Fourth Judicial Circuit State of Florida Mental Health Courts Duval County Mental Health Court Participant Handbook The Honorable Magistrate John A. Sampson, III, Presiding “Learning to Live Stronger & Smarter” Table of Contents Introduction 3 Mental Health Court Overview 3 Mental Health Court Team 4 Mental Health Court Expectations 5-7 Mental Health Court Proceedings & Dress Code 7 Mental Health Court Incentives and Sanctions 9-10 Mental Health Court Phase Descriptions 10-11 Duval County Mental Health Contacts 12 Page 2 of 12 Duval Mental Health Court Revised 08/02/2013 INTRODUCTION The Fourth Judicial Circuit Mental Health Court (“MHC”) began in 2007. This court-supervised mental health and/or cooccurring treatment program is a collaborative effort among the Fourth Judicial Circuit, State Attorney‟s Office, Public Defender‟s Office, Jacksonville Sheriff‟s Office, Nassau County Sheriff‟s Office, Mental Health Resource Center, River Region Human Services, Quality Life Center, Starting Point Behavioral Health, Daysprings Village, and other community providers. MHC is designed to be a 12 month program. However, you may be extended past the 12 month point in order to successfully complete MHC. The purpose of MHC is to offer a treatment-focused alternative to incarceration for persons suffering from chronic and persistent mental illness or co-occurring disorders (substance dependence or abuse and mental health disorder). MHC seeks to address the cause for the criminal behavior that brought about the pending charges, whether due to noncompliance with medication, lack of accessibility to services, loss or lack of benefits, etc. The goal of MHC is for you to achieve stability with your mental health disorder, abstinence from illicit and illegal drugs, and abstinence from all criminal activity. MHC is designed to promote self-sufficiency and to return you to the community as a productive and responsible member. Mental Health Court has been developed to help you. The Judge, court staff, and the treatment team are present to guide and assist you but the final responsibility is yours. You must be motivated to make this change and commit to a change of lifestyle. Although this begins as a voluntary program, it is not your choice to simply withdraw from the program once you have signed the Participation Agreement. Only the MHC Judge can determine if you are to be removed from the program. This handbook has been developed to assist you by providing answers to any questions you may have and by giving you an overview of the program. You will be held accountable for complying with the information that is listed in this handbook. As a participant, you will be expected to follow the instructions given in MHC by the Judge and to comply with the treatment plan developed for you by your treatment team. This handbook will detail what is expected of you as a participant in MHC and will review general program information. You are required to read and abide by all rules and procedures outlined in this handbook and you are encouraged to share this handbook with family and friends. MENTAL HEALTH COURT OVERVIEW Following arrest and if determined to be legally eligible, you will be offered a choice between MHC and prosecution of the pending charges. A representative from the State Attorney‟s Office will discuss the MHC Program with you and a Public Defender or your private counsel will advise you of your choices. Remember, that while electing to enter MHC at this stage may be of your choosing, once you enter MHC you may not elect to withdraw from the program voluntarily. If you were sentenced to complete MHC as a condition of probation or in lieu of prison, your successful completion will meet the requirement of your sentence. However, failure or discharge from MHC will result in a Violation of Probation and subsequent prosecution/sentencing. Final determination of entry into the program shall only be made by the Judge with recommendations from the Assistant State Attorney, Public Defender, Mental Health Court Program Staff and treatment providers. On your initial court date, you will be assigned a Case Manager who will provide supervision and assistance with needed services. Your defense counsel will continue to represent you throughout your participation in MHC. If you have entered the program with private counsel and can no longer afford this expense, you may request court-appointed counsel to represent you. The eligibility criteria for Duval County Mental Health Court includes: a. An active criminal charge(s) of a misdemeanor, second degree felony, or third degree felony b. A history of persistent and chronic mental illness (Diagnoses include Psychotic Disorders, Mood Disorders, or Anxiety Disorders. This also includes co-occurring disorders.) c. At least 18 years of age and must reside in Duval County Page 3 of 12 Duval Mental Health Court Revised 08/02/2013 MENTAL HEALTH COURT TREATMENT TEAM The MHC Treatment Team for each client consists of, but is not limited to the: a. Mental Health Court Program Coordinator b. Mental Health Court Monitor c. Peer Specialist d. Mental Health Court Case Manager e. Primary Therapist f. Psychiatrist or ARNP (Advanced Registered Nurse Practitioner) g. Assistant State Attorney h. Assistant Public Defender i. Judge j. Jacksonville Sheriff’s Office Representative The MHC Program Coordinator maintains contact with the MHC team members to ensure ongoing communication, client compliance, and adequate delivery of services. The MHC Monitor screens each perspective candidate for their appropriateness and eligibility for participation in MHC. The Peer Specialist is a person who has progressed with their own mental health disorder or is in recovery from alcohol and/or other drugs. They are trained, certified, and willing to identify themselves as a peer while working to assist others with mental health disorders and chemical dependency. Equipped with both their training and their own recovery experiences, they will provide support in educating clients about life skills and model coping strategies. The MHC Case Manager is assigned to assist with obtaining and maintaining services such as medical appointments, obtaining or reinstating disability benefits, housing, referrals for vocational training, education, employment, and other needs. Each participant will be assigned to a Therapist to address the emotional aspect of their treatment and recovery. A Psychiatrist/ARNP is assigned to each participant for evaluation, diagnosis, and to prescribe the appropriate medication. Regular appointments with both the Therapist and the Psychiatrist/ARNP will be scheduled to monitor progression and any set backs that may arise. A representative from the State Attorney‟s Office and the Office of the Public Defender is assigned to all program participants (unless a private attorney is retained). For judicial supervision, a Judge or Magistrate will preside over MHC. Representatives from the Jacksonville Sheriff‟s Office are present to offer assistance with needed information and/or cooperation with their office. Page 4 of 12 Duval Mental Health Court Revised 08/02/2013 MENTAL HEALTH COURT EXPECTATIONS Upon entering MHC, a Participation Agreement is signed. This agreement lists the program expectations by which you must agree to abide. These expectations include, but are not limited to: 1) You are not to change your residence or employment without first obtaining the approval of your Case Manager. Prior to moving, you will need to provide your new address information in writing to your Case Manager. You must keep your Case Manager informed of any changes in employment status. 2) You are not to leave Duval County without the approval of the MHC Judge. Travel can be requested for situations such as a day trip to an area close by. Overnight travel is not permitted unless the participant is at least in Phase III and has been compliant with acceptable progress being made. A minimum of 48 hours notice is required. Otherwise, only travel that is for cases of family emergency and/or death will be approved by the MHC Judge. Travel Requests are to be submitted to your Case Manager for approval. (Form 1: Client Travel Request) 3) You are not to engage in and/or commit any new criminal offenses. Warrants and/or new arrests could result in termination from the program. This includes traffic related offenses. 4) You are prohibited from using or possessing any legal and/or illegal drugs and/or alcohol (in any form). Sobriety and mental stability are the primary focus of this program. Maintaining a drug free lifestyle is very important in your recovery process. You are prohibited from consuming alcoholic beverages, including nonalcoholic beverages as they do contain small amounts of alcohol. Participants are prohibited from using or possessing certain prescription drugs/medications: Amphetamines (i.e.: Adderall, Pseudoephedrine); Barbiturates (i.e.: Fioricet); Benzodiazepines (i.e.: Valium, Xanax); Opiates (i.e.: Tylenol 3, Lortab); Oxycodone (i.e.: Percocet), Propoxyphene (i.e.: Darvon). (Form 2: Prohibited Drugs/Medications List) You are prohibited from using or possessing any prescribed and/or over the counter drugs/medications without obtaining approval from MHC prior to purchasing or ingesting anything. a. If you must seek medical attention you are required to inform your physician that you are in a Mental Health Court treatment program and cannot be prescribed narcotic/addictive medications. b. You must submit copies of all medical documentation within twenty-four (24) hours of release to your Case Manager. c. You must have all medical providers fill out the physician contact form and submit this form to your Case Manager within twenty-four (24) hours of receiving treatment. (Form 3: Physicians Contact Form) d. You are strictly prohibited* from using or possessing any and all “designer drugs” that can be purchased legally or illegally. Any and all “smoking mixtures” (other than products specifically designated to contain only tobacco) are strictly prohibited. Any and all products sold or marketed under false pretenses with the warning “not for human consumption” are strictly prohibited. e. You are strictly prohibited* from using or possessing any alternative or “replacement” drugs such as Methadone and Suboxone (a/k/a Buprenorphine) as well as any substance intended to replace an otherwise illegal substance. * Violation of this rule may result in immediate termination from MHC- regardless of other progress made. 5) You are to keep all scheduled appointments. This includes individual and group counseling sessions, mental health appointments, medical appointments, educational sessions, AA/NA, and home visits. For any individual therapy appointments that are missed, you are responsible for contacting your primary therapist to make arrangements to reschedule. If you are unable to attend a scheduled session/appointment, you must contact your Case Manager. You must leave a voicemail or send an email or text message in the event you cannot reach your Case Manager. Page 5 of 12 Duval Mental Health Court Revised 08/02/2013 Failure to attend treatment or missing scheduled appointments will result in sanctions. If absence is excessive, it may result in termination from MHC. If you are late for court, AA meetings and/or group/individual treatment sessions, you may not be allowed to attend and will be considered noncompliant. Illness and/or transportation problems will not be considered valid reasons for you to be late or to miss your scheduled court dates, AA meetings, group/individual treatment sessions and/or other appointments. It is your responsibility to be present and to be on time. 6) You are to follow the rules/follow instructions as they are given. It is very important to follow all of the program rules. Examples of violations which could result in termination include multiple missed drug tests, consistently demonstrating a lack of program participation and/or continuously failing to follow instructions of the treatment provider, Peer Specialist, Probation Officer, Case Manager or the Court. However, there are behaviors that you may choose to engage in that will subject you to immediate termination after only one offense. If you are here to waste time and attempt to „fake it „til you make it,‟ this will not be accepted by MHC. (See SANCTIONS on page 9) As you progress and consistently follow the rules and achieve your goals you will receive incentives from MHC. These incentives are described further in this handbook. In the same manner that poor behavior/choices is sanctioned, good behavior/choices is rewarded. (See INCENTIVES on page 9) 7) You are to take your medication as prescribed. When medication has been prescribed by the doctor, it is your responsibility to continue the medication regimen that is provided. If there are any questions or concerns regarding the medication (i.e. the dosage, the frequency, and/or any side effects), these issues need to be addressed with your Case Manager. The Case Manager will assist you in calling your Psychiatrist and/or Primary Care Physician to schedule an appointment to have your medication reviewed. If you are not taking your medication as prescribed, you will be considered non-compliant. You will receive a 30 day supply of medication unless otherwise determined by staff. All medication history should be listed on Form 4: Medication Log. The purpose of this document is to assist you with keeping track of your prescriptions and with being more educated as to your Mental Health needs. You are to take all prescription medication with you to your medication management appointments. This will ensure that the psychiatrist/ARNP is aware of all of the medication that you have and can assist in the prevention of any medication interactions. 8) You are to submit to random observed drug and alcohol testing. You will be tested throughout the duration of the MHC Program. You will be tested a minimum of two times per week. You are to contact the Drug Testing Color Line seven (7) days a week by calling (904) 255-1050. Any day that your color is called you are required to report to the Duval County Courthouse, 2nd Floor, Suite 2321 for testing any day your color is called between the hours of 8am-5pm unless otherwise instructed. If you miss a drug test, you are required to report for testing by 9 a.m. the next day. The Mental Health Court Judge will have access to all drug test results including any failures to test. Additionally, any member of the MHC team may order a drug test at any time. Tampering with the drug/urine test will be deemed a positive test and may result in your expulsion from the program (this includes flushing, diluting, using someone else‟s urine, etc.) A positive or “dirty” test will not automatically disqualify you from the MHC Program however, sanctions will be imposed. The Judge will be reviewing your overall performance in the program when determining sanctions. Page 6 of 12 Duval Mental Health Court Revised 08/02/2013 9) You are neither to make threats towards other participants or staff nor to behave in a violent manner. Violent or inappropriate behavior will not be tolerated and will be reported to the Court. This will result in termination from MHC. 10) While in Court and/or at treatment centers, you are to remain seated and quiet at all times unless otherwise instructed. It is very important to maintain appropriate behavior in Court for the benefit of yourself and others present. All cell phones and/or electronic devices must be turned off in the courtroom and at group meetings. These devices will be removed from your possession if found to be in use. 11) You are to restrict involvement with other MHC participants. Romantic involvement is prohibited between participants. You are not to engage in intimate relationships with other MHC participants. This includes romantic involvement as well as living with other participants. Financial transactions between or among MHC participants is also strictly prohibited. Violating this section is grounds for automatic termination from MHC. MENTAL HEALTH COURT PROCEEDINGS & DRESS CODE As a MHC participant, you will be required to appear in court on regularly scheduled dates. MHC proceedings are held every Tuesday at the Duval County Courthouse on the second floor in courtroom 212. At each appearance, the Judge will be given a progress report containing information from the treatment provider and the Peer Specialist regarding your attendance in all program services, level of participation and drug screen results. The Judge will ask you questions about your progress and discuss any specific problems you have been experiencing. If you are doing well, you will be encouraged to continue with the program and work with your treatment team (case manager, peer specialist, and treatment provider as well as other programs ordered by the court and court staff) toward success. If you are not doing well, the Judge will discuss this with you and the treatment team to determine further action. If you commit program violations (i.e.: failure to attend individual or group counseling sessions, positive or missed drug tests, failure to attend AA/NA meetings, etc.,) the Court will impose sanctions. (See SANCTIONS on page 9). With repeated violations of program requirements, and a failure to progress satisfactorily, the Court may impose the ultimate sanction of discharge from the program. Failure to appear in court on the date and time you are scheduled will result in a warrant for your arrest. If you cannot appear in court as scheduled, you must notify your Case Manager as soon as possible to explain why you cannot appear. Illness and/or transportation problems will not permit you to miss your scheduled court dates. It is your responsibility to be present for court and to be on time. You are required to be present no later than 2:00 p.m. You will be notified in advance regarding court cancellations, including those due to scheduled holidays. You are also encouraged to keep documentation of your pass dates. As a participant, you will be expected to wear a shirt or blouse, pants, dress or skirt. Shoes must be worn at all times. While you may be permitted to dress comfortably and casually for your treatment sessions; you are not to wear shorts, tank-tops, flip-flops and/or hats when appearing for court. Clothing bearing drug or alcohol related themes or promoting/advertising alcohol or drug use is considered inappropriate. Sunglasses are not to be worn inside the courtroom or at treatment centers unless medically approved. Your pants are not to be excessively baggy and are not to be worn “to sag” in court or in treatment appointments. Men‟s shirts are to be tucked in neatly prior to entering the courtroom. Speak with your treatment team if you need assistance obtaining appropriate clothing. Your treatment will be provided through a team approach with the combined resources of mental health treatment and drug treatment staff. The treatment provider will assess what level of treatment will best meet your needs and set a schedule of groups and appointments to begin your treatment services. If it is deemed necessary for you to be admitted to a residential treatment program, your treatment plan will include the requirements of that program. If you are not admitted into a residential treatment program, a multi-component outpatient program will be developed with you. Page 7 of 12 Duval Mental Health Court Revised 08/02/2013 An initial treatment plan will be developed by you and your treatment team following an overall assessment of your needs. The plan will act as a guide for your initial treatment phase and within it, you will set goals, select methods for meeting those goals, and develop target dates for achieving those goals. Your treatment will consist of the initial psychiatric evaluation followed by medication management appointments, individual and group therapy sessions, and other support groups to provide you with information and education. This treatment plan will be maintained by your treatment provider and will be updated as you progress through the program. Substance abuse counseling is comprised of two separate formats: individual and group. If receiving co-occurring services as part of your treatment plan, you will be required to participate in both types of counseling. Together they are designed to help you develop self-awareness, realize your self-worth, and develop the strength to practice self-discipline. The individual and group counseling sessions will include problem identification and alternative solutions. Your attendance at counseling sessions will be reported to the Judge as part of your progress report. You must have prior permission from your counselor to be excused from a counseling session (acceptable reason for absence - hospitalization; documentation from the hospital will be required). Page 8 of 12 Duval Mental Health Court Revised 08/02/2013 MENTAL HEALTH COURT INCENTIVES AND SANCTIONS INCENTIVES MHC recognizes the effort that it takes in attempting to improve your behaviors, your choices and ultimately your lifestyle. With that in mind, MHC recognizes all markers of success even if in a small way. We‟re proud to support your progress and do our part to keep your spirits lifted as you travel down the road to change. Examples of behaviors/accomplishments that lead to incentives are included below for convenience. This is not a complete list. It only represents possible incentives that you may receive if compliant with MHC: Behaviors/Accomplishments 1 day clean and sober Assisting others Infraction/Violation free for 60+ days Maintaining employment Monthly report of being clean and sober Multi-day clean and sober Obtaining drivers license Obtaining employment Obtaining GED or degree Outstanding accomplishment Perfect attendance Phase completion/advancement Recognition of investment in treatment program Possible Incentives/Responses Applause Fishbowl drawings Books Gift certificate Candy Lunch with the MHC team Coffee with the Judge/team Praise from Judge Decreased court appearances Recognition certificate Early dismissal from court Recommendation letter for job Early phase advancement Reduction of community service hours Reduction of supervision Sobriety tokens Standing Ovation Travel privileges SANCTIONS If you fail to comply with MHC, the Judge may, at his discretion, order one or more of the following sanctions. Examples of infractions that lead to sanctions are included below for your convenience. This is not a complete list and only represents possible sanctions that you may have imposed if you fail to comply with MHC. Examples of Typical Infractions/Violations Behavioral issues in MHC (poor attitude Failing to submit AA/NA and/or being disruptive) meeting slips Failing to complete community service Failing to follow hours counselor/case manager instruction Failing to follow court instructions and/or orders Failing to submit community service hours Missing probation check-in Providing a dilute/altered Missing treatment group sessions drug test Noncompliance with COA rules and Tardiness to and/or absence regulations from court Positive drug test Tardiness to and/or absence from treatment group sessions Filling prescribed medication without authorization Lying or deliberately omitting information to/from the court Missing drug test Missing mental health appointment Tardiness to Mental Health appointments Use of drugs and/or alcohol Use and/or Possession of synthetic and/or designer drugs Examples of Serious Infractions/Violations (may result in immediate removal from MHC) Engaging in romantic/sexual relationship with any participant New criminal arrest/offense Possession and/or Use of synthetic and/or replacement drugs Tampering/Falsifying drug test Threats of violence or violent behavior Submitting falsified documents Page 9 of 12 Duval Mental Health Court Revised 08/02/2013 Examples of Possible Sanctions/Responses 4-24 hours of community service Admonishment from Judge Essay on topic related to infraction Increased AA/NA meetings Increased drug testing Keeping a calendar Phase extension Role reversal Stay to the end of court Verbal and/or written apology 10-40 hours of community service Curfew Education workbooks Increased contact/level with treatment Increased court appearances Increased supervision Return to lower phase in MHC 50-100 hours of community service Incarceration Increased contact with treatment Increased level of treatment Inpatient or in-jail treatment Peer review Program removal Re-start of MHC Round Table with MHC Team Automatic Sanctions/Responses to Certain Behaviors Missed/Positive drug test = Automatic extension in phase regardless of progress (# of days is based on phase) Missed court hearing = Capias (warrant) for your arrest MENTAL HEALTH COURT PHASE DESCRIPTIONS The MHC Treatment Program is a four-phase, highly structured treatment program lasting for a minimum of one year, depending upon your individual progress. Each phase consists of specified treatment objectives, therapeutic and rehabilitative activities and specific requirements for advancement into the next phase. The components and requirements for advancement from each phase are described below. You are responsible for completing ALL phase requirements before advancement can occur. PHASE I 4-6 WEEKS Sign Mental Health Court Deferred Prosecution Agreement Complete Psychosocial Assessment & Intake Begin to attend treatment services (e.g. Individual therapy 1x/week, Living Well Mental Health group & Medication Management) Complete Initial Psychiatric Evaluation with ARNP/Psychiatrist Engage in services with Mental Health Court Case Manager (e.g. Home visit, Targeted Case Management Assessment & Service Plan) Engage in Mental Health Intervention Group 1x/week Attend Mental Health Court weekly Compliance with all prescribed medications from ANRP/Psychiatrist 30 days of clean time (includes being alcohol free) Complete and submit petition for phase advancement (Form 5: Petition for Phase II ) PHASE II 6-10 WEEKS Regular attendance/compliance of treatment services as indicated on treatment plan (active participation in Individual & Group therapy) Compliance with scheduled medication management appointments Compliance with all prescribed medications from ANRP/Psychiatrist Demonstrated progress of completion of treatment objectives (as indicated by completed objectives) Attend Mental Health Court bi-weekly Abstinent from all substances of abuse Attend two Recovery Support Groups per week Attend Mental Health Intervention Group 1x/week 60 days of clean time (includes being alcohol free) Complete and submit petition for phase advancement (Form 6: Petition for Phase III) Page 10 of 12 Duval Mental Health Court Revised 08/02/2013 PHASE III 10-16 WEEKS Regular attendance/compliance of treatment services as indicated on treatment plan (active participation in Individual & Group therapy) Compliance with scheduled medication management appointments Compliance with all prescribed medications from ANRP/Psychiatrist Demonstrated progress of completion of treatment objectives Attend Mental Health Court every three weeks or as ordered Abstinent from all substances of abuse Attend two Recovery Support Groups per week Obtain employment or commit to providing volunteer service and job search weekly Attend Mental Health Intervention Group 1x/week 90 days of clean time (includes being Alcohol free) Complete and submit petition for phase advancement (Form 7: Petition for Phase IV) PHASE IV 16-20 WEEKS Regular attendance/compliance of treatment services as indicated on treatment plan (active participation Individual & group therapy) Compliance with scheduled medication management appointments Compliance with all prescribed medications from ANRP/Psychiatrist Demonstrated progress of completion of treatment objectives (as indicated by completed objectives) Attend Mental Health Court every three weeks or as ordered Abstinent from all substances of abuse Attend two Recovery Support Groups per week Maintain employment or continue providing volunteer service and weekly job searching Attend Mental Health Intervention Group 1x/week 120 days of clean time (includes being Alcohol free) Complete and submit petition for graduation (Form 8: Petition for Graduation) Once you have successfully completed the criteria for each phase, you will advance to the next level and eventually be a candidate to graduate from MHC. It will be necessary to discuss your progress toward the goals you initially set and why you believe you have met the graduation criteria. Approval for graduation from the program shall be determined by the MHC Judge with input from the MHC treatment team. Your family will be invited to join you in court as the Judge congratulates you on successfully completing MHC and achieving your goal to establish a mentally stable and drug-free life. Upon graduation, your case will be dismissed by the State Attorneys Office (if in MHC under Pre-Trial Diversion). Your record relating to the arrest that resulted in your participation in MHC may be eligible to be sealed or expunged. After graduation, you will be provided with the necessary paperwork to apply for such relief. However, if you lose this packet, you can request a packet from the State Attorney‟s Office to proceed on your own behalf or retain an attorney to represent you. We hope this handbook has been helpful to you and answered most of your questions. If you have any additional questions or concerns about MHC, please feel free to ask your attorney or any member of the Mental Health Court Treatment Team. Mental Health Court telephone numbers are listed in the back of this handbook. We wish you good mental health! Page 11 of 12 Duval Mental Health Court Revised 08/02/2013 DUVAL COUNTY MENTAL HEALTH COURT CONTACTS Stacey D. Smiley Mental Health Court Program Coordinator Duval County Courthouse 501 W. Adams St., Room 2307 Jacksonville, FL 32202 (904) 255-1044 direct extension (904) 255-1040 main extension Teri Roark Drug & Mental Health Court Director Duval County Courthouse 501 W. Adams St., Room 2307 Jacksonville, FL 32202 (904) 255-1046 Richard Gordon Assistant Public Defender Public Defender‟s Office 25 North Market Street Jacksonville, FL 32202 (904) 255-4771 Michael Hrin State Attorney Representative State Attorney‟s Office 220 East Bay Street Jacksonville, FL 32202 (904) 630-1212 ext. 6884 Kenny Arnold Senior Director River Region Human Services 2055 Reyko Rd. Jacksonville, FL 32207 (904) 899-6300 Erin Jones, CRPS-A Certified Recovery Peer Specialist, Adult River Region Human Services 3020 Warrington Street Jacksonville, FL 32254 (904) 899-6033 ext 4209 Page 12 of 12 Duval Mental Health Court Revised 08/02/2013
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