Evaluating the Anchorage Mental Health Court

Evaluating the Anchorage Mental Health Court

Teresa W. Carns

Carns, Teresa W. (Winter 2002). "Evaluating the Anchorage Mental Health Court." Alaska Justice Forum 18(4): 2. The Alaska Judicial Council is in the first stages of evaluating all of the therapeutic court programs currently underway in the Alaska Court System, including the Court Coordinated Resources Project (CRP), also known as the Anchorage Mental Health Court. Evaluating the Mental Health Court presents special difficulties. Unlike other therapeutic projects which focus on drug or alcohol addiction, the expected outcome in Mental Health Court is not a cure but stability or improvement in the situation. Because each defendant's situation and illness or condition is different, the program may differ for each client and may last for a different length of time.

The Alaska Judicial Council is in the first stages of evaluating all of the therapeutic court programs currently underway in the Alaska Court System. Although demonstrating the effectiveness of therapeutic justice projects will be essential to their continued existence and improvement, the data desired by policymakers and citizens can be very difficult to obtain.

Evaluating the mental health court project (Court Coordinated Resources Project, or CRP) has presented special difficulties. In those therapeutic projects which focus on drug or alcohol addiction, the programs have been designed to include a beginning—usually the date on which the defendant's plea is entered and final agreements are signed—sometimes phases or specific steps, and an end—the "graduation" date. These programs typically include a specified set of activities: status hearings before the judge with all members of the team, monitoring of drug or alcohol use, specific sanctions and incentives, treatment requirements, and other conditions such as employment. Each defendant receives similar treatment.

In contrast, the mental health court project usually handles defendants who are chronically ill, for whom the expected outcome is not a cure but stability or improvement in the overall situation. Because each defendant's situation and illness or condition is different, CRP does not have a set program for each defendant. Not only do programs differ for each client, they may also last different lengths of time—from a few weeks to a year or more. There are no specific criteria for successful "completion" of a CRP program: the judge, treatment providers, case managers and attorneys must decide when the defendant has met the requirements set in the treatment plan. In the other therapeutic court projects, all of a defendant's cases are consolidated before the therapeutic judge as a condition of participation. In CRP, some defendants have cases that are not handled by the CRP or have different CRP cases going on at the same time. CRP defendants may complete a treatment plan or leave the program and then return months later with a new CRP case.

In designing an evaluation of the project, the Judicial Council has first set parameters for each case. The starting date for evaluation will be the date of the first CRP hearing in the case file. A case will be considered to have received CRP services if it has at least four total CRP hearings described in the file. The end date for evaluation purposes may be a date shown in the file as the end date (these rarely are available for project cases before April 2001), the date of the last hearing in the case, or a date—chosen depending on the date when the evaluation data are being collected—six months, one year, or another appropriate number of months after the first date in the file. The services provided will be distinguished according to case management providers. Finally, the outcomes for each defendant will be based on the defendant's own record before and after entering the court. Because of the referral processes used to send defendants to CRP, and the resources available for the work, it is not possible to define an experimentally valid control or comparison group.

The Judicial Council has designed two different databases for information about each case. The first, the criminal justice database, focuses on the charging and sentencing aspects of each case. This database includes data about not only CRP defendants but defendants in each of the other projects that the Council is evaluating and any control or comparison group defendants for the other projects. This database will have less information about individual defendants, but will permit analysis within each therapeutic justice project and also among the individual projects.

The second database derives from a database designed for use by any drug court or therapeutic project and approved by the Department of Justice. The Judicial Council is adapting this database to meet the needs of each individual therapeutic project. It will include much more information about each defendant, the intake process, case management, and outcomes. Obtaining the data will require that the case manager interview the defendant and incorporate information from a variety of sources—court hearings, case file, treatment providers, etc. Because of these restrictions, the custom databases will primarily contain information about the defendants actually receiving services from the therapeutic justice project. Information about earlier participants in the projects or about control or comparison groups will have to be separately entered from case files or other sources of information. CRP staff and the Judicial Council are still adjusting this database to meet the project's needs.

The outcome measures for the mental health court project include a comparison of the numbers of days incarcerated from before the program to those after a certain period in the program and a comparison between the number of days spent at Alaska Psychiatric Institute before and during/after participation in CRP. These data will come from the Department of Corrections and API. The evaluation will determine the total number of days the defendant has been incarcerated or at API during his adult lifetime, the number of days spent during the year before the defendant entered the CRP project, and the number of days spent in either location after receiving services from CRP for a specified period of time (e.g., six months, twelve months, or other appropriate period). Two different criteria will indicate improvement or success. If the defendant spent significantly fewer days in incarceration or API during the period of actually receiving services from CRP, the defendant's handling will be described as successful, because CRP services cost the state substantially less money than either incarceration (about $114/day) or API. If the defendant spends significantly fewer days in either situation after the end of CRP services, it will be considered a further success.

Other criteria for success may also be used, depending on the data available for the evaluation. For example, an improvement or stabilization in a defendant's housing situation as a result of CRP services also shows success. The number of these criteria that can be used and their validity will depend upon the data collected by program staff and made available to the evaluators. The Council will also draw on data from other agencies, such as criminal history information from the Department of Public Safety. The Council will make status reports every six months to the court and the Mental Health Trust Authority.

Teri Carns is the senior staff associate with the Alaska Judicial Council. She is also co-authoring a piece on therapeutic justice in Alaska that will appear in the June 2002 issue of the Alaska Law Review.