When mental illness leads to an arrest, this court steps in

Anita Wadhwani The Tennessean Published 10:00 p.m. CT Jul. 28, 2018 Updated 10:22 p.m. CT Jul. 28, 2018

When mental illness leads to an arrest, this court steps in...

When Charles Chesney's bipolar disorder is left untreated, the energy surging from sleepless, nonstop, manic days and nights takes over his life.

"Boy, does it make you feel good," said Chesney, a 39-year-old artist and performer. "For me, I thought I was capable of doing everything I wanted to do in life. I almost ran naked down Broadway."

Instead, Chesney ran naked down the street outside his family's Whites Creek farm.

It was one of a half-dozen episodes in the past six years that ended with Chesney in handcuffs.

Chesney vandalized cars in East Nashville — he was manic and angry about gentrification, he said — then ran to crouch in the bathroom of a nearby restaurant, where police found him.

He lay down on a snow-covered sidewalk in front of a bar, refusing to move even as patrons stepped around him. Arresting officers were concerned he would suffer from exposure.

He stood outside his mother's bedroom window and yelled that he would burn all the pictures he had of her "so you won't haunt me," then threatened to set fire to his adjacent apartment.

That offense, in March, landed Chesney in mental health court, an alternate court system that seeks to rehabilitate and treat people whose mental illnesses have ensnared them in Nashville's criminal justice system.

Getting care...

In Tennessee, where you live can affect your mental health

Just a fraction of people with serious mental illness commit crimes of any kind, but the city's criminal courts,

jails and prisons are straining to cope

with increasing numbers of nonviolent

offenders who have untreated mental illness.

At least a third of the men and women in Nashville jails have a mental illness, according to Sheriff Daron Hall.

While the budget for the Tennessee Department of Correction increased by more than 54 percent between 2008 and 2017, the budget for the Tennessee Department of Mental Health and Substance Abuse Services has remained the same.

Some experts say if more money was spent to support mental health treatment programs in Tennessee, the steep cost to the criminal justice system would decrease.

Tennessee now ranks 35th in the nation in spending on mental health, allotting $87.48 per person — well below the national average of $119.62, according to the

National Association of State Mental Health Program Directors Research Institute.

Mental health court sees the results of those state priorities, said Judge Melissa Blackburn, who presides over Davidson County's mental health court.

Instead of sentencing offenders like Chesney to jail time, which often exacerbates mental health issues and leads to a cycle of arrests, the court requires treatment while the men and women it supervises remain in their communities.

"You want to get them out of jail so they stay out," Blackburn said. "I don't want them back."

Your Recovery... Just Ahead!

Once the mania sets in...

As a participant in mental health court, Chesney is on probation and lives in a therapeutic halfway house in Antioch. As a condition of probation, Chesney attends counseling and 12-step programs and is required to work.

The court's staff enrolled Chesney in the state's Behavioral Health Safety Net program, which helps pay for his psychiatric medication. Chesney is required to make one phone call a day to an automated system that randomly assigns drug tests to people on probation.

Chesney said the routine established by the judge's rules and his medication have stabilized his life. On the hourlong bus ride from his Antioch halfway house to his downtown restaurant job, Chesney takes out his markers to work on his art. He uploads videos of his spoken word performances to YouTube.

Chesney had few bipolar symptoms until his 20s when he began taking hallucinogens' and other illegal drugs.

His first hypomanic episode erupted a decade ago. He was with his now ex-wife and mother, just before an open mic performance. He began speaking so fast — "as fast as my brain could think" — that they did not understand him.

Then, he said, he saw a "rainbow going into the sun and I was just walking downtown. I went to my old job and took off my shirt."

There was newly laid cement outside. Chesney ran through the cement "like Bugs Bunny, took off my shoes, took off my pants, decided to run naked down Broadway, then went back to my old job and caused a scene. I threatened to call (federal immigration enforcement) on his co-workers."

Chesney was involuntarily committed to Middle Tennessee Mental Health Institute for five days and given psychiatric medication.

Chesney ran out of the pills. He didn't refill them.

Deep cuts in mental health services...

Tennessee once was a leader in providing an array of mental health services to residents, enrolling people who had serious and persistent mental illnesses in Tenn Care, which covered the costs of prescription medications, psychiatrist visits, inpatient care and providing transportation for people without access to private health insurance.

In 2005, then Gov. Phil Bredesen abruptly cut more than 21,000 people with serious mental illnesses from the program as part of broader budget-driven cuts to Tenn Care. Those individuals lost immediate access to ongoing medication, psychiatric visits and social workers.

In its place the state created a Behavioral Health Safety Net, which provides fewer services and enrolls only uninsured residents who make less than the poverty level.

The impact on mental health court was immediate, said former Judge Dan Eisenstein, who retired as presiding judge over the court in 2014 but remains active in advocating for greater mental health care access.

"As soon as Tenn Care went away, the numbers skyrocketed," he said. "Mental health court wasn't set up to handle the numbers we were seeing. And it hasn't stopped. It's just coming to a head."

Funding for the court has seen a dramatic decrease at the same time the court is seeing increased caseloads — there are about 120 people enrolled at any given time, a more than threefold increase over a decade.

The court is funded through fines paid by those convicted of driving under the influence — a fund that has seen a 40 percent drop in the past five years as Uber and other ride-hailing services were established and prosecutors began accepting more plea deals, according to Mark Winslow, administrator for the court.

Last year the court received a one-time $40,000 appropriation by the city. Winslow said there is no guarantee it will receive funding next year.

'You get angry after you've been in a hypomanic state for days'

When Chesney threatened his mother with burning her picture and his apartment at their family farm in March, she called police.

"I'm a sweet guy and a nice guy all the time," he said. "But you get angry after you've been in a hypomanic state for days."

Officers stood outside the home — where Chesney lived with his girlfriend in an adjoining apartment — for seven hours waiting for staff with a mental health Mobile Crisis Unit to be available.

Police eventually handcuffed Chesney and took him to jail for a psychiatric assessment. Days later, he was accepted into mental health court. He remained in jail for another 30 days while mental health court staff found housing for him.

Housing has always been a problem, but it is increasingly difficult as the housing market has boomed. People admitted to mental health court stay in jail longer as caseworkers try to find housing, Blackburn said.

“I will not release anyone to the street," she said.

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