Mental HEALTH COURTDOCKET

Since it'sinception in July2021,the Mental Health Court Docket ("MHCD") isnow fullyoperational with many accomplishments.To reach these milestones,policiesand procedureswere developed,necessaryregulatory provisionsfor establishing serviceswere proposed, stakeholderswere identified,all necessarypersonnel were hired,and office space wassecured.

The first referral to the MHCDwasreceived in August 2021 and the first participant wasadmitted to the program in November.In March of 2022,individual counseling wasprovided through the Kagman Health CommunityCenter for the first time.ByMay, five full-time employee "FTE"positionswere filled,with the Manager coming on board the last week of May.The MHCDteam attended national conference training,and upon return to the CNMI, developed Tracksand Phasesto incorporate best practices.In July,MHCDhad itsfirst participant advance to Phase II. Bythe end of September,both Community Supervision Worker positionswere filled.In the fall,group counseling session for all participantsbegan and MHCDheld itsfirst quarterlyworkshop,bringing the stakeholdersand the team in one table,face to face for the first time.

The priorityfor 2022 hasbeen establishing the structure and protocolsfor the new court, updating and creating forms, streamlining internal and external processes,establishing data collection system,and building relationshipswith stakeholdersfor effective court operation.However, with limited Mental Health Court national guidelines,insufficient training,and frequent unforeseen incidentswithin dailyoperations, there are yet more structuresto be developed and updated in the upcoming year.

Another prioritywashelping participantsto begin taking medication and connecting them to treatment quicklybyreducing the wait time for appointments.By prioritizing treatment schedules and activelyengaging with stakeholders,improvementshave been seen with new referrals. Nevertheless,the wait for MHCD participantsto receiving treatment isstill too long.

Another accomplishment for MHCD wasthe development of the docket'sTracksand Phases.The Tracksand Phasesmatchesservices and supervision to participantsat different risk and need levels. Following best practice standard recommendations,there are currentlyhastwo different tracks for participant at different risk and need levels.Track 1 targets individualswho have mental health and co-occurring substance use disorderswho are at a high risk to re-offend.These individualsare least likelyto succeed without intensive support and supervision. Track 1 isdivided into five phases lasting a minimum of 22 months. Track 2 emphasizestreatment for individualswith mental health disordersand for individualswho do not require high intensity supervision.Track 2 isdivided into four phaseslasting a minimum of 18 months.Each phase consistsof specifictreatment goals,activities, and requirementsthat must be met before participantscan move to the next phase.Moving into the next phase isnot automaticand will be determined bythe judge and the team according to individual progresswith recommendation from the treatment providers. Recognizing that the mental health court docket isgoal-based and not time-based iscrucial for the successof participants. Furthermore,one phase doesnot fit all.Each track and phase are geared toward each individual's goalsand progress.The MHCDis still in itsinfancystage of development.Continuouseffort is needed through the trial-and-error processto determine the most suitable method to obtain the desired outcome for participants.

RISK/NEED LEVEL TRACKS PHASES

High - Risk

High - Need Track 1: Supervision and Treatment Emphasis

Duration: 22 - 28 months

1.Acute Stabilization

2.Clinical Stabilization

3.Pro-Social Habilitation

4.Adaptive Habilitation

5.Continuing Care

Low - Risk

High - Need Track 2: Treatment Emphasis

Duration: 18-24 months

1.Acute Stabilization

2.Clinical Stabilization

3.Pro-Social Habilitation

4.Adaptive Habilitation

Funding

For FY2022, through PL22-22,MHCDreceived $610,402: $417,858 for 7personnel and $192,544 for operations.

MHCDwasalso awarded a CJPAJAGGrant in the amount of $10,000 for training purposes.Partial fundswere expended to attend the 2022 Treatment CourtsSummit in Denver,Colorado in the month of October. Additionally,the Judiciarywasawarded the Byrne DiscretionaryCommunity Project Funding/Byrne Discretionary Grant for technical assistance to determine the viabilityof a mental health treatment court with a specificdocket for veterans.The approved award amount is$303,000 over three yearsuntil September 30,2025.The project's request of Change of Scope hasbeen approved.The project will involve contracting professionalswith experience to conduct research,compile data,seek and determine funding availabilityfor the long-term viabilityof the court, train court staff and stakeholders,establish and develop policiesand procedures,and propose needed regulatory or statutoryprovisionsto set up the court services.Budget modificationshave been reviewed and approved internally bythe Chief Justice.Modificationsare currentlybeing reviewed bythe BJAgrantsmanager.

Personnel And Office Space

Atotal of seven positionswere created for the MHCDdivision.Asplanned,all vacancieswere filled bySeptember 26,2022: Manager,Clinical Liaison,Case Manager I (2),CommunitySupervision Worker (2),and Deputy Clerk II. The Case Managerswere the first personnel hired for the division.The MHCDteam operatesout of the previous Law Revision Commission office in the Guma' Hustisia.

Mhcd Organization Chart

Data And Statistical Information

For 2022,MHCDreceived a total of three referralsfrom the Office of AttorneyGeneral.One referral did not meet the legal eligibilityrequirementsdue to the defendant being charged with a dangerousoffense.There are no pending referrals.To date,there are a total of five participantsin MHCD; four out of five participantshave a dual diagnosis.Two participantsadvanced to Phase 2,with one being on Track 1 and the other on Track 2.

The program saw an increase in all aspectstowardsthe fourth quarter of the reporting year.Increasesin the frequencyof court hearings,case management,supervision,and drug testing resulted not onlyin the increase in the number of violations,but also provided the opportunityto use positive reinforcement to encourage desired behaviorsand provide therapeuticadjustmentsasneeded.Furthermore,reduction of new arrestswhile in the program,behavior change,decline in substance use,and noticeable positive effectswithin participants have been observed.The graph below illustratesthe overall MHCD performance for 2022.