Using the System to Break the Cycle
Using the System to Break the Cycle | Davidson County Mental Health Court, Judge Daniel Eisenstein, Centerstone, Mental Health Cooperative, Park Center, Tonia Dixon-Gilbert, Cumberland Heights, Barbara Larew-Adams, Tennessee Titans Cheerleaders

The Healthy Mental Health program kicked off with assistance from the Tennessee Titans cheerleaders.
Hope and help are available for some of the city's most vulnerable entrants into the criminal justice system. Since 2001, the Davidson County Mental Health Court has worked with hundreds of clients to try to make sure they don't become repeat offenders.

A four-year federal grant allowed the General Sessions Court to establish a Mental Health Court in Davidson County. The grant, which was requested by the Public Defender's Office with the full support of the District Attorney General, was approved in July 2000 and became operational in January 2001, making Nashville the fifth city in the nation to have such a program. Metro Council ensured continued funding when the federal grant expired in 2004.

Today, Judge Daniel Eisenstein, General Sessions Court Division II, oversees the program with help from a staff of five.

"We are responsible for supervising the probations or diversions for people involved in the criminal justice system with serious and persistent mental illness," Eisenstein explained of the very specific population served.

His court, he continued, oversees those arrested and found guilty of a misdemeanor or those who have been placed in a criminal diversion program, in addition to more than two dozen offenders who have been sent to his staff for supervised probation from the criminal court for more serious offenses.

"We supervise them for the period of probation," he continued, noting that can range from 11 months and 29 days for a charge such as trespassing to much longer supervisory periods for those with multiple misdemeanor or criminal charges. "We've grown dramatically in the last three years so we're running about 160 people at any given time."

Venus & Mars Addiction Recovery

When it comes to addiction and recovery, there are vast differences between treatment needs of men and women, according to Barbara Larew-Adams, director of clinical services for Cumberland Heights.

"Women progress more quickly into addiction than do men, and the physical consequences are greater faster," explained Larew-Adams.

Based on national statistics, more than 150,000 women in Tennessee are substance dependent or substance abusers, yet 90 percent never receive treatment.

Last month, The Women's Center of Cumberland Heights was dedicated to provide gender-specific therapy and treatment in an effort to more effectively reach women in need of help. The 16-bed women's-only inpatient facility is located on Cumberland Heights' flagship River Road Campus in Nashville.

Studies show women are more likely than men to develop serious health problems from addiction — problems such as liver damage, brain damage, heart disease and cancer. Other harmful consequences of addiction among women include suicide, automobile accidents and sexual assault.

Addicted women are nearly twice as likely to die from an illness related to their addiction than men in the same circumstances. Further driving the seriousness of the issue home, almost four times as many women die from illnesses related to addiction than from breast cancer.

The good news is that experience shows when women access treatment for their addiction, they progress more quickly toward recovery than do men, and they have a higher success rate than men.

"More than one in four households nationally experience the effects of addiction, a disease that has dramatic effects on the family," said Larew-Adams. "With this new inpatient capacity, we are hoping to initiate a community-wide dialogue on the challenges for women in addiction and recovery for themselves, their families and friends."

Mary Faulkner is the director of The Women's Center of Cumberland Heights, which is housed in the newly renovated 6,000 sq. ft. Templeton Hall.


Eisenstein said his office works with Centerstone, the Mental Health Cooperative and Park Center, in addition to other community resource providers, to help those under the court's supervision find better outlets for their time and energies.

"Our goal is to break the cycle of re-arrest and conviction and get them out of the revolving door," he said.

Numerous research studies have shown that those with developmental disabilities and serious or persistent mental illness typically do not respond well to the normal strictures of the traditional criminal justice system. As a result of this disconnect, these offenders often wind up facing longer periods of incarceration and/or higher rates of recidivism.

"About 70 percent of the people that enter our supervision — and it's a very structured supervision — are successful in graduating," Eisenstein continued of the Mental Health Court approach. "Our recidivism rate is very low. It's under 10 percent," he added of statistics showing new arrest and conviction among program graduates.

Eisenstein credits the court's success with taking a common sense, practical approach to the specific needs of this population.

"If you get somebody in treatment, give them a place to live and give them something to do, chances are they're not going to get into trouble," he noted.

While the general approach is based on common sense, Eisenstein doesn't downplay the complicated issues facing those who wind up in his court.

"Almost 100 percent of the people we work with are dual diagnosed meaning they also have addiction issues," he said. However, he added, having a year or more to work with those being supervised by the court does allow time to establish healthy patterns and behaviors, which have typically been carried forth.

The success seen by the Davidson County program and other early pioneers has now been replicated in similar courts across the nation. While pleased with the progress that has been made, Eisenstein and his staff are always looking for ways to expand their reach and improve outcomes.

A new program, which was launched at the end of October, looks to offer additional help to the most motivated of the court's supervised offenders. The Healthy Mental Health Program uses journaling and other creative outlets to help participants see themselves in a new light.

"You've got to think healthy first before you can be healthy," stressed Tonia Dixon-Gilbert, the Mental Health Court client specialist who has spearheaded this new effort. She said the population she and her colleagues serve face many issues including physical health complaints and competency issues that can make it difficult to adopt healthy actions and attitudes.

"With our clientele, it's hard for them to see themselves with any worth," she said. "And then when they're in the legal system, they're just so beaten down and so ashamed."

By offering them the opportunity to engage in activities they enjoy … whether it be exercise or writing music or journaling … the court hopes to turn those negative thoughts into positive energy. Participants keep a log of whatever activity they have chosen and bring their book to supervisory visits. Dixon-Gilbert said that the act of writing down what they have done can help show them who they are and all they have accomplished.

"For a person in our demographic to start to write or read is just huge," she said. "We try to catch them when we get them and have their interest peaked. We kind of circle around them and give them support," Dixon-Gilbert continued of the team effort.

She added that it truly is a team effort. Not only do those that work with the Mental Health Court participate, but the new program is sponsored by the Tennessee Titans Cheerleaders. Dixon-Gilbert said the support is active, hands-on participation with the program, and she credited the cheerleaders with seeing this need in the community and being willing to step up to help fill the void. In addition, to the staff and cheerleaders, Dixon-Gilbert said participants work with numerous support providers who help provide everything from counseling to potential employment.

Right now less than 5 percent of the court's offenders have been selected for the program, Dixon-Gilbert said. However, she noted, the program is evolving and changing every day in an effort to find the best ways to meet the needs of those with mental illness who truly want to make positive changes in their lives.