Mental Health Court tries to treat instead of punish

KANSAS CITY, Mo. -- Mental health counselor Danielle Foster had just started as program manager for the new Mental Health Court in Kansas City. Foster didn't even have business cards the day last June that James Cotton raced into her office.

Angry, flushed and sweating, Cotton hit the 12-foot square office like heat lightning. Cotton, 49, was a welder with big, powerful hands.

A few days earlier, those hands choked one mental health worker, nearly clipped another worker, and fought with police officers who arrested him for the attack on the workers, court records said.

Now Cotton was in Foster's office on perhaps his last chance. A judge let him out of jail -- only if he got help.

Foster, 31, seated him in front of her and kept her back to her office door at Swope Parkway Health Center.

He yelled about police. He was going to sue. He got up, sat down, got up, paced.

Foster suspected bipolar disorder, drug use or both. She was right about bipolar disorder.

Chased a police car

The mania first hit Cotton in his 30s. In the 1980s, he burned a condemned house, and a judge committed him to state mental care. Medication stabilized him, and state doctors released him about a decade ago.

He was fine until May, when the abstainer started drinking beer and stopped his medication. He couldn't sleep and drove too fast. The traffic tickets started. He got three tickets when he chased a police car for fun.

By far, he was the sickest person Foster had evaluated for the new court program. Under it, a judge holds off jail time, fines and other punishments for petty offenders and forces them to get treatment.

Kansas City Municipal Judge John B. Williams, 54, with gray-streaked hair, beard and mustache, took his place on the bench in a courtroom within the city courts building on Locust Street.

On June 18, Cotton walked into Williams' courtroom. Cotton wore overalls and no shirt. He was loud, belligerent, then gone before Williams heard his case.

Williams and Foster were worried. The judge issued an arrest warrant to protect Cotton from himself.

The Mental Health Court routine was new then, although the experiment took shape two years ago.

The idea started when a family member of a mentally ill person slipped an newsletter under the door of Kansas City psychoanalyst Richard Nadeau. It told him there was a mental health court in Florida, one of about three in the nation.

He lobbied County Executive Katheryn Shields, and Shields appointed a committee. The committee lined up $100,000 a year from the mental health levy and $100,000 a year from Jackson County's anti-drug tax to fund the court for three years.

Last March, the first Mental Health Court opened in Lee's Summit. The Kansas City court followed three months later.

Yelling at traffic

But on June 18, Williams and Foster weren't thinking about the court's future. They wanted to know where Cotton had gone.

Hours after Cotton left the courtroom, someone called police to Interstate 670 and Locust Street.

Court records describe the police version of events: Cotton breached the peace "by yelling obscenities at oncoming traffic" and injured an officer "by pushing him into a wall."

Police eventually captured him and took him to the city jail.

But the Mental Health Court didn't give up. Foster made sure a doctor treated him in jail, and Cotton took his medications.

June 25 is a day Foster will never forget. That was the day she saw Cotton in Mental Health Court and witnessed a change "like night and day."

In clinical terms, he had stabilized. Cotton was "a gentle person who had made mistakes, wanted to go home, wanted to work and take his medicine," Foster said.

Last month, Foster and Cotton chatted quietly at a session in her office.

He doesn't remember much. As for mania, he described it: "You can't stay put. You've got to go. You've got to do it."