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Hamilton County's Mental Health Court: Battling addiction, mental health issues during a pandemic - The Cincinnati Enquirer

Alexander Ralph, Special to The Cincinnati Enquirer and USA TODAY NETWORK Published 10:39 p.m. ET June 8, 2020

Maura Kiger is graduating from the Hamilton County Felony Mental Health Court program after battling major depressive disorder and opioid addiction. Photo: Sam Greene/The Enquirer

Every Wednesday, Judge Jody Luebbers stands beside the empty jury box in her courtroom with key staffers from Hamilton County Felony Mental Health Court.

Their task: to find out how defendants in the program are doing.

Over speaker phone, a man tells them about his morning exercise routine. Another references an aggressive neighbor on whom he has filed a police report. A woman reports how much she loves her new place in Norwood.

Before the coronavirus pandemic scaled back operations at the courthouse, Luebbers, a Hamilton County Common Pleas judge, conducted these check-ins in person, in her courtroom.

Luebbers was an early advocate for establishing the county's Felony Mental Health Court (MHC), which opened in 2010, is guided by the principle of "treatment in lieu of conviction."

Prior to its founding, Luebbers and her fellow judges routinely sentenced people whose mental health problems exacerbated the very drug addictions that helped land them in the courthouse.

"Substance abuse and mental health are cousins," said Brooke Lipscomb, a Felony Mental Health Court liaison. "They live on the same street. But you can't manage your substance abuse without managing your mental health."

By the end of 2010, the program had 29 clients. Ten years later, the program serves roughly 75 defendants annually.

Defendants admitted into the voluntary program submit to a rigorous treatment plan that includes a sobriety pledge, frequent drug testing, and individual and group counseling. Upon graduation, a process that typically takes 18-24 months, felony charges are expunged from the graduate's record.

The majority of participants' felonies consist of drug possession; the program excludes drug dealers and those who have committed violent offenses.

Many defendants "have been dealt something in their life that others have not," Luebbers said. "I'm trying to keep them out of jail, out of the hospital. Trying to give help they need. A stable place to live. Get them reconnected with their families. And just trying to get their lives better. And then society is better for it.

The program, however, is not right for everyone. For every two who graduate, one will drop out or be asked to leave if they consistently flout requirements.

Staff consists of Program Director Gary Yuratovac, Lipscomb and seven case workers, each of whom is employed by Greater Cincinnati Behavioral Health Services.

Three probation officers and three attorneys are also involved. Clients are divided among the dockets of three judges, Luebbers, Lisa Allen, and Tom Heekin.

The judges and staff are realistic about the challenges their clients face. Relapses and mistakes come with the territory.

"We know how deep addiction runs," Yuratovac said. "If your first drug test comes up positive, that's to be expected."

The judges, however, want to hear about these lapses from the clients themselves, rather than from the drug screen reports. "I tell clients," Luebbers says, "they have to be honest and cooperate and communicate."

The program helps with housing and employment. And personalized attention is a tenet of the program.

"We have college students pursuing advanced degrees down to people that are very mentally ill," Yuratovac said. "Mental illness does not discriminate. Everyone needs a different treatment plan."

For a treatment model that relies on personal contact, the coronavirus has upended much of MHC's method of delivery of care. "The biggest challenge," says Yuratovac, "is that for a lot of these clients the routine is very important. Disruption may dis-regulate the clients. It's very hard to get a sense of how someone is doing in just a phone call versus in front of a judge."

Phone calls, though, have by necessity become the program's lifeblood. Each day the seven case workers call each of the 7 4 people now in the program. For the roughly 20 most at-risk, a caseworker conducts in-person visits, albeit while donning a mask and following social distancing guidelines. And each Wednesday there are these group calls placed by Lipscomb, Yuratovac and Luebbers.

One of these calls was to Maura Kiger. Kiger, who has major depressive disorder and has battled opioid addiction, entered felony mental health court with her three sons in foster care and was pregnant with a child she was in the process of placing permanently with another family.

Like any new MHC admission, one of Kiger's first tasks was to write a letter to the judge outlining her goals for herself in the program. Kiger's list started with getting her kids back. It also included finding housing, obtaining a driver's license, and graduating treatment.

She's graduating.

The Mental Health Court's tradition is to do it up for graduation. The judges and staff all attend, as do board members and clients still in the program's earlier stages. The graduates can invite anyone they want. For some of them, this may be their very first graduation of any kind. There's food and soft drinks, lots of photos and hugging. A staff member speaks about each individual client. About who they are, and the distance each has traveled to re-start their life.

Kiger still thinks of it: ''We were going to have our families there. It's a big accomplishment. Our kids and our parents. Just the people who care about us. And mostly our case workers, who've helped us so much."

But it will be different for MHC's graduating Class of 2020. The pandemic has wreaked havoc with graduations, and this one is no exception. She and 11 of her peers will have a scaled-down graduation that follows social distancing guidelines.

This new graduation will be limited to four graduates a day and will take place over three days – June 9, 10, and 11. Graduates can each invite up to two guests.

In February, Lipscomb took Kiger aside in court and, referencing Kiger's list, told her, "Girl, you've done it. You've got it all."

"When she said that – it was like one of those moments. I just kept thinking about that for the next few days," Kiger said. "And it hadn't dawned on me that I wrote these things down last year, and now I do have them. And then my next thought was, if that's what happened in this past year, then that's what I need to do with this next year."

"I need to write a new list."