A Court of Refuge

by Ginger

  Individuals who have experienced trauma are at an elevated risk for substance abuse disorders, including abuse and dependence; mental health problems (for example, depression and anxiety symptoms or disorders, impairment in relational-social and other major life areas, other distressing symptoms, and suicide).11 According to the Substance Abuse and Mental Health Service Administration, “Trauma-informed criminal justice responses can help to avoid re-traumatizing individuals. This increases safety for all, decreases the chance of an individual returning to criminal behavior, and supports the recovery of justice-involved women and men with serious mental illness.”12 Having the flexibility in my regular criminal division to give voice to defendants and apply therapeutic jurisprudence principles (similar to the mental health court) enables Linda Withers and other defendants the equal opportunity to experience the sentencing phase of a case from a restorative perspective.

  Both parties agreed to renegotiate the plea.

  “Judge,” Ms. Withers said, wiping away tears, “I want to thank you for referring me to Carolyn and for helping me understand the secrets I have been too ashamed and afraid to confront. All my life I have lived in terror. If this driving-under-the-influence charge is what it took to help me, then I am grateful.”

  “You need to know, you are not alone, given all you have achieved in your life, despite what you have endured,” I said.

  As the hearing concluded, the Court Deputy called the next case on the docket. Michael Evans approached the bench. It took several minutes before I realized he was the defendant who had required the services of the Henderson Behavioral Health Center’s mobile crisis team.

  “Mr. Evans!” I greeted him. “I didn’t recognize you. How are you?” I asked.

  “Judge, I am so much better. I spent time with the therapists, and they are treating my depression. I am in therapy and I am feeling more optimistic about the future. I have a new part-time job and hope to become full-time within the next few months. Thank you for caring. . . . I don’t know what would have happened if I had not gotten help soon.”

  I asked him what he would like to do with his case. He had been charged with allegedly stealing several plastic electrical-outlet covers from a local hardware store. He responded that he would like to enter a plea of no contest and to take responsibility for what he did.

  “I will never forget this incident,” he said. “I had no idea how far down I sunk, Your Honor. I felt as if I was drowning.”

  “I understand, Mr. Evans,” I said and then called the next case.

  CHAPTER 8

  Brothers and Sisters

  It is estimated that that at least 8.4 million Americans provide care to an adult who suffers from an emotional or mental illness.1 As stated by the Sibling Leadership Network, siblings often become the next generation of caregivers with very little advance notice or training.2 For many aging caretakers of their adult children, the thought about what will happen to their adult child as they themselves age and then die is too uncomfortable to consider and is often avoided.3 Many parents “hope” that siblings will care for their mentally ill brother or sister, but without prior planning and clarification of roles or legal documentation, often siblings assume the caregiving role without needed information and without an opportunity to exercise choice.4 Sibling caregivers are called the “club sandwich generation,” as they are multitasking caregiving roles for their older parents, their own family, and their brother or sister.”5 When sibling caregivers appear in court on behalf of their brothers or sisters, I am cognizant of these pressures and do everything I can to try to ease their burden.

  According to research, these competing responsibilities are often physically, emotionally, and financially challenging and can cause significant distress.6 Caregivers for family members with mental illness provide on average thirty-two hours a week to caring for their loved ones, and about half (48 percent) report that their loved one is financially dependent on them.7 As the need for sibling care-taking continues to grow, the unique needs and experiences of these caregivers need to be better understood. Particularly, where the research indicates that most aging parents have not engaged siblings in planning for transition into the care-taking role and do not know what to expect.8

  For some, the caregiving responsibilities can become overwhelming, particularly when caregivers also have their own family and jobs, and the arrest of a brother or sister can become one crisis too many to manage.

  Larry Stiller lived a simple life in a small assisted-living facility in Fort Lauderdale. It was one of a small number of group homes that were decent, clean, and well staffed. It was owned by a family who was well known in the community and cared deeply about their residents, who were vulnerable and in need of supportive services. Larry, in his mid-forties, had been diagnosed with both schizophrenia and intellectual disabilities. He loved his morning coffee and interacting with others around him. Larry had been arrested in front of a fast-food restaurant for allegedly “harassing customers for money.”

  “Judge Wren, I didn’t mean to get arrested, I just needed some extra money to buy coffee,” he said.

  This was the topic of conversation each time Larry would get arrested. In fact, prior to these incidents Larry would go off his medication, but he never wanted to talk about that.

  The first time Larry was referred to the mental health court, he sat in the jury box handcuffed to the high-back chair and nervously bounced up and down. With every anxious motion, he pleaded with me to call his brother.

  “My brother, Mark, is at work. Can you call him . . . can you call him?” he asked repeatedly as tears ran down his face.

  “Judge,” Janis, the in-court clinician interrupted, “I think we need to send Larry to the hospital. He is not well.”

  I looked at Larry. He was tall and thin, with short reddish blond hair. He looked anxious. I thought that if I phoned his brother, it may help to calm him down and ease his anxiety.

  “One minute, Janis, I know we’re busy, but let me try to reach his brother,” I said. “What’s the number, Larry? Do you know it?”

  I admit that after seeing the behavior Larry had exhibited in his previous court, I was surprised when Larry rattled off his brother’s telephone number by heart and so quickly that I could not keep up. I asked him to please repeat the number for me, then placed the phone on the corner of my judge’s bench on speaker mode. Larry started to perk up visibly. As the phone rang, Larry’s enthusiasm began to boil over as he fidgeted in his chair and began to yell at the phone: “Pick up—come on—pick it up!”

  It seemed as though the phone rang forever. Minutes passed, measured out by the steady, unanswered ring. Just as I was ready to give up, Larry’s brother answered the phone. As soon as Larry heard his brother’s voice, he squealed with delight. “Mark, its Larry! I’m in jail, again.” And then, after a theatrical pause, “I’m sorry.”

  I took the phone off speaker and introduced myself to Larry’s brother, Mark Stiller. I explained to him that Larry was in a specialized mental health court and was going to be transported to Broward Health (a system of hospitals and other healthcare facilities) for psychiatric evaluation and stabilization. I told Mark that the hospital case manager assigned to Larry would contact him when Larry was ready for discharge.

  Mark was two years younger than Larry. When Larry was ready to be discharged from the hospital, the case managers arranged for Mark to come to the courtroom to pick him up and take him back to his living facility. As the two men stood before the bench, I saw little family resemblance between the two brothers. What was evident, however, was that Mark had gone through this process many times—perhaps too many times. His demeanor suggested that he was clearly miffed that he was in court again for what seemed like petty actions of his brother. Each time Larry was arrested, it was Mark who bailed him out.

  “I love my brother—but he won’t stop panhandling,” Mark said, exasperated. “I have done everything that my parents asked me to do. I give him spending mon
ey, I buy him groceries, I take care of his out-of-pocket medical bills, I take him out when I can, I buy him clothes. It seems to me that when he gets bored or lonely, he walks to the shopping center near his facility and begs for money, even though he doesn’t really need it.” Mark paused, sighed, and shrugged as though he was working the words out of himself. He shook his head and met my gaze. “Judge, I’m trying to start my own business, and this is getting really stressful,” he said.

  “I understand,” I replied.

  I did understand. It sounded awful. Mark was in the prime of his life, trying to focus on his own responsibilities, and Larry was not exactly behaving like a team player. From his perspective, this was more than he bargained for or deserved. Janis and I offered several suggestions, such as a day treatment program or a consumer drop-in center not far from where Mark lived. At these drop-in centers, run by peers for peers, people with mental illness can visit and seek support, participate in social and recreational activities, and engage in self-advocacy and recovery-oriented activities. Larry responded to each of these suggestions by saying, simply, “I am fine where I am.” It seemed that Larry had his routine and could not appreciate that his routine was landing him in jail and stressing out his brother.

  Janis suggested that we follow Larry in the court and see how he does. Given the fact that he seemed otherwise happy where he lived, she did not want to “upset the apple cart.”

  I had a long talk with Larry in the courtroom that day about safe choices and good decisions. I am not sure whether he was capable of comprehending what I said, but I hope he heard some of it.

  Larry was affable and fast talking, but I could tell he required a great deal of redirection and patience. He would drift off in the middle of important directions and seemed to disengage right when I, a clinician, or even his brother, Mark, tried to tell him something essential. I could understand and appreciate Mark’s frustration.

  Mark was married with two children, yet he dutifully embraced his role as custodian of Larry’s affairs. Mark explained that their parents had passed away several years ago, and Larry became his responsibility. Even though it wasn’t always easy, he said that he was fully open to continuing to care for his brother.

  “Larry is fortunate to have a brother like you to support him,” I said. I also emphasized that the court understood how challenging and at times overwhelming the caregiving role can be. Over the years we have met extraordinary brothers and sisters who have stepped up to take care of their siblings, with little fanfare and virtually no support or respite.

  Thomas Capello had been arrested for resisting an officer without violence after he allegedly failed to produce his identification and show it to a police officer when the officer stopped him for drinking a beer on Fort Lauderdale beach and asked for his ID. Thomas had been diagnosed with bipolar disorder, and he was off his medications. The encounter became tense when he could not produce his identification. His brother, Jeffrey, appeared in court with him, and as they stood side by side, it was difficult to tell one from the other. They were identical twins.

  Jeffrey explained that Thomas had been injured in a car accident when he was a teenager and had spent several months in solitude while he was treated at a local hospital. The traumatic brain injury had left him unable to live alone, as he had difficulty remembering things and needed help caring for himself. Fortunately, the injury was not worse, and there were many activities that he enjoyed doing.

  “Sometimes Thomas forgets to take his medication,” Jeffrey explained.

  “Jeff and I are in business together,” Thomas proclaimed in a proud voice. “We are cabinetmakers. Just like our father.”

  “That’s true, Judge,” Jeffrey added.

  Jeffrey explained that his parents had been born in Italy, and their family had immigrated to New York when the twins were three years old. In the 1970s, the family relocated to Florida, where their father started a kitchen-remodeling business. I laughed to myself, thinking that is exactly what my family had done: my grandparents and other relatives decided to escape the harsh winters up north and build a new life in the Sunshine State.

  Janis suggested that I order a psychological evaluation to determine Thomas’s mental competency to stand trial. She speculated that the traumatic brain injury and resulting cognitive disabilities were significant and needed to be reviewed.

  Over the course of several months, the Capello brothers came to court a number of times. Each time they were called to the bench, we marveled at the closeness of their bond and their deep sense of caring for each other. They were extremely fortunate that they had the family business together. They also gave special meaning to the phrase “my brother’s keeper.”

  The concerns over what happens to an adult child with serious mental illness is often raised in mental health court. Many mental health court consumers are from single-child households or they are not close to their siblings. As the parents age, they can no longer provide the level of care that a mentally ill person requires, and often there is not a caregiving transition plan in place.

  Not all siblings are willing to take on caregiving responsibilities. Some are weighed down by the burdens in their own lives and others are so estranged that they could not possibly act as feasible caregivers. Many may not have the financial resources or physical space to bring another family member into their home on a permanent basis. It is no small thing to care for the well-being of another person.

  Within the next few weeks, I watched as the court deputies escorted in defendants for the mental health court docket. I heard Larry’s voice even before he walked through the courtroom doors.

  “Judge, I’m sorry, it’s those police officers!” Larry yelled. “They have something against me—they hate me!”

  “Larry is making choices, and they aren’t good ones,” Janis said, her voice heavy with concern.

  “Well, we knew that Larry is extremely vulnerable in the community,” I said. “What was I supposed to do, incarcerate him for hanging around a shopping center and asking for money? I knew that Larry would be at risk in the jail. That wasn’t a solution.”

  “Larry, where is your brother, Mark?” I asked.

  “I don’t know, Judge. I haven’t seen him in a while. I think he went to visit friends,” Larry said.

  Janis and I looked at each other, tacitly acknowledging that perhaps Mark was unable to continue supporting his brother. Perhaps he took a much-needed break or maybe he had moved out of the county. Janis offered to call him and at least try to confirm if he would pick his brother up. Clearly, some psychosocial strategies needed to be tried. Janis got on the phone and dialed his brother’s number.

  The line had been disconnected.

  We did not have the heart to tell Larry.

  “Let’s talk about how we can help you, Larry,” I said. “Let’s talk.”

  CHAPTER 9

  Changing Hearts and Minds

  As we entered the ballroom of a major conference hotel in downtown Miami, I could feel the electricity in the air. In the five years since its founding, not only had the mental health court gained national prominence for justice innovation, but also its process was solidifying as we settled into our individual roles. It seemed to me, as presiding judge, as if there was a new wave of energy and understanding about the people whom the court was serving. We had not only begun to change the minds and attitudes about mental illness of the judges and lawyers in the community, but we also had grown through our own experiences, as witnesses to recovery and the boundlessness of human potential.

  Based upon dialogues held in court, we learned that most people who have been referred to the court were high school graduates, had attended or graduated from college, and were working or had worked prior to their illness. It was fascinating to us how many people who had come through the court had attended some college or graduated with an associate’s or bachelor’s degree. Even when people self-reported that they were homeless or staying with friends, we asked about their
former lives. No one, we found, is born without aspirations or dreams.

  As our hopes and expectations grew, our sense of empowering court participants became stronger. We asked everyone, “What are your strengths? What is your vision for your life?” The deeper the questions, the higher the level of conversations and dialogues.

  As presiding judge, I have seen that the depth of commitment to wellness and recovery has told the story of the court. Just as having the belief of another person can be the key to recovery, we found the court’s belief in its clients facilitated the miraculous.

  As the Broward County Mental Health Court celebrated its anniversary, the intensity of the public’s response to the court and its work was overwhelming. Before long, new mental health courts were being established across the country. It seemed that in Broward County’s quest to create its own court of refuge, our community had stumbled on a “tipping point of desperation,” which, unexpectedly, exploded.

  As news of America’s first mental health court spread, the courtroom filled not only with mental health consumers, advocates, and their families but also with delegations from around the country and the world. Every day, mental health advocates from all disciplines scrambled to find space in the courtroom. When the seats ran out, news cameras and journalists lined the walls and recorded sessions, watching court proceedings unfold one after the other.