A very long time ahead: API launches new programs for mentally ill defendants

Officials at the Alaska Psychiatric Institute, the state’s only psychiatric hospital, say they plan to double the facility’s capacity to treat felony-level criminal defendants deemed incompetent to stand trial.

A separate program provides treatment for people with less serious violations, which deviates from the current practice of dismissing charges.

New programs help to answer agency officials say there is a major backlog in states’ criminal justice systems when it comes to offering so-called competency restoration to people with mental health issues. In Alaska, people accused of crimes must be able to understand the proceedings or meaningfully assist in their defense in order to stand trial. otherwise, the charges against them must be dismissed.

API is the only facility in Alaska where defendants with serious mental health issues are reinstated to meet this threshold, as determined by a judge.

The facility has come under fire in recent years because a lack of beds has left people spending months behind bars waiting to be admitted, leaving criminal charges unclear. The hospital has only 10 so-called years of reinstatement, and waiting lists for the program have been years months or years, the situation agreed upon by the court and hospital officials is unacceptable.

At a recent open house, forensic psychologist Dr. Christine Collins and other API officials announced a new program that will allow more defendants to receive competency-restoration treatment while incarcerated. The jail-based program will open 10 new beds for felony defendants and 10 outpatient clinic beds for misdemeanor defendants, they said.

Before the new programs, there were only 10 skills returns API’s beds to serve the entire state are the lowest per capita in the nation, said Dr. Kristy Becker, chief of clinical services.

Defendants charged with a felony now have the option of going through an outpatient rehabilitation program, which aims to connect them to the state’s mental health court, where they have access to additional resources and services, Becker said.

Instead of punishing criminal offenses, the new outpatient program aims to provide community supervision, legal restitution and additional support, he said.

It acts as a sort of bridge to get them out of jail and into a community setting with more supervision than they otherwise would have if their charges were just dismissed, which is basically what’s happening now with these misdemeanor cases, Becker said. .

Rejected payments cost

Restoring competence is more about education than treatment. Such programs use a variety of techniques, such as therapy or medication, to stabilize the patient, and then teach them the basics of the trial process enough to allow their case to move forward.

The practice has raised questions nationally about money spent simply making sure defendants go through the trial process, even though some say they shouldn’t be in the criminal justice system.

According to researchers, people with serious mental health problems are generally less violent and are more likely to be victims of crimes than to commit crimes themselves. However, the programs can prevent potential violent offenders from dropping charges and return them to the community.

Two random violent attacks in Anchorage involving people who had been found incompetent to stand trial highlighted challenges in Alaska’s rehabilitation system.

A man who was found incompetent to stand trial last year after assaulting two women in separate incidents has been released from prison and then stabbed another woman at the Loussac library. In 2018, a man found incompetent to face charges in a series of violent, unprovoked assaults was released from custody after his charges were dismissed and he then fatally stabbed an employee at an Alaska zoo.

Criminal incompetence charges are usually dismissed because the long waiting list for services often means the accused person spends longer in jail waiting to enter a program than they would if convicted of a crime, which judges say violates the defendant’s rights. .

Currently, only a small number of defendants who have been determined to be incompetent to stand trial have access to API for rehabilitative services. But even those who enter the institution are not assured of success: more than half cannot be brought back to the qualification threshold. This means that their charges will be dismissed or they will be held under a civil bond.

Statewide, an average of 216 defendants per year were found incompetent to stand trial in the past three years, according to API data. Of these, just under 20% received skills restoration services.

In Anchorage, nearly two-thirds of the slightly more than 200 annual cases in which defendants who received a competency evaluation resulted in a finding of incompetence, according to three-year average fiscal data provided by the Alaska court system. According to the state’s data, an average of 53, or about a quarter, were sent for rehabilitation.

Of this number, on average only 12 made it to the recovery program API each year. Some cases were still on the waiting list, and a few defendants were found competent before taking API, but an average of 32 cases were dismissed by either the court or prosecutors, according to the data.

In all, 37 Anchorage respondents received restoration in the past three fiscal years. Of those, 14 qualified after the program, but 21 still didn’t meet the required threshold and had their charges dismissed, the records showed. In a few cases, the accused were still in the program.

[Statewide data tells mixed story about crime in Alaska]

The long wait lasts

Overcrowding and long waiting lists are a national problem, because the need for skills restoration services has grown significantly in recent decades.

In Alaska, a The 2019 study identified outpatient and prison-based skills restoration programs as a possible solution. The programs being implemented now have been a very long time coming, Collins said.

There are now 50 people on the waiting list to restore API competencies, said Melissa Luce, an assistant at the department. Each person spends about five months in jail waiting for a bed and to start a program, he said.

If someone cannot be reinstated after going through the program, the criminal charges against them must be legally dismissed. It is also possible that defendants unsuitable for rehabilitation, such as those with severe intellectual disabilities, will have their charges dismissed, Becker said.

With the new program, the 10 additional years available for reinstatement will be housed at the Anchorage Correctional Complex, Becker said. They house felony-level defendants who don’t require hospitalization, people who can take their medication, go to group therapy and follow instructions in jail, he said.

The outpatient program is housed in a small office on Gambell Street and is staffed by Collins and two psychiatric nurses. It comes to provide competency-restoration treatment for people charged with only non-violent crimes and on bail, Collins said.

Ideally, it restores competency to people whose charges would otherwise be dismissed so they can go to mental health court and connect with services there, Becker said. Mental health court is a voluntary program that serves defendants with mental health problems or disabilities to provide treatment plans and monitor progress in hopes of controlling underlying factors that may predispose a person to crime.

The new programs, called Journey to Resilience, were funded in part by $850,000 from the Alaska Mental Health Trust Authority to establish and oversee the program for three fiscal years, and $800,000 from the Alaska Legislature added to each API’s base budget. According to Brian Studstill, director of communications for the Alaska Department of Family and Community Services.

API plans to track data on patient outcomes and analyze the impact of new programs on waitlists and backlogs, Becker said.

The programs officially began several weeks ago, but officials plan to begin intake sessions with the first few clients in the coming weeks and begin group therapy sessions early next month, Collins said. The program will initially accept only a few patients, but the plan is to expand to serve 10 people in each program in the next three to six months, Becker said.

He hopes the new programs will shorten Alaska’s waiting list, but it’s not yet clear how significant the changes could be.


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