Mental Health Judge Is Not A “Social Worker” But Uses Docket To Connect Individuals With Mental Illnesses To Social Workers

Judge Tina Snee of the Fairfax County General District Court speaks at first mental health docket graduation. Photo courtesy of Fairfax County Government.

(10-6-20)  I want to thank Fairfax County General District Judge Tina Snee for answering questions about the county’s mental health docket, which is an important part of the overall Diversion First program that was created to divert individuals with mental illnesses and addiction problems into treatment services rather than having them languish in jail and ultimately being released untreated. 

  1. What made you agree to add a mental health docket to your already full schedule as a Fairfax County General District Judge?

I joined the bench in 2015 from a background of civil litigation.  It was my first immersion into the criminal justice system, and I was surprised at the number of defendants who presented, or charges reflected mental health and/or addiction issues. I was approached by Fairfax Court Services to see if I would be willing to work cross agency on the Fairfax County Diversion First Initiative.  We decided it would be beneficial to add a Behavioral Health Docket so we successfully petitioned the Virginia Supreme Court for approval of a Behavioral Health Docket and after its first year of operation can say it is a success.

All of us who work on Diversion First are doing it in addition to our busy schedules but we all receive a great deal of satisfaction seeing the benefits to individual defendants and the criminal justice system here in Fairfax.  

  1. Some Virginia Judges oppose problem solving dockets – arguing that they require judges to become “social workers” or they argue defendants who come before them shouldn’t get special treatment simply because they have a mental disorder. How do you respond to those arguments?

The simple answer is I am trying to connect those on the docket to a “social worker” not be a social worker. I am still a Judge, and this is still the criminal justice system. The Fairfax County Mental Health Docket was approved by the Virginia Supreme Court and follows the structures implemented by the NADCP (National Association for Drug Court Professionals). NADCP provides a structured outline of the roles of each MH Docket team member (Judge, Prosecutor, Defense, Probation, Treatment). This outline clearly defines each team member’s role and duties – a sort of “stay in your lane” approach. The judge does not enter into a role of a “social worker.” The Judge hears the perspective of the team and requires participants to follow treatment recommendations.

At pre-court meetings, the team discusses each participant’s progress, to include challenges and successes that have occurred over the course of the past two weeks. We discuss possible treatment interventions, supervision adjustments, sanctions, and incentives. This allows us to have a discussion between everyone – treatment, supervision, defense, and prosecution – the judge ultimately decides if there will be a sanction or incentive issued. However, the judge does not determine the treatment intervention – treatment providers make that decision based on each individual’s treatment needs.

  1. You said in your graduation remarks that the three graduates faced more requirements than if they had gone through the standard criminal justice system. What did you mean? Can you share with us some of those higher expectations?

The criminal justice system requires a defendant to plead to the charges and if found guilty a sentence that may or may not include jail time. It does not require reflection on what brought on the criminal charges or require that they change behavior or provide in most cases the help to change. Frequently individuals who had histories of mental illnesses were placed on probation with a mental health condition. If individuals are struggling (not following treatment recommendations, frequent positive drug screens, etc), they run the risk of getting a probation violation – this is an additional criminal charge which carries possible jail time. Sometimes jail is easier then changing behavior.  The mental health requires change and will strongly supervise that while providing the needed services.

Participants are required to : Follow treatment recommendations, whatever those recommendations may be. All participants receive an updated assessment/evaluation as they enter into the docket to determine what the recommended level of care is. Treatment needs are fluid and may change while a participant is in the program – if there is a major change in treatment need (increase in psychotic/manic symptoms, hospitalization, frequent positive drug screens), we will have the individual reassessed to determine the updated level of care. It is not uncommon to have someone start the docket at one level of care and move into a higher or lower level of care (sometimes several times) while in the program.  Treatment is not “one size fits all” – we look at each individuals’ treatment needs and determine what level of care can help them meet those needs.

While in the program, individuals are required to attend frequent court hearings – the mental health docket occurs on the 1st, 3rd, and 5th Friday of the month. The frequency of court appearances depends on what phase of the program each participant is in (with more frequent appearances required in the earlier stages of the program). An incentive given for positive behaviors/progress in the program is decreasing court appearances. As individuals are preparing to graduate and are in the maintenance stage of change, they only appear before the court 1x monthly.

When individuals initially enter the program, they are required to check in with probation/court services 1x weekly and come to court once every two weeks. If individuals appear to be struggling, we may increase the frequency of the court appearances/supervision.

What frequently happened before the advent of specialty dockets was that individuals who had histories of mental illnesses were placed on probation with a mental health condition. A risk associated with this is that if individuals are struggling (not following treatment recommendations, frequent positive drug screens, etc), they run the risk of getting a probation violation – this is an additional criminal charge which carries possible jail time. The MH Docket seeks to address many of the same problematic behaviors that would lead to a probation violation WITHOUT further entrenching the individual in the criminal justice system. We do this via-a-vis sanctions – when an individual is struggling, we work with them by adjusting treatment recommendations, increasing supervision, and implementing sanctions – the goal of this is to correct and change the problematic behavior without further entrenchment in the criminal justice system. The goal for all of our graduates is for them to graduate from the program with NO outstanding criminal charges, no probation requirements, and no further involvement in the CJ system.

Sanctions are graduated in nature and increase in severity if the problematic behavior continues; sanctions are accompanied by treatment interventions. Some samples of sanctions include:

*Verbal reprimand from judge
*essay/writing assignment
*Sending daily schedule to docket coordinator
*GPS ankle monitor
*SCRAM bracelet
*Increase in court supervision (with probation)
*Increase in court appearances
*Flash jail sanction (24-48 hours incarceration)

Likewise, we use incentives when participants are doing well; incentives are also graduated in nature and can include:

*Verbal praise from judge
*Certificates of completion
*Prize wheel
*gift cards
*decrease in supervision
*Decrease in court appearances

  1. You said that you and your team wondered if one graduate would make it through the program. How do you evaluate candidates? We know that those charged with crimes who have a mental illness spend five to seven times longer in jails because judges and prosecutors are reluctant to risk releasing them.

    Individuals are initially referred by many sources to include: defense attorneys, commonwealth’s attorneys, treatment providers, law enforcement, victims’ services, probation, family members, neighbors. Honestly, we receive referrals from anyone who is either directly or peripherally involved in an individual’s case. The Court does not limit participation based on the type of charges. One thing that separates the MH Docket from the other specialty dockets in Fairfax County is the breadth of the types of charges that we can accept – we can accept felonies, including violent felonies. One important piece that permits us to work with such charges is the involvement of the Victims’ Services Section of the Fairfax County Police Department. When the docket was in its infancy, the prosecutor who was working with the us at the time, Casey Lingan, recognized that we were receiving referrals for individuals with significant charges (robbery, malicious wounding, assault and battery, assault on law enforcement). Instead of making a blanket rule that we don’t accept people with felonies or violent felonies, Mr. Lingan reached out to Victims’ Services to see if someone could be assigned to the MH Docket program. Pam Kelly has been assigned to the MH Docket since it started in July 2019 – her role is make sure that any victims’ who are involved in a client’s case have a voice at the table when negotiations are being made (to include no contact orders or any other special conditions to be included in the participant contract). Ms. Kelly attends all MH Docket hearings and provides updates to victims as needed. We have found that having Victims Services involved in the MH Docket ensures that we have buy-in from everyone involved in the case.
    The most important criteria for an individual entering the MH Docket is that they are high risk/high needs.  High risk to recidivate and in high need of services.
    Regarding “wondering if a participant will make it through the program” many of our participants begin the program with few resources or natural supports. When we begin working with them, we look at each participant holistically to consider what connections/supports need to be addressed in addition to MH treatment and medication. For instance, if someone is street homeless, uninsured, and actively abusing substances, we need to address their immediate safety and basic needs in addition to connecting them with a psychiatrist and case manager. Our goal is to make sure that our participants are safe, housed, insured, sober, have a structured daytime activity, are working with a treatment provider, and psychiatrically stable.

      5. Judges in drug courts expect some of their graduates to relapse. How will you and your team handle incidents if someone accepted in your program relapses?

Relapse is part of recovery, and we recognize that. This docket deals with both substance abuse relapses and psychiatric decompensation. When an individual relapses/decompensates, we work with their treatment team to stabilize them, ensure their safety, and then address the relapse/decompensation with treatment adjustments. This can include: adding a substance abuse component into the treatment plan, adjusting medication, possibly hospitalization or partial hospitalization, residential treatment, increase in drug testing, recommending a higher level of care, etc. We may also increase court supervision to ensure that we are closely monitoring that individual in the days/weeks following the relapse/decompensate.

      6. What can we do to support your work?

Funding. The interest in our program is high. We receive a tremendous volume of referrals. Unfortunately, we will not be able to expand past 25 participants until we receive funding for additional staff (treatment coordinator, treatment providers working specifically with the MH Docket team). Like many other agencies within Fairfax County, Diversion First took a huge blow in regard to funding for FY21. We recognize that the pandemic has impacted all county budgets, but in order to expand, we need funding for more positions.

     7. Are there plans to expand your docket so more can be helped?

      Our capacity for the Docket is 25 and we have reached 18 in one year.  We would need additional resources in order to increase capacity.

However, as I stated earlier, we have implemented procedural changes so anyone with Behavioral Health can receive a quicker screening, connection to services and earlier release from jail with appropriate supervision.  We are striving to make further changes as well with the Commonwealth no longer being involved in most misdemeanors in Fairfax County.

  1. You said in your remarks that you were proud of the three graduates and spoke as if you had gotten to know each of them on a personal level – more than the typical defendant.  We know the docket is helping individuals with mental illnesses but what impact, if any, has it had on you and those on your team? Has it changed you as a judge?

All of us involved in the MH Docket have been changed.  It is very gratifying to know we have set up a system for success.  I hope it has made me a better Judge.

About Judge Snee:

Tina Snee was appointed to the General District Court in July 2015. She is currently the presiding Judge of the Fairfax Behavioral Health Docket. Prior to her appointment she was a substitute Judge and sat in JDR and the GDC Courts. Her legal career spanned twenty-six years focused mainly on civil litigation in the trial and appellate courts of Virginia, Maryland, and the District of Columbia. She has also been an active volunteer in her community both on and off the bench.  


MH DOCKET HANDBOOK september 2020

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.