July 6, 2016

Athens Court Helps the Mentally Ill Get Treatment and Avoid Jail

Photo Credit: Erica Hensley

Three years after finishing the Treatment and Accountability Court program, Emmanuel Ellison is still in the habit of waking up early and lifting weights at 7 a.m.

Emmanuel Ellison recently celebrated a milestone even more important than his 40th birthday last month. April marked three years of sobriety after decades of heavy drinking, committing petty and felony crimes and unexplained extremes in mood and energy that he now knows were caused by untreated bipolar disorder.

Ellison credits the Athens-Clarke County Treatment and Accountability Court with his sobriety and his new life. He and four other lawbreakers, all diagnosed with serious mental health disorders, graduated from the program in February. Ellison immediately framed his diploma and hung it on the living room wall of his East Athens home.

TAC and other mental health courts aim to keep mentally ill repeat offenders out of Georgia’s prisons and jails, which are notoriously ill-equipped to help them. Gov. Nathan Deal and many state legislators back the expansion of these special courts as a type of criminal justice reform that improves public safety and shrinks tax burdens.

There are now 31 mental health courts in the state. The Athens TAC is handling 30 cases right now. Statewide, such programs are keeping more than 500 people out of costly jails and prisons.

Like many TAC clients, Ellison came from a family that was chaotic and abusive, and he left home at a young age, bouncing around sketchy Athens neighborhoods. He cycled in and out of local jails and state prisons, sober when he was behind bars and psychotic off and on. He knew he needed help, but he didn’t know where to turn. Every release from jail was harder than the last, Ellison says. “I couldn't adapt to society because my anger and paranoia took such a toll.”

More than half of state inmates suffer from mental health problems, according to the U.S. Justice Department. And as in-patient mental health facilities have been shuttered, jails and prisons have become de facto mental health hospitals.

Ellison’s luck changed in late 2012, when he faced an aggravated battery charge. He was assigned a public defender who thought TAC would be better than another regular trial and more jail time. Ellison was skeptical at first, but agreed to an evaluation with social worker Elisa Zarate, who coordinates the Athens TAC. His rap sheet and initial mental health assessment made him a likely candidate.


Photo Credit: Erica Hensley

Ellison framed his diploma from the ACC Treatment and Accountability Court and hung it on the wall.

In early 2013, Ellison was examined by psychiatric professionals at Athens-based Advantage Behavioral Health Systems, the mental health contractor for the accountability court. They diagnosed him with bipolar disorder and alcohol use disorder, a dual diagnosis that fits about half of TAC participants. Advantage laid out an individual treatment plan that required Ellison to keep regular psychiatry and addiction treatment appointments, participate in cognitive and social skill classes and show up for weekly meetings with court staff.

TAC requires people to stay in treatment for at least 18 months, but judges can extend the sentence. Ellison had a rocky start. He didn’t feel like he deserved to be in the program, and he was ashamed of his past behavior. He also clashed with TAC’s strict schedule, missed appointments and took up drinking again. But he communicated with the team and Judge David Sweat, who presides over the court, that he needed more help. “I didn’t change my environment at the beginning,” he says. “And I hadn’t learned to trust yet.”

After his relapse, the court sent Ellison away for 30 days of mandatory residential care. Every day during his stay, he met with a psychiatrist and participated in group therapy. By the time Ellison left, he was stabilized on a three-drug regimen. He’s been sober ever since.

Zarate and case manager Kristen Daniel are on call for problems, and they know that time is the great healer. Getting off the streets is also key. “We want them to be accountable and compliant with their probation and treatment, but before we can expect them to do that, we have to help make sure they have a roof over their head and have food,” Zarate says.

Throughout most of his time in TAC, Ellison lived with his mom. He says her no-nonsense attitude helped keep him on the path to recovery and maintain Sweat’s barracks-like schedule. He prays and lifts weights every day at 7 a.m. and keeps an early bedtime—old TAC habits fostered by morning check-ins and evening curfews. All this helped Ellison re-enter regular life, and so did forging personal ties with Daniel and Judge Sweat.

But there was a setback. After about two years in the program, Ellison was in a car crash that severely injured his back and killed his younger brother. He’s still dealing with the legal, medical and emotional ramifications of the wreck. TAC helped him work through a tragedy that would have totally derailed him just a few years earlier, he says.

Since then, Daniel helped Ellison qualify for SSI—Social Security disability benefits—which allowed him to get his own duplex apartment. Ellison leads a simple life now, and one that he is proud of. He walks a lot, both for exercise and meditation. He picks up medicine for his mom and plays basketball with his grandsons. Talking about his family makes him tear up, and says he’s still not used to being a comfort for his family instead of a constant source of worry for them. “Every day I wake up, and it gets easier,” he says. “And I feel good.”

Legally, Ellison is still on probation and meets monthly with his probation officer. He goes to meetings to stay sober and remain connected to TAC participants and staff. “With Emmanuel’s case, he knew that he had people that he could call and talk to, and that he trusted,” says Daniel. “It really made the difference for him.”

Navigating the criminal justice system is tough for anyone, and it’s especially hard for those who struggle with mental health and substance use disorders. Repeat offenders with these burdens often lose hope and feel powerless. “Support groups and skill classes give their power back to them,” Daniel says.

Mental health policy advocates say that expanding accountability courts can divert people with mental illness into treatment and rehabilitation and reduce the crowding of jails and prisons. Some critics say the effectiveness of courts like TAC hasn’t been scientifically proven. Zarate is seeking funding so researchers can be paid to conduct a formal evaluation of TAC, which she is confident would pave the way for more slots for people like Ellison. Six months ago, the capacity of the program was increased to 50.

Ellison considers TAC his family, he credits the program with saving his life, and he wants to help that family grow. “It’s on you if you want to succeed or not,” he says. “They give you that responsibility, and they teach you how to believe in yourself.”

This article first appeared at Georgia Health News and is republished with permission.