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Anticipating surging cases, Maricopa County court expands mental health services

Partnered with Valleywise Behavioral Health, the county’s mental health court opened a new physical courtroom alongside a virtual program to hear mental health cases more efficiently.

PHOENIX (CN) — After a nearly 200% increase in mental health cases in the past decade, Maricopa County Superior Court officials hope new infrastructure will help the court system keep up with the seemingly endless demand. 

Partnering with various county officials and others, the court's probate and mental health department opened a new mental health courtroom at Valleywise Behavioral Health Center in Phoenix's Maryvale neighborhood and a new virtual court process at Connections Health Solutions’ urgent psychiatric center.

Valleywise Behavioral Health's fourth mental health courtroom opened on Nov. 28, costing nearly $2.9 million.

Valleywise is a group of four psychiatric hospitals for those with mental and behavioral illnesses. Each hospital has a built-in courtroom to hear court-ordered evaluation and treatment cases. One is in Mesa, one is in central Phoenix, and there are now two courtrooms in the Maryvale location.

The courtrooms are overseen by commissioners, not judges, though commissioners have the same judicial powers in these cases.

The second Maryvale courtroom follows a 169% increase in mental health cases over the last decade according to Keith Kaplan, probate and mental health court administrator.

In 2012, the court saw about 4,000 new petitions for court-ordered evaluation and about 3,000 petitions for court-ordered treatment. In 2021, those numbers jumped to 10,000 and 4,500, respectively. 

“By opening the second courtroom at Maryvale, we’re not only addressing current growth, but we’re expecting to address future growth at all of the Valleywise facilities,” Kaplan said. 

Officials say the new courtroom will meet the current demand, but they expect the rise to continue.

Across the four Valleywise centers, 306 beds are in use, serving a county of 4.5 million people. Valleywise anticipates that 326 beds will be full by the end of February, and the total will reach 398 beds once the Maryvale center is fully operational.

Due to staffing shortages, only five of the eight 24-bed units at Maryvale are used. 

“We’re experiencing the general challenges that all health care organizations are facing with recruiting and retaining nurses and other staff,” said Gene Cavallo, Valleywise's senior vice president.

The virtual system at Connections is a one-year pilot to test the efficacy of holding the court process at that location. Connections offered up 16 beds for patients going through court-ordered evaluation and treatment.

“If successful we do anticipate, contingent on funding, to look and identify whether or not it's a good opportunity to build another courtroom at Connections,” Kaplan said. 

The establishment of both the new courtroom and the virtual courtroom was made possible by county's American Rescue Plan Act funding, Kaplan said.

Construction and move-in at Maryvale cost nearly $2.9 million.

Keith Kaplan, Maricopa County probate mental health department court administrator, points to the front of the newest Valleywise Behavioral Health courtroom in Maryvale. (Joe Duhownik/Courthouse News)

The new courtroom sits on the second floor of the Valleywise center, adjacent to the first. Below the courtrooms is an emergency department, a pharmacy and a lab, along with full X-ray and radiology equipment.

An elevator takes patients down from their units directly to the back door of the courtrooms, keeping them out of the public eye until they’re in the room. Kaplan said that makes it easier and more efficient to get people in and out of hearings. The courtrooms being in the same facility where patients live makes the process smoother.

Above the courtrooms on the third through sixth floors are the eight patient units.

The second courtroom opened Nov. 28, and the virtual courtroom opened Jan. 23. Two months in, commissioners say the second courtroom has eased the load — for now. 

“My workload is lower right now, but I’m fully anticipating that it’s gonna go back up," said Commissioner Elise Donnadieu, who has overseen the first Maryvale courtroom since 2019.

Commissioner Annielaurie Van Wie oversees the new courtroom.

“This is really getting up and doing good work in the community,” Van Wie said. “You really get to help people, and you can see it in front of your eyes.”

She said everyone involved in the process wants what’s best for the subject.

“By the grace of God, I could be that person,” Van Wie said. “I have been the person in the back of the court with a family member in a process like this. I just treat people with dignity, because they deserve it. Because they’re humans.”

The mental health court process

There are three ways in which a person enters the mental health court according to Trent Buckallew, a Phoenix-based criminal defense attorney experienced in Maricopa County's mental health courts.

Most often, a person is taken to an urgent psychiatric care facility after a mental health crisis. The court receives an application for emergency admission, and the person is placed on a 24-hour hold. After 24 hours, a doctor either releases the person or sends them to one of the four Valleywise Behavioral Health Centers with a court-ordered evaluation petition.

Family can also file a petition for a court-ordered evaluation, in which case a team evaluates the person and decides if they need to be taken in.

Finally, a defendant in a criminal case enters the mental health court if found unfit to stand trial. The goal is to restore them to a state in which they can face their charges. Buckallew said this is the least common method of entry.

After a court-ordered evaluation, the person is held for 72 hours, during which two doctors examine the subject and must independently agree that they fall into one of four categories: “danger to self,” “danger to others,” “persistently or acutely disabled” or “gravely disabled.”

If the doctors agree, the court has six business days to hold a court-ordered treatment hearing.

“It’s a rocket docket by design because obviously the people there have committed no crime,” Buckallew said. “They're just alleged to be not well and in need of help.”

If the court can’t schedule a hearing in six business days, the case is dismissed. 

“In the process, we’re depriving them of liberty,” Buckallew said. “If we’re gonna do that to citizens, it better be well regulated.”

Kaplan said there are never delays.

“We try to set hearings on the fourth day just to ensure that we have a little bit of space to push it to the sixth if needed,” he said.

If the court finds that a person fits into one of the four categories, the court commissioner issues a 365-day treatment order. That typically entails 180 days of inpatient treatment, but a person might be held for a year if found to be “gravely disabled.”

Buckallew said the creation of the new courtroom should help the courts keep up with the demand so long as they can properly staff it.

“If it’s properly staffed, then you should have multiple judicial divisions operating under these tight deadlines,” he said. “If you only have one judicial division and they can’t handle the workload, then they’re gonna have to start triaging and figure out which cases we’re gonna dismiss and which ones we’re gonna move forward.”

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