholm Family Foundation.

"We were fortunate to have the Browning Foundation's support in spearheading this effort to keep our most vulnerable out of the criminal justice system," Chris Browning said. "We were doubly fortunate to collaborate with Seattle University School of Law's Clinic faculty and administration to found this clinic."

It definitely takes a certain type of lawyer to take on this job.

"This is difficult work, full of challenges, but also great rewards," Kurth said. "We're not just advising them. You have to want to talk to them, and to be patient and develop a rapport. You are their counselor and their advocate."

"Nothing to be ashamed of"

The Mental Health Court Clinic exposes students to many cases that are difficult, both legally and emotionally. Before the afternoon court hearings, defense attorneys, the prosecutor, social workers, probation officers and others with knowledge of the clients and the cases meet to discuss the day's docket. They drink Diet Dr. Pepper, eat lunch and talk about what's ahead to try to determine the best way to address each case on that day's docket. They don't always agree, but they hear each other out before heading into the courtroom.

"The law can be a healing profession. The work of the mental health court attorneys is evidence of that."
Dean Annette Clark

Each client has different needs, obstacles and support systems, and representing them provides students invaluable experience and insight. One day, Giske again sat before the judge questioning a client who had experienced a clear break from reality.

"I don't recognize this court as being an authority over the universe..." the woman said. "All laws are written by Satan, and you're trying me by Satanic laws."

Student Nick Allen represented a pretty, soft-spoken woman who was accused of stalking and violating an anti-harassment order. She quietly explained that she didn't understand why the person has filed such an order against her, when she only wants to share God's love.

Both women were detained for further evaluation.

Student Andrew Rice struggled to get through to another client who had refused to take part in a mental health evaluation. The client appeared for court wearing a tie, and sat quietly awaiting his turn to speak to the judge. Rice, Kurth and the judge tried to persuade him to agree to an evaluation, but the man continued to decline, using a nonsensical jumble of legalese as explanation. Eventually the judge ordered him to jail to be examined by mental health professionals.

Municipal Court Judge Michael Hurtado presides over Mental Health Court. Firm but compassionate, he demands respect for all defendants. 

"No one will ever be berated in this court," Hurtado said. "A mental illness is nothing to be ashamed of."

There are many success stories. Clients who are in compliance with the conditions imposed by the court check in and get encouraging words from the judge.

"I hope you look at this as a way of getting help," Hurtado told one woman who was doing well in the program. "We all need a little help one way or another."

Another woman who had met her court-ordered obligations for two years proudly accepted a certificate showing she had graduated from the court.  

"You're the one who decided to take advantage of the services this court offered to make yourself well," Hurtado said as he shook hands with the client.

She thanked everyone for the support along the way.

"It's good to have a court that supports equal human rights for all," she said.

Annette Clark, interim dean at the law school who also holds a medical degree, said it's fitting that such a clinic found a home at Seattle University School of Law, which strives to educate outstanding lawyers to be leaders for a just and humane world. The law school has hopes for the clinic and related courses to expand to include other problem-solving courts.

"The law can be a healing profession," Clark said. "The work of the mental health court attorneys is evidence of that.

Summer 2010