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Sara Foss's Thinking It Through
by Sara Foss

Thinking It Through

A Daily Gazette life blog
Her column and blog rolled into one

Innovative approach to mental illness

It’s a typical day in Schenectady’s Alternative Treatment Court.

One man seems a little rattled, and so City Court Judge Matthew Sypniewski pauses to ask him how he’s feeling.

“Are you thinking clearly?” he asks.

It’s a question Sypniewski asks with some regularity.

He oversees the ATC, which identifies defendants charged with low-level crimes who are diagnosed with a mental illness and transfers their cases from an incarceration setting to a court and probation supervision setting. Defendants who opt to participate in the program receive help obtaining mental health treatment, medication and other services, such as housing.

The man seated before Sypniewski indicates that he is thinking clearly. He agrees to plead guilty to a misdemeanor criminal mischief charge and enter the program. If he completes it, the misdemeanor will be reduced to a violation.

“Welcome to the program,” Sypniewski says. “I think it will be a nice fit.”

I met Sypniewski a couple of months ago while moderating a panel discussion on the legal services available to the poor in Schenectady County, and became interested in learning more about the ATC and how it functions.

Perhaps most noteworthy is that the program works: According to Deborah Slack-Bean, the public defender who handles most of the cases that go before the ATC, the success rate tops 80 percent.
Far too often, mentally ill defendants wind up in jails and prisons, which are lacking in treatment and services for the mentally ill.

Just last week, The Associated Press reported that a schizophrenic inmate at the Rikers Island jail in New York City died after being left alone in his cell for seven days and denied some of his medication. He became increasingly agitated, clogging his toilet and stripping off his clothes; by the time medical staffers were called in, he was too weak to move.

I won’t argue that the inmate, 39-year-old Bradley Ballard, was a harmless fellow, what with his history of assault and public lewdness charges. But his treatment was inhumane and it’s worth asking how he might have fared with better treatment and attention to his mental health.

Earlier this month, a special report in USA Today found that more than half a million Americans with serious mental illnesses are “falling through the cracks of a system in tatters,” and that the mentally ill “who have nowhere to go and find little sympathy from those around them often land hard in emergency rooms, county jails and city streets.”

What’s especially troubling about this trend is that while our understanding of mental illnesses has improved over the past century, people still struggle to obtain adequate and appropriate treatment, and those who run afoul of the law often encounter a system that emphasizes punitive measures, rather than a more rehabilitative approach.

How refreshing it is, then, that Schenectady has chosen to take a different, more innovative tack.
Now about a decade old, the Alternative Treatment Court program is a collaborative effort. Shortly before the court session I attended, Sypniewski met with staff from the county Public Defender’s Office and Probation Department to discuss the day’s cases. Usually representatives from Ellis Hospital are present, but on this particular Monday they had other obligations.

Most of the people who come before the Alternative Treatment Court are aware that they have a mental illness, Sypniewski said. And they are often repeat offenders who are weary of going to jail and want to try something different.

“Most are at a point where they know they need help,” he said.

In order to graduate from the program, a process that typically takes between six and nine months, defendants must comply with their treatment regimen, show up for appointments and stay out of trouble.

Sypniewski said defendants will occasionally suffer setbacks and that he is generally inclined to give second chances.

“The goal is to avoid recidivism and to put people in a position where they have the tools they need to be productive,” he said. He added, “You do have individuals fall off track. You can see them quickly deteriorate and you try to get them on track quickly.”

I liked what I saw from Sypniewski and the other members of the ATC team. It is expensive to keep mentally ill people in jail, and it seldom solves the underlying problem. By offering an alternative, and working closely with defendants who fit their criteria, they’re doing us all a favor.

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