EDITOR’S NOTE: This is Part 2 of a two-part series on mental health services in the Mahoning County justice system.

YOUNGSTOWN — A great deal of conversation about Mahoning County’s justice system in recent months has focused on its role in providing mental health services.

Last Thursday, legal experts and mental health professionals from across the county and state met on a 3 ½-hour Zoom call to discuss what is being done and what can and should be done better.

Led by retired Ohio Supreme Court Justice Evelyn Stratton, director of The Ohio Project — a subsidiary of the national Stepping Up program — county and municipal judges joined Sheriff Jerry Greene, Mental Health and Recovery Board Executive Director Duane Piccirilli, state agency leaders, educators and nonprofit organization representatives to assess mental health and addiction recovery services provided to those who end up in court or in jail.

Among solutions discussed for the jail was hiring a forensic mental health navigator.

These professionals largely help to move high-need individuals to Ohio’s regional psychiatric hospitals, most commonly used for competency restoration. They also partner with jails to provide support and necessary external resources for them while in jail throughout the process of referral and transition, and keep the courts updated on their progress.

While the position usually is funded by the Ohio Department of Behavioral Health, Piccirilli said the county will find other funding or pay for the jail’s navigator because that person will be dedicated solely to Mahoning County.

The Zoom call also gave considerable time to several of Mahoning County’s judges to speak about the programs they run to help residents with extreme mental health and addiction challenges. These programs help everyone from children to veterans and victims of human trafficking.

JUDGE ROBERT RUSU

The conversation began with Mahoning County Probate Court Judge Robert Rusu, who operates the My Fresh Start Court.

“When I took the Probate Court bench in 2014, I immediately noticed a need for mental health treatment in Mahoning County. As a civil judge, my job is to help people get treatment when they don’t want it,” he said. “I kept seeing the same repeating individuals over and over again, and I felt like I wanted to do something, so I started the My Fresh Start AOT court.”

Stratton explained that AOT — Addiction Outpatient Treatment — court programs allow county and municipal prosecutors to drop low-level charges and refer those defendants to a civil court program to ensure they get proper treatment.

“But if you didn’t have an AOT, prosecutors would not want to just send them back out onto the street, and if they were found incompetent, they were sent to a hospital bed for a six-month term,” Stratton said.

If they were rehabilitated at those hospitals, then they could be released for good cause, but if not, they had to be either returned to the hospital or released if there was no room for them.

“AOT prevents that really bad outcome and provides treatment and connects them with resources, so it’s so important,” Stratton said.

She praised Rusu for adopting the concept early.

Rusu said if mental health and criminal justice professionals think a person needs additional supervision to keep up with their treatment, they enter the docket and appear in Rusu’s court about every two weeks, with their case manager, a representative from MHRB and a representative from the National Alliance on Mental Illness.

“I try to talk to them and impress upon them why they need to maintain treatment, why it’s good for them, and we help with housing, jobs, reinstatement of licensing and public benefits,” Rusu said. “I’m more a cheerleader for them than a stern lecturer. I try to help them…when a judge makes a phone call, people tend to answer and it gets things done easier.”

Since starting the program in 2018, Rusu said his court has helped 182 people, ages 18 to 87.

JUDGE THERESA DELLICK

Since taking over in 2001, Mahoning County Juvenile Court Judge Theresa Dellick has reduced the number of occupied beds in the county’s Juvenile Justice Center from more than 150 to 11. That’s a good thing, she said, because the facility only had 40 beds to begin with.

“What do we do? We address trauma-informed matters,” she said. “I’m trauma- informed, trained by SAMSHA (Substance Abuse and Mental Health Services Administration), and I offer my services to anyone for trauma-informed training. I follow the SAMSHA model and it works. I appreciate (Youngstown Municipal Court) Judge (Renee) DiSalvo having me train some of her staff, and I hope it helps. Everyone in our court is trauma-informed. We address mental health and addiction.”

Dellick said in 2011, her court had approximately 6,000 cases and today it has fewer than 2,500. In 2001, when she took the bench, juvenile court had 2,000 delinquent cases, and that number is now below 300.

The court also operates Building Bridges, a program under Magistrate Linette Stratford, that helps adult teens who are aging out of the foster system get the support they need to live on their own. The court is also just beginning a new family dependency court program that will be under Magistrate Gina DeGenova.

The court’s early warning system also works with families to counter truancy, which Dellick said is a smaller-scale problem that can easily lead to larger ones.

“It starts in the juvenile system,” she said. “We help parents understand and work with their children…Little problems become big ones and end up in Common Pleas judges’ laps.”

JUDGE ANTHONY DONOFRIO

Mahoning County Common Pleas Court Judge Anthony Donofrio runs one of only 10 reentry courts in the state, the “Second Chance Offender Reentry” court, or SCOR.

“The primary function of reentry court is to help citizens returning from incarceration to the community by providing support, education, access to treatment and mental health services, housing, job training and employment,” Donofrio said.

The program follows released inmates for two to five years and Donofrio said 95% of sentenced defendants coming through the court return to the community.

He said the U.S. Bureau of Justice Statistics found that of inmates who left state prisons, 44% were arrested at least once within their first year out, and within nine years, five of six had been rearrested.

Donofrio said that of the court’s 29 active participants, 24 are treated for substance abuse as well as mental health and five are treated for mental health only. None is treated only for substance abuse problems.

Among the many challenges the court’s participants face, Donofrio said transitional housing is among the most significant.

“Some of our participants have only minor mental health or addiction disorders and are not a good fit for sober living,” he said.

For example, some sober living houses will not allow their residents to work for 30 days. For those who already have jobs, that poses a considerable barrier to success.

Some require Intensive Outpatient Program treatment, and for those who already have completed it, they will have problems complying with the house’s standards.

Another issue is the inability to pay misdemeanor fines, which are not structured around the defendant’s ability to pay. That can result in warrant blocks that inhibit their ability to secure housing, licenses and avoid additional misdemeanor charges that set back their progress.

JUDGE RENEE DISALVO

When Youngstown Municipal Court Judge Renee DiSalvo first took the bench, she wanted to start a mental health court, but she was visited by the human trafficking task force and was asked to consider a court to serve that unique population.

She obliged. But unlike the numbers seen in the county’s other specialized docket courts, DiSalvo notes that the nature of the cases in her court make it “extremely slow moving.”

So far, only 16 to 18 defendants have come through the program. She said three defendants are on the lam, and the court does not know if they are even alive.

“I’ve never worked with a population like the women and men who have been trafficked,” she said. “I haven’t had one in my court that didn’t experience abuse from an early age. The youngest was 3. The stories are just horrifying — what these individuals have had to live with all their lives.”

The hardest part, she said, is trying to reach them.

“The amount of time it takes for them to trust you enough for you to break through is just crazy, and with one girl, we never broke through,” she said.

DiSalvo said the court faces many challenges, including housing as Donofrio mentioned, but among the greatest is that defense attorneys — interested in getting their clients the best deal — don’t always see the value.

The maximum sentence for a charge of prostitution, a fourth-degree misdemeanor, is only 30 days in jail and even that usually does not happen. So attorneys are reluctant to ask their clients to commit to an 18-month or two-year program.

And when housing lets one of them slip through the system, the cost of setbacks is monumental. Ensuring the safety of victims and trying to keep them from their traffickers can be daunting. The court has had to send victims to safe houses out of the county and even as far as Southern states.

Finding after-care treatment also poses challenges and without it, many victims return to that life.

“Every time there’s a failure, it’s another trauma,” DiSalvo said.

And the buy-in from defendants in the short term also is not what she would prefer, but DiSalvo said the docket is about a long-term investment in the person and having a little faith.

“One of the strengths I see is that they begin to see there’s a community and people they can trust, and a lot of them have never had that in all their life,” she said. “Even though they may not finish the program, you’re planting seeds.”

JUDGE MAUREEN SWEENEY

Common Pleas Court Judge Maureen Sweeney operates the county’s felony mental health court program, known as CARES — Change Applying Rehabilitation, Education, Support.

The program is for defendants charged with a third-, fourth-, or fifth-degree felony offense who also have a diagnosis of schizophrenia, bipolar disorder or other serious mental illnesses on a case-by-case basis. If there is a third-party victim involved, the victim must consent to the defendant’s enrollment in the program

The defendant must plead guilty and commit to the two-year program. If they complete it, the guilty plea is vacated and that portion of their criminal record can be expunged.

The program requires them to abstain from drugs and alcohol, and participate in rigorous substance abuse and/or mental health treatment.

Sweeney said so far, only one person has reoffended after the program.

Like Donofrio and DiSalvo, Sweeney said the program faces challenges with finding proper housing for its participants, as well as getting them on the right medications and even language barriers.

Sweeney said it also takes a lot to get through to the defendants and get them to understand how poorly they’ve been treating themselves.

“One of our biggest problems is self-medication,” she said, referring to the defendants’ propensity for drowning their problems in alcohol and illicit drugs, rather than seeking proper professional treatment. “They’ve been self-medicating most of their lives.”

JUDGE JOHN DURKIN

Common Pleas Court Judge John Durkin runs what was, at its founding in 1997, only the second drug court in Ohio. Today, there are more than 165 drug court dockets, and Durkin’s has served more than 1,600 Mahoning County residents, with a recidivism rate of less than 9%.

Durkin, who will retire June 30, 2027, said the court has anywhere from 30 to 35 felony-level defendants enrolled at any given time and usually hosts two to four graduation ceremonies each year.

In October, after Mahoning County commissioners approved $75,000 from opioid settlement funds through the OneOhio Foundation to support Durkin’s specialized docket, he said the severity of his defendants’ charges is actually what makes them ideal candidates for the program.

“There’s a lot of evidence-based research that indicates that for programs like drug courts, the most ideal candidate is someone who is high-risk and high-need,” he said. “That simply means they have a severe substance abuse disorder and they have had failed attempts at probation in the past.”

JUDGE CARLA BALDWIN

Youngstown Municipal Court Judge Carla Baldwin runs the Veterans Justice Outreach Court in Mahoning County.

These programs, often operated in conjunction with local Veterans Affairs offices, are designed to divert veterans from the criminal justice system to get the VA benefits and other local support for recovery.

They work with a VJO specialist in VA centers, courts and jails, who partners them with a veteran peer mentor that helps them manage problems that stem from common veteran challenges like substance abuse, PTSD and traumatic brain injury.

As of this year, approximately 750 such programs operating across the country.

“(Wednesday) we graduated two amazing young ladies and they are the example of why we do what we do,” Baldwin said. “Most, if not all, our participants have co-occurring disorders.”

Like those in Durkin’s court, Baldwin said her target population are those at high risk and with the highest need of treatment. Baldwin said one of last week’s graduates was exactly that kind of person when she entered the program.

“She gave my team the blues. Addicted to opiates, kids in foster care, her life was a mess,” Baldwin said.

“In court yesterday, she had a newborn baby, she’s married, had her mom with her, and she has full custody of her other two children as of January,” she said.

Baldwin’s program has seen 58 graduates and only one of the past 55 has reoffended, she said.