Target Problem and Rationale
The process that formed the King County Mental Health Court was catalyzed by the brutal, random murder of Fire Department Captain Stanley Stevenson by a mentally ill offender in a Seattle park in August 1997. The assailant was a misdemeanor defendant who had been found incompetent by the Seattle Municipal Court. The defendant was released into the community by the court just prior to the homicide. The shocking incident prompted King County executive Ron Sims to convene a task force including broad representation of mental health and justice system professionals to review how mentally ill offenders were handled by the justice system. The Mentally Ill Offenders Task Force, chaired by the Honorable Robert Utter, retired chief justice of the Washington Supreme Court, was given the responsibility of making recommendations for improving the handling of mentally ill persons in the criminal justice system. Among many other suggestions, including reevaluation and reform of competency law, the Task Force recommended the establishment of a mental health court in the King County District Court on a pilot basis.
King County District Court Chief Judge James Cayce led a mental health court Task Force to develop plans and examine the feasibility of establishing such a court. In February 1998, as part of that process a group of judges, as well as other justice and health system officials, visited the Broward Mental Health Court and, upon their return, incorporated their observations into a plan released by the Mental Health Court Task Force in August 1998. After further planning, budgeting and coordinating activities, the King County District Court Mental Health Court began operation in February 1999.
King County?s Mental Health Court Task Force identified several areas in justice processing that failed to address difficult issues raised by the mentally ill and that appeared likely to contribute to their frequent returns to the system. Under normal court procedures, defendants might appear before a number of different judges as their cases were heard at various stages of processing, even in the same case. With little extra attention paid to individual defendants as cases moved through a high-volume court system, mentally ill defendants?whose mental illness may have caused their involvement in criminal justice?were simply moved through the court process like everyone else. Moreover, judges presiding over high-volume courtrooms did not have special training in dealing with the special issues presented by the mentally ill, nor were they generally aware of the treatment resources that might be available in the county to treat the offender and protect the public.
When charges were dismissed, the mentally ill defendant merely disappeared from the court?s jurisdiction, hopefully to be handled by other agencies elsewhere. Other mentally ill offenders would, upon conviction, be sentenced to probation or local jail time, two options also usually poorly suited to their problems. The Mental Health Task Force found that, as a result of normal procedures, mentally ill defendants and offenders often reoffended and were recycled through the system again and again. In fact, the King County Mental Health Court Program Narrative reports that a 1991 study of the King County Jail showed that offenders admitted to the psychiatric unit had an average of 6 bookings into the jail in the 3 years prior to their current offense, with longer average lengths of incarceration than comparable nonmentally ill inmates (Steadman, 1991).
In its planning stages, the King County Mental Health Court was greatly influenced by the Broward County Mental Health Court, which began operation about a year and a half earlier. The King County Mental Health Court had seven primary goals outlined by the Task Force in Recommendations for the King County Mental Health Court (August 1998). They included:
Following the example of the Broward Court, the King County Mental Health Court employs a team approach. It is made up of court representatives from justice agencies and treatment providers who are assigned to the Mental Health Court and develop relevant expertise through intense training and experience in the mental health and court systems. An important aim of the approach is to have a strong and experienced team proficient in dealing with the problems associated with the mentally ill in the criminal caseload; one consisting of individual members who work well together and who provide a ?seamless connection? between community mental health and the criminal justice system. In King County the dedicated team approach is intended to eliminate the gaps and problems in communication characteristic between agencies and organizations that are part of the problem.
District Court has jurisdiction over misdemeanors (offenses with maximum penalties of no more than 1 year in jail) in King County, although municipalities in the county, like Seattle, also have municipal courts that have jurisdiction over misdemeanors. With an estimated 29,199 misdemeanor cases entering the system in 1999,13 the King County District Court represents a high-volume urban misdemeanor court. The King County Mental Health Court considers candidates who are charged with misdemeanor offenses.
Mental Health Court candidates include individuals whose crimes or charges appear related to mental illness, who have been referred for competency evaluation, whose medical histories include a diagnosis of a major mental illness or an organic brain impairment, or who are determined by court clinicians to need mental health treatment. In addition, many candidates have records of prior arrests or convictions, which may include felonies and crimes of violence, provided mental illness is believed to have been a causative factor in the candidate?s history, or a factor in the current offense. In fact, one current court participant has a prior conviction for murder and rape, both of which are believed related to his history of mental illness. The court believes that they are able to provide proper supervision for these types of defendants, and considers part of its mission the treatment of dangerous individuals such as the violent offender whose much publicized crime triggered the development of the court initially. Participation in the Mental Health Court is voluntary and, after the model of some drug courts, was originally designed to require a guilty plea or a plea of no contest and, in most cases, results in a term of probation and a suspended jail sentence. Consequently, most of the defendants were likely to have convictions on their record at the end of the treatment process. Since that time, the program has evolved, such that a larger number of defendants may enter the court through a statutory petition for deferred prosecution or an agreement with the prosecution for a deferred sentence. With successful participation in the Mental Health Court, these defendants are much more likely to have charges withdrawn and not reflected on their records.
Candidates for the Mental Health Court are identified principally at the post-arrest stage by the jail medical staff while awaiting their first court appearance in the county jail. However, referrals also come from justice officials, other misdemeanor courtrooms, or friends or family who may believe that an individual?s involvement in the criminal process is the product of mental illness. To expand the scope of misdemeanor defendants eligible for its services, the District Court has been negotiating with misdemeanor courts from nearby cities, including Bellevue and Shore Line, to have their defendants referred for participation in the King County Mental Health Court.
The King County Mental Health Court has received 199 referrals since February 1999. Most (76 percent) were male, between the ages of 31 and 50 (61 percent), and white (74 percent). About half (51 percent) had been referred by the jail, with an additional 43 percent sent by judges, 3 percent by defense attorneys and the remainder by family members or probation officers. Seventy-one percent of the defendants were in custody at the time of the referral. The majority of the referred defendants (55 percent) were not in mental health treatment at the time of the referral. Twenty-five percent were homeless at the time of referral. Only 22 percent were able to live independently. The remainder lived in either some form of supported living arrangement, or their residence location was unknown to the court. Forty-five percent of those referred had a co-occurring drug or alcohol disorder.
King County Mental Health Court Procedure
The King County Mental Health Court process begins with identification of possible candidates at the probable cause/bail hearing stage. (For an overview of the referral process in King County, see Figure 2.) Although referrals to the Mental Health Court can come from police who believe an arrestee may be mentally ill, generally candidates are drawn from among misdemeanor arrestees who have been detained pending their first court appearance (which occurs within 24 hours of arrest). Upon admission to the detention facility in Seattle, mentally ill defendants are first identified through the jail?s normal intake screening procedure. When the assessment indicates that a detainee has serious mental health problems and might be a candidate for the Mental Health Court, the defendant is informed about the program and his or her consent is requested so the jail staff may share the information in the assessment with the Mental Health Court. Should the defendant refuse but be found competent,14 the confidentiality of the information obtained is assured. When a defendant appears to be mentally incompetent, the court is alerted by the jail staff, who then send a memo to the court containing the defendant?s name and charges only, without detailed defendant information. When a defendant does give consent, the assessment information is provided to the court for review. All members of the Mental Health Court team of professionals are notified by e-mail that the particular defendant is being referred. In this way, each actor in the court process has an opportunity to prepare for the defendant?s first appearance in the court, usually the following afternoon.
Generally prior to their first appearance in the Mental Health Court, candidates are interviewed at the jail by the court monitor. Her job is to gain an understanding of the defendant?s mental health issues. As part of that process, she requests a release of information approval from the defendant to enable her to access the defendant?s treatment history, if any. If possible, she will also communicate with the case manager who has handled the defendant?s treatment in the past. The court monitor prepares a report for the Mental Health Court containing information about the defendant?s history, including any current medications, history of compliance with treatment, behavior at home and/or in the jail, as well as information about housing and family support, if any.
In addition, the monitor prepares a treatment plan that would go into effect upon the defendant?s release and participation in the King County Mental Health Court, including living arrangements and provisions for supervision and treatment. During this process, the monitor spends time getting to know the defendant as well as explaining the workings of the Mental Health Court to the defendant and offering preparation for the hearing and the period following. Ideally, the report and proposed treatment plan that the monitor produces are provided to each of the relevant courtroom staff prior to the defendant?s first hearing. The Mental Health Court is also alerted to competency issues based on the opinion of the court monitor through her informal evaluation and information given to her by the jail medical staff. There is currently no formal assessment instrument, although such a tool is being developed for use by Mental Health Court staff.
Prior to the start of the first hearing, the prosecutor, the public defender and the court monitor, will meet to review the information gathered about the candidates and to discuss the particular mental health issues that may be involved. The discussion includes the analysis and recommendations of the court monitor as well as analysis from the jail mental health staff, with input from the prosecutor and defense counsel.
The first hearing begins with a determination of probable cause, particularly if defendants were referred to mental health court before a probable cause hearing was held in the normal fashion before a traditional court judge. Once probable cause has been established, the King County Mental Health Court judge then proceeds to address the major threshold issues: competency and detention. Most of the defendants who are candidates for this court are in custody due primarily to homelessness or instability related to their illness that puts them at higher risk than nonmentally ill defendants to fail to appear in court for the next hearing date. One of the Court?s principal objectives is to place candidates in treatment as soon as possible and avoid further confinement.
The Program Manager reports that an estimated 15 percent of the candidates appearing at the first hearing in Mental Health Court appear to be incompetent and are referred to Western State Hospital for competency evaluations through an order of the judge. Defendants who are found competent are returned to the Mental Health Court. Incompetent defendants charged with a violent offense, who have a history of violence, or have been found not guilty by reason of insanity or incompetency on charges involving physical harm in the past, may be held under the state?s competency statute, Title 10 RCW, section 10.77.090,15 which allows for hospitalization for up to 29 days (including the time it takes to complete the evaluation), and/or 90 days of out-patient treatment, to try to restore competency. Defendants who do not meet the criteria may not be held by the state for the additional 14 days and must have the charges dismissed. However, such defendants may also be evaluated to determine the appropriateness of civil commitment.
Defendants who, at the end of this period, are restored to competency are rescheduled to appear in Mental Health Court to decide upon participation in its program. Defendants who are still found to be incompetent at the end of the statutory treatment period must have their criminal charges dismissed. They must also be referred to the county-designated mental health official for evaluation to determine the appropriateness of involuntary civil commitment. At this stage, the focus of the inquiry will be on whether the defendant poses a danger to public safety or security, and will not depend upon whether or not the defendant was charged with a felony.16 In the past, the court lost jurisdiction over misdemeanor cases once the defendant was found incompetent to stand trial.
Once the threshold question relating to competency is resolved, the judge decides whether to accept the case and determines whether the defendant wishes to participate in the program based on the input from the Mental Health Court team and on consideration of the monitor?s report and treatment plan. In the cases of defendants who are competent but unstable, the judge?s next concern is to determine the nature of treatment and support services appropriate for the defendant so that an informed decision about entry into the Mental Health Court program can be made.
Because in many cases the defendant is confined prior to this hearing the next important decision involves the defendant?s release from custody. The judge not only seeks to release the defendant from custody but to place the defendant in the community with the services that will be needed to en-sure safety and stability. Once such a service plan is set up, the defendant will be released as soon as possible under the supervision of a case manager who will monitor and support the defendant, now a Mental Health Court participant, through the process. Defendants who already have a home to return to with an appropriate support system are released quickly. Others are released from jail when a shelter bed or other appropriate placement becomes available, usually within a week. Thus, although the judge seeks to release the defendant from custody as soon as possible, the defendant remains in custody at the jail with jail-based services and monitoring by the Mental Health Court until the appropriate release options can be employed.
In the experience of the King County Mental Health Court so far, it appears that few defendants refuse the treatment option once the preliminary matters are completed. Even so, most candidates who wish to enter the program are released pending adjudication under the terms of the service plan for an initial period of a week or two. During this period of provisional participation, defendants are given the opportunity to become familiar with the aspects of the proposed treatment regimen under the supervision of the court monitor before they are returned to court to make a decision about whether they wish to continue. Upon return to the Mental Health Court, if a defendant should decide to opt out of the program, the criminal case is simply listed in the normal fashion for adjudication. Defendants may occasionally prefer going to adjudication because they do not agree that they have a serious mental health problem or because they believe that they have a good chance of a favorable outcome at trial.17 Under the original program design, defendants who choose adjudication were not eligible to return to Mental Health Court upon conviction. This policy was recently revised to allow a defendant who requests a trial to continue to attend the treatment program to which they were provisionally assigned on their own, whether they are ultimately convicted or not. Should they be found guilty at trial, the defendants are now eligible to return to treatment court program.
Defendants who decide to enter the Mental Health Court treatment program must address their charges first, either by entering a plea of guilty or no contest to the misdemeanor charges, petitioning for a deferred prosecution,18 or entering an agreement with the prosecutor for a deferred sentence. Statute governs the deferred prosecution in Washington, where it is considered a pre-arraignment disposition. No finding of guilt is entered for the defendant and upon successful completion of the program the defendant is eligible to have his charges dismissed. The defendant must petition for the deferred prosecution, which may be granted by the judge over the objection of the District Attorney. The deferred sentence generally comes about as a result of plea negotiations between the prosecutor and the defense attorney. While there is an initial finding of guilt, defendants who successfully complete the program are eligible to have their charges dismissed. A disposition can be granted by the judge over the objection of the prosecutor. In most cases, the defendant will be placed on probation in the Mental Health Court for up to 2 years or will receive a suspended sentence of up to 1 year while participating in the program. For individuals pleading guilty to driving-under-the-influence charges, pleas are accepted and a sentence of up to 5 years? probation may be imposed. In some instances, persons charged with domestic violence misdemeanors are determined to be eligible for the court. In these cases, defendants are granted a ?stipulated order of continuance.? In it they waive the right to a jury trial and agree that if they do not comply with the conditions of release to the Mental Health Court treatment program the judge can find him guilty on the basis of the facts in the police report without taking any testimony.
In appropriate domestic violence cases, successful completion of the Mental Health Court treatment program results in dismissal of the charges (and no record of conviction), following procedures often employed in misdemeanor domestic violence cases in regular court. This permits an opportunity in cases of mentally ill defendants who have been charged with domestic violence-related offenses to begin and complete treatment without being required to plead guilty. The matter is handled in this way in order to assure that these defendants are not penalized for trying to address their illness by opting to enter treatment court.
From February through December 1999, 54 defendants (27 percent) of the 199 defendants referred decided not to enter the King County Mental Health Court treatment program and were transferred back to normal criminal calendars. Dispositions for the remaining 145 defendants included the following: 69 defendants (48 percent) chose to participate and an additional 33 (23 percent) remained undecided as of December 31, 1999. Of the remaining 43 defendants, 6 cases had been closed, 17 cases were dismissed by the prosecutor, 13 cases were screened out as being inappropriate for mental health court, and the prosecutor elected not to file charges in District court in 7 cases. Of the 69 defendants who entered mental health court, 35 pled guilty, 8 received stipulated orders of continuance, and 6 were granted deferred prosecution status. The 20 remaining participants were referred from other courts, either having already been placed on probation, or having pled and had the sentencing transferred to mental health court. As of the end of the year, 63 participants were on active probation.
Once the candidate opts in or formally enters the Mental Health Court, a probation officer is appointed to supervise the participant. The probation officer works as part of the Mental Health Court team and maintains close contact with the participant, whether in custody or in the community. The probation officer coordinates and communicates with the caseworker at the treatment facility handling the defendant?s care and the Mental Health Court case manager. Once the treatment plan is put into effect, the probation officer and the case manager check on the participant?s progress and ensure that court-ordered treatment is being provided.
Participants are required to return to King County Mental Health Court for review hearings at regular intervals?or when the judge determines that it is necessary?to assess whether they are complying with the requirements of the treatment process or there are any difficulties that need to be addressed. One of the most common issues for supervision surfacing at the review hearings involves the participant?s failure to take the prescribed medication. In cases in which the participant appears to be having great difficulty in complying with the treatment process, a hearing may be scheduled and the defendant may be taken into custody if found to be in violation of the terms of probation, and such a sanction is deemed appropriate. In rare instances, failure to take medication may mean that the participant can become a threat to himself or others. In such cases the court may refer the defendant to the state hospital to determine whether temporary involuntary civil commitment is necessary. The use of jail to motivate the participant to take the program seriously is rare (usually jail is what the Mental Health Court is seeking to avoid). When it occurs, it usually is for short periods of no more than a few days detention. Defendants who are purposefully noncompliant and who do not respond to repeated counseling by team members and the judge in court appearances may have their probation or suspended sentences revoked and be ordered to serve their sentences in jail.
The Treatment Approach in the King County Mental Health Court
King County Mental Health Court supports its participants in treatment by drawing on an array of treatment programs and ancillary services available through the county?s existing community mental health system. The community mental health network of services includes 17 treatment facilities at locations throughout the county. Although the geographic coverage offered by these programs is an asset to the Mental Health Court, the size of the county and the number of treatment services involved initially posed a challenge to the Mental Health Court in coordinating services, communication and procedures.
The King County Mental Health division has contracted with United Behavioral Health (UBH) to oversee the managed care network, to coordinate the treatment, and to monitor and act as case manager for its participants as they are referred to the 17 mental health providers. The court monitor employed by UBH for the purpose of managing the Mental Health Court caseload is the link between treatment providers and the court. The monitor ensures that the providers respond to the wishes of the court promptly, from expediting screening of candidates for the court to addressing particular problems with services that might arise during the Mental Health Court treatment process. The court monitor assigns an agency to each participant to determine what services are needed and to monitor the progress of treatment carefully for the court.
Participants are assigned to programs based upon their individual needs, and at locations as near to their living situations as possible to facilitate attendance in treatment. The types of services provided vary depending on the particular problems of the participants, but may include medical evaluation, monitoring of medications, psychotherapy, supervised living situations, and other relevant social services. In addition, vocational preparation and an educational component are available to defendants who have the ability to benefit from them. Most of the defendants are placed in community-based, out-patient programs, unless acute care or more intensive services are needed. When in-patient or residential treatment is recommended, participants must specifically consent before they can be placed in a program. Participants who refuse the structure, support and supervision of in-patient programs may be held in jail for lack of other sufficiently secure options. Jail is used as a last resort, in part because services provided there are not as comprehensive and are by nature short-term, and in part because the Mental Health Court seeks as one of its primary goals to move mentally ill individuals out of jail into community treatment.
The participants entering the King County Mental Health Court present a variety of challenges for treatment services. One of these challenges is the large number of participants dually diagnosed with substantial substance abuse problems as well as serious mental illness. Given the nature of the criminal justice-based population of participants entering the treatment process, the King County Mental Health Court has discovered in its early stages of development that services for the dually diagnosed are insufficient. Unfortunately, only eight providers in the county network are able to treat dually diagnosed participants on an out-patient basis. In addition, only two programs, one run by the county, and the other by the state, are available to provide MICA services on an in-patient basis for these participants, and there is a long waiting list at both facilities. Thus, there is a shortage of treatment resources available to deal with this commonly encountered type of participant. There are also special programs available in King County to address problems such as anger management or domestic violence issues.
The Mental Health Court experience in the early stages has also shown that a majority of participants require assistance in finding appropriate living arrangements. Resources are very limited for patients requiring residential programs and structured living arrangements. The need for structured living situations varies on a case-by-case basis. For some participants who are in immediate crisis, special housing to support stabilization of their mental health symptoms is an urgent requirement. Others homeless participants may have been accustomed to living in makeshift living arrangements and now resist any type of structured living arrangement. Although a variety of programs are utilized to try to address these needs, the county is not well funded to meet the needs of the mental health defendants for structured residential care. To make up for the lack of availability of structured care situations, the Mental Health Court attempts to supplement the support and supervision it provides with ?wrap around? services. Through these services the defendant is engaged in some sort of structured treatment or activity from morning to night each day, with specialized case managers who visit the participant daily to monitor compliance with day treatment and medication, and try to respond to problems as they arise.
At this stage of its development, the King County Mental Health Court itself does not have an aftercare program, but seeks to facilitate the participant?s transition to full use of community mental health services after involvement with the court. The use of community services is voluntary, of course, so that an aim of the court treatment process is to build strong links to appropriate services for participants so that most will carry on without supervision by the Mental Health Court. In its planned evaluation research, the Mental Health Court intends to track the clients for 3 years after release from probation to see whether they were successful in preparing clients to continue to access the support services.
Success and Failure in the King County Mental Health Court
It is early in the development of the King County Mental Health Court to measure program successes. However, two kinds of measures seem to be available for assessing the realization of the court?s goals, short of the longer-term evaluation it has planned. The court?s initial aims have included identifying and enrolling (from the jail, other courtrooms, friends, relatives and attorneys) mentally ill persons charged in misdemeanors. In 10 months of operation, the King County Court had screened (received and evaluated) 199 referrals and enrolled less than half of them in the court-supervised treatment process. Although Judge Cayce believes there are many more mentally ill misdemeanor defendants in King County who could benefit from participation in the Mental Health Court, the court has already begun to tap a potentially large population and gained some operational experience. It has identified resource and treatment needs in its first months of operation. In addition, the court has revised some of its program requirements, including the policy that required the loss of the treatment court opportunity to defendants who opted to contest their charges at trial, and the requirement that the majority of the defendants plead guilty in order to enter the program. The court is now open to the return to treatment court of defendants who are convicted at trial, and the option of deferred prosecution or deferred sentencing dispositions, with the likelihood of a dismissal of the charges upon successful program completion, is being more liberally granted. These adjustments will result in expanded opportunities for defendants to enter into the treatment court program without necessarily being penalized with a criminal conviction.
According to the Mental Health Court?s mission, the principal measures of success are to place participants in appropriate medical, behavioral health treatment and related services, and to monitor, case manage and supervise them through their involvement with the Court. With rare exceptions, the terms of probation extend for 1 year. Thus, a negative measure of the court?s performance would be large numbers of participants who violate conditions of probation, or suspended sentences, who then had to serve jail or probation sentences outside of the control of Mental Health Court. These data are not available at the time of this writing, particularly because the court is only about 1 year into its implementation. More difficult interim measures would seek to indicate how well candidates had been placed into treatment, had stabilized and were functioning. Because participants have different problems related to their mental illnesses, an early measure would reflect forward progress in bringing participants into stable settings and more normal life routines. The use of probation as the principal vehicle for supervision by the court will provide data for measures of compliance and progress at a later date. At this stage, with the King County Mental Health Court still adapting and expanding, the most relevant measures of success have to do with implementation of services and reaching the intended target population.
13 This information can be attributed to the District Court financial officer, Office of the Administrator for the State of Washington, Caseloads at the Courts of Washington (1999).
14 The competence assessment is made informally on a preliminary basis, pending a more indepth evaluation to be done if so ordered by the court. The jail has been given guidance on the legal definition of incompetence by the prosecutor?s office.
15 For a more thorough explanation of this stature, see Washington State Rules of Criminal Procedure, Title 10 RCW: Criminal Procedure, Section 10.77.090. It provides, in relevant part, that: (1)(a) If at any time during the pendency of an action and prior to judgement the court finds a defendant is incompetent, the court shall order for the proceedings against the defendant be stayed. (d)(1) If the defendant is: (A) Charged with a non-felony crime and has: (I) A history of one or more violent acts, or a pending charge of one or more violent acts; or (II) been previously acquitted by reason of insanity or been previously found incompetent under this chapter with regard to an alleged offense involving actual, threatened, or attempted physical harm to a person; and (B) Found by the court to be not competent; then (C) the court shall order the secretary to place the defendant: (I) At a secure mental health facility in the custody of the department or an agency designated by the department for mental health treatment and restoration of competency. The placement shall not exceed 14 days in addition to any unused time of the evaluation under RCW 10.77.060 (which provides for a period of time not to exceed 15 days for the purposes of a court ordered competency examination). (ii) At the end of the mental health treatment and restoration period...the defendant shall be returned to court for a hearing. If...competency has been restored, the stay entered...shall be lifted. If competency has not been restored, the proceedings shall be dismissed... (B) If the defendant was in custody...at the time of dismissal, the defendant shall be detained and sent to an evaluation and treatment facility for up to seventy-two hours for evaluation for purposes of filing a petition under chapter 71.05 RCW (which relates to the civil commitment of the mentally ill)... (e) If the defendant is charged with a crime that is not a felony and the defendant does not meet the criteria under (d) of this subsection, the court may stay or dismiss proceedings and detain the defendant for sufficient time to allow the county designated mental health professional to evaluate the defendant and consider initial detention proceedings under chapter 71.05 RCW.
16 This statute went into effect in March 1999, based upon the recommendations made by the Mentally Ill Offender Task Force and in response to the incident that resulted in the murder of Captain Stevenson by a mentally ill misdemeanant who was released after a finding of incompetency.
17 This may be based on the assessment and advice of counsel or despite it. Some defendants may simply decide that the penalty, such as time served, will be minimal and that they would rather be at liberty without the constraints associated with the treatment plan.
18 Deferred prosecutions can be used for misdemeanor charges, but there was some confusion about whether a defendant would be limited to only one such disposition in a lifetime. The public defenders would be reluctant to make use of the deferred prosecution option for a Mental Health Court charge. If they believed that the defendant was likely to be arrested in the future for a DUI charge, they did not want to take such an opportunity on a less serious offense.