This presentation explains the importance of developing a more integrated, collaborative and comprehensive approach to care advocacy for our recovering clients with criminal charges and other legal issues.

1. `

2. Justice In Recovery
Making the Case for Stronger Care Advocacy &
Clinical Collaboration for our Clients in the
Courtroom
iCAAD London 2019
Heather R. Hayes, M.Ed.,
LPC, CIP, CAI
Interventionist
Atlanta, Georgia
Jeffrey J. Merrick, Esq.
Attorney At
Law/Interventionist
Los Angeles, California

3. Objectives
 More effective care advocacy for clients with
substance use and mental health disorders
 Strategic partnership with the courts, prosecutors,
probation & parole
 Realignment from punishment / criminal justice to
treatment /much needed care
 Recognizing disguised opportunities for Intervention
 Maximizing external motivators for long-term recovery
success and internal change

4. US News Article 4/29/17
Mental Illness In Jail
 Twin Towers Correctional Facility / Los Angeles County Jail:
 Over 4,000 mentally ill inmates (30% of overall population)
 High percentage of this population Dual / Substance Use
 Over last 7 years, overall population spike of over 50%
-- Sheriff’s Department attributes this to rise in meth use.
 Meth recovered inside the jail increases 750% over last 7 years
US News 4/29/17 (M. Balsamo,
AP)

5. Mental Health Inmates
 Nearly a quarter of both State prisoners and jail inmates who had a
mental health problem, compared to a fifth of those without, had
served 3 or more prior incarcerations.
 Female inmates had higher rates of mental health problems than
male inmates (State prisons: 73% of females and 55% of males;
Federal prisons: 61% of females and 44% of males; local jails: 75%
of females and 63% of males).
 Only 1 in 3 State prisoners, 1 in 4 Federal prisoners, and 1 in 6 jail
inmates who had a mental health problem had received treatment
since admission.
-Bureau of Justice Statistics
www.bjs.gov/index

6.  More than one in four adults living with serious mental health problems also has a
substance use problem.
 Mental and substance use disorders share some underlying causes, including
changes in brain composition, genetic vulnerabilities, and early exposure to stress
or trauma.
 Substance use problems occur more frequently with certain mental health
problems, including: Depression, Anxiety Disorders, Schizophrenia & Personality
Disorders
 Certain illegal drugs can cause people with an addiction to experience one or more
symptoms of a mental health problem.
 Mental health problems can sometimes lead to alcohol or drug use, as some
people with a mental health problem may misuse these substances as a form of
self-medication.
-www/MentalHealth.gov
The Dual Connection

7.  Legislative Intent
 Rehabilitation vs. Punishment
 Goal - Trade Jail for Rehab
 PC 1000
 Prop 36
 Deferred Entry of Judgment
 Case Dismissed!
 Clean Record
 Suspended Sentence – Violations Without Recovery
 Home Monitoring
 Work Release
 Weekend Jail
 Early Release Jail / Prison
Alternative Sentencing

8. Least Amount of
Jail Time / Legal
Consequences
Right Amount of
Treatment / As
Long As It Takes
ETHICAL BALANCE
Attorney
Client /
Criminal
Defense
Care
Advocacy /
Alternative
Sentencing

9. TIGHT SQUEEZE / QUICK FIX

10. Help Me
Who is your client? Family, identified client, both?
Determine what kind of help, if any, is indicated.
Have the charges resulted from substance use or mental health disorder?
Look at underlying behavior. Is it healthy for a family to defend the behavior/choices
at issue?
Does legal help advance the client’s interests? Release is not necessarily help.
Flight risk? Safeguards?
Is the client willing to enter treatment? For as long as necessary?
May need intervention. Care Advocacy. Court-ordered treatment.
Hiring private attorney may not be in client’s best interests

12. Engaging the Client
Engaging the Team
Engaging the Court

13. Care Advocacy

14. Care Advocacy
 Process – Not An Event – Over Time
 2 Way Street
– Treatment to Court (Reports / Progress / Recommendations)
-- Court to Treatment (Goals / Sentencing / Accountability)
 HIPAA Privacy Rules / Releases of Information
 Open Up Necessary Communication Upfront / Avoid Roadblocks
 Prepare Your Whole Team (Integrated / Coordinated
Communication Throughout Case)

15. Care Advocacy
 Involve Client As Much As Possible
 Case Management versus Case Handling
 Motivation / Reality Testing / Managing Expectations
 Confirm / Double-check Information / Warrants? Other Cases?
Check with Family – Attorney.
 Know the Case! (Case Calendar / Transport / Offenses / Possible
Sentencing/ Pro Licensing Concerns )
 Clinical Before Legal / But Know Limitations / Legal Restrictions

16. Care Advocacy
 Clinical Care Reporting -- Advocating for Client Care
 Letters for Court / Calendar Ahead / Motivate Client
 Clinical Recommendations / Advisements
 Program Strengths / The Care Plan / Aftercare
 Client Progress / Testing, Meetings, Specific Goals
 Problems Addressed / Problems Ahead
 Attorney/Client/Family --- Limiting Input & Involvement
 Letters from Others: Family? Sponsor? Victim?
 Transport to/from Court – Plan Ahead
 Supporting Client & Appearances

17. Care Advocacy
 Attorney Involvement --- Throughout Treatment -- Collaboration is
Key –Treatment / Clinical & Legal
 Parallel & Intersectional Processes -- Legal Motivators are under-
utilized / Strong external motivation for internal change
 Identify the Issues to be Addressed in Treatment --- for Court, for
DA, Community.
-- Case Restrictions / Requirements (e.g., periodic reporting,
electronic monitoring, bond restriction)
-- Complaint / Discovery (e.g., 911 Call, Body Cam Videos
Police Reports )
-- Can you do more (e.g., anger mgmt, volunteer work)

18. Clinical Meets Legal
 Know The Case to Assess the Client’s Needs / Appropriateness for
program
 Know the Case to Address the Behaviors / Clinical Moments with Client
 Complaint / Charges / The Arrest
 Discovery: Photos / Police Reports / Video / Body Cam
 Client Statements (now versus time of arrest / investigation)
 Witness Statements
 Victim Statements -- Versus Client as Victim / Empathy

19. Strategic Partnership
 Drug/DUI Court
 Mental Health Court
 Judge
 District Attorney / City Attorney
 Defense Counsel
 Care Advocate
 Treatment Program
 Mental Health Professional
 Probation /Parole
 Bail Bondsman
 Client’s Family & Support Network
 Strange Alliances – co-addict / co-defendant / Victim
 Interventionist

20. Intervention
 Treatment Indicated / Client Unwilling
 Client in Trouble / Loss of Control
 Family Focus Higher/ Problem More Visible
 Court Involvement / Assistance
 Maximum Consequences / Leverage / External
Motivators
 In Custody / Threat of Custody / Back to custody
 Access to client over time / Single location
 More Willingness / Freedom vs. Treatment
 Needs Attorney, Bail, Etc.
 Supervision & Terms of Probation
 Redefining Freedom
 Fear – The Great Motivator

21. Context &
Solution
Treatment
Clinical
Reporting
Recovery
Care
Advocacy
External Motivation
I

26. Common Obstacles
New Case May Trigger New
Violations & Warrants
 Deal With Upfront
 Good Communication usually resolves
 May jeopardize treatment
Admissions & Liability Traps!
 Leaving for Treatment may Trigger New Violations &
Warrants
 Prior Court Approval Required?
 Prior Probation/Parole Approval?
 May need to choose different treatment center
 Liability Trap? Errors and Omissions Claim Possible
 Release of Information – HIPAA – Prior to Admit --
You & Family

27. Common Obstacles
Client May Not Report Truthfully or
Accurately
 Independent Search Best
 Family/Client should do due diligence
 Family often does not have full story
 Client’s memory often off – distorted
Client’s Record & Prior Cases:
 Bench Warrants
 Probation Violations
 Parole Violations
 County Restriction
 State Restriction

28. Client In Custody
 Care Planning First
 Family resources / Family As Client
 Attorney and/or Care Advocate
 What help is indicated and healthy
 Do Not Delay / Insert Treatment ASAP
 Willingness / Intervention
 Rules of the Road
 No legal help if not helping themselves
 Change Agreement in Place
 No Negotiating
 $ on Books / Enabling / Limit Phone
 Family Spokesman / Care Advocate
 Treatment in Place
 Professional Assessment
 DA/Court Approved if possible
 Admission Confirmed
 Door to Door Transport / By Program
 Minimize Flight Risk
 Minimum family contact

29. Myths About Treatment
 Treatment As Magic Wand
 Prejudice to Court Case
 Prejudice to Career
 Only Willing if Court-Ordered
 Primary Concern is to Bail Out – Treatment Later
 Felony Charges Prohibit Out of County Treatment
 Will Violate My Probation / Parole (e.g., Drug Use)
 Will Lose Child Custody
 Family View – Court As Social Worker
 Jail As Sobriety / Recovery (“Clean Time”)
 Let’s wait and see!
 Legal First – Then Treatment

30. Case Examples
 Diversion On Commercial Burglary
 Diversion on Drug Distribution
 2 Meth DUIS + Intervention + Drug Court
 Probation Violations Excused
 Warrants Recalled
 Cases Dismissed
 Sentences Suspended
 Records Cleared
 Long-term Treatment – Long-term Success
 Family Healing / Reconnection

31. Better Outcomes