Judge Wayne Mallia: How Criminal Court Considers Mental Health

Judge Mallia (00:00)
On personal level, I would definitely feel responsible if I had somebody come into my court I knew was using and I said, well, just go on home. And the next night they do some drug that has fentanyl in it and they overdose.

Matt (00:16)
I'm Matt Handy and you're listening to My Last Relapse. So first, let's just talk about who you are, what you do, and then we'll get into some detail.

Judge Mallia (00:27)
So my current title at this point is a senior district court judge. So basically that means I'm retired from the bench, but I still do other judge work for what we call visiting judge work, which would be covering for other judges either in Galveston County or the surrounding counties. When they're not able, they're on vacation, they go to a conference, or maybe there's a case they can't hear because of conflicts, then visiting judges help fill in.

And my position right now is more of a kind of a unique type of visiting judge because it's more of a permanent position because I'm over several programs in Galveston County to address the mentally ill and help them get out of the revolving door of our criminal justice system.

Matt (01:18)
Okay, how long, did you practice law?

Judge Mallia (01:21)
I was with the district attorney's office straight out of law school. So I was there for 13 years and then I was first assistant, nine of those thirteen.

Matt (01:29)
Okay. And you Galveston the whole time.

Judge Mallia
Galveston the whole time, the whole practice, the whole time I was a Judge.

Matt
Okay, and what got you interested in mental health?

Judge Mallia (01:41)
So, when I was on the bench in Galveston, I started the first specialty court in Galveston County. It was called STEP, which stands for Sanctions Towards Effective Probation. So, I got that program up and running and it worked out very well. And then I was starting a drug court in Galveston County, or we were all starting a drug court. And then I left the bench and another judge took over.

And then at some point after Judge Mark Henry was elected, he was interested in building up the different programs in Galveston County to address the mentally ill who are going through our criminal justice system and just seem to be stuck in it and cycling through it time and time again. And he just approached me and asked me if I was interested in starting a mental health specialty court.

Matt (02:34)
Do you know like the average number of people that are going because Galveston County is it isn't tiny But it also isn't huge, right?

Judge Mallia (02:43)
Correct, it's about mid-size for Texas.

Matt (02:45)
Okay, how many people are going through the mental health system in the courts every year?

Judge Mallia (02:50)
So, Galveston County did a study from 20, the time period was from 2022 to 2024, and we found that approximately 40 % of the people being booked in the jail were screened positive for having a mental illness.

Matt (03:08)
Yeah, I'm in the SUD world. I've also been arrested probably 40 plus times easily, right? And something that I talk about all the time is that not all people who have mental illness issues have SUD issues, but every single person that has SUD issues has mental health issues.

Judge Mallia (03:30)
I would say that's probably pretty accurate.

Matt (03:32)
And are you is that 40 % screening specifically mental health or mental health SUD?

Judge Mallia (03:39)
Mental health. So those, the 40 % are coming up positive for an indication they have a mental illness. And of course it's like I say, it's a screening process. So we don't say with 100 % certainty, however, we find that most of, they are screened with a mental illness, they do have a mental illness.

Matt (04:01)
Yeah, I mean, it's probably some don't screen for it rather than some do that don't have it.

Judge Mallia (04:06)
That's a good point. I agree with that.

Matt (04:08)
And the people who are doing the screenings, it's like intake in the jails, right?

Judge Mallia (04:14)
Exactly. It's right in the beginning of the booking process.

Matt (04:17)
Yeah, and so this is where they actually have to go through a medical screen, a pre-screening to get okayed to even go into the jail, correct? Right. Okay. So does Galveston have a jail or is everybody going to Harris County?

Judge Mallia (04:30)
So now that Galveston County has a jail and it is in Galveston.

Matt (04:34)
Oh okay. Okay, so everybody travels to there to get booked. Okay. Is there a script, at least part of the screening process that can like exclude them from being accepted into the jail? Like is it they're mental, just medical though, not mental.

Judge Mallia (04:55)
No, correct. The medical definitely, if they have a medical issue, they'll divert them to hospital. But mental illness, no, they are, it's just a matter of finding out about the mental illness and the extent of it. But they will be booked in whether they have a mental illness or not.

Matt (05:08)
Right the severity.

Yeah, somebody said it a long time ago to me, they were like, the biggest mental health facilities in each county are the jails. Yeah. And then they were like, the biggest mental health facility in the world is LA County Jail.

Judge Mallia (05:22)
That's very accurate.

That's the largest jail in the...

Matt (05:32)
I think the complex is like 30,000 inmates or something like that. That's what I heard, I don't know. It makes sense though, because there's like 12 million people in that metro area, so.

Judge Mallia (05:43)
But yeah, and that's a very accurate statement in just about any county would look at in Texas or the United States.

Matt (05:51)
Yeah, any state. Okay, so post-screening, they're getting booked. then what are the typical charges that if they're... Are you guys finding that there's like a predisposition towards certain charges for mentally ill people?

Judge Mallia (06:09)
So right off the top of my head on the misdemeanor level, very common for criminal trespass, is a very common charge. Sometimes a criminal mischief, which is damage to property. Then you sometimes have your assault causing bodily injury. And typically when you get that charge, what you're going to be looking at is a family member that is a complainant or a victim of the assault. So on the misdemeanor level, it's a little easier to kind of generalized on the felony level, it gets more difficult to say. a lot of possession charges, possession of illegal drugs, definitely right on top of the list.

Matt (06:50)
Yeah, something that I've found to be true in my life, but then also in the many, many, I mean, hundreds of interactions with people that I've been in treatment with or in jail with or whatever is that a lot of the family members are just completely unaware of like what their family member is going through. And so if a family member heard this and they heard you say something like, you know, especially if they're unaware of this situation, right? If their loved one's getting arrested for criminal mischief or trespassing or something like that to maybe start looking at mental illness.

Judge Mallia (07:28)
Yes, they're constantly getting in trouble with the law. It may be a good indication that maybe the mental illness is involved. hopefully addressing that will help address them constantly getting in trouble with the law.

Matt (07:46)
Do you, so okay, let's get into your program. First is step, right? That's what you call it.

Judge Mallia (07:52)
So that was the first program I started when I was on the bench. That program doesn't exist anymore. I did the program and one other judge who started the drug court did that program, but neither one of us are on the bench, so that program doesn't exist anymore.

Matt (08:08)
Okay, so I just found this out, is that the judges kind of run their own programs and then it's up to them to like either pass the baton on or it just kind of dies when they leave the bench.

Judge Mallia (08:18)
So it could be in that situation if there's nobody like you said behind them who are interested in picking up the ball and running with it. So I know, like in Harris County, they are pretty consistent in keeping that type of court open with some judge filling it in.

Matt (08:38)
Like if it's an effective program, they're going to keep it open. Was it effective? Was stuff effective?

Judge Mallia (08:41)
Correct. Yes, I believe so. I believe it was. So, STEP, basically what the purpose of STEP was, if somebody on probation was committing what we call a technical violation, what I mean by technical, they missed some reporting periods, they're not caught up on their fines or fees, maybe some testing positive for drugs, things like that.

Matt (08:47)
What did it do?

Judge Mallia (09:12)
What would happen is the probation officer would bring them in front of me for what we call an administrative hearing and the probation officer would tell me what the problem was. I talked to the probationer and saying, look, everybody here is here. We want to help you get through probation. Your probation officer wants to help you. I want to help you, but you got to do your part. You got to take responsibility and you got to do your part. You have a commitment while you're on probation to follow the conditions and you've got to follow all of them.

It just talked to them like that. So let's straighten this out. Let's figure out a plan with your probation officer. We're going to straighten this out. then about 30, wait about 30 more days. And then I have them come back in front of me, the probationer and the probation officer. And the probation officer will update me about how the probationer is doing. And typically the update is going to be that they're either catching up or they're fines or fees or working on it. I mean, all we want them to is to try. So that could be as little as paying.

$10 a month if that's what it takes. then also just if they had a positive drug where they go into the treatment that is recommended based on that and are if they're not reporting or they're reporting now. And I do that for every 30 days until the probation officer gets in front of me says, Judge, I think the probation is back on the right track and they don't need to come back anymore.

Matt (10:31)
Okay, how many of those specific situations were you seeing a month?

Judge Mallia (10:36)
I'd say about 30. What I would do is have a special docket. So we'd have them all come at once on a special docket, special time of the day. So all the probation officers would be there with the probation.

Matt (10:38)
Okay, so like one a day. Okay, that makes sense. And so then that kind of evolved into the drug court.

Judge Mallia (10:57)
Yeah, so being a specialty court, drug courts started more prevalence of more drug courts and looked into it and said, you know, that'd be a good thing for Galveston County to have. So I formed a committee and we just started working on that with the committee, working towards developing a drug court.

Matt (11:20)
So I, I'd never participated in a drug court program my wife had, and in California, it's a little different. it's like one of the most, it's an 18 month, very intense. get sentenced to it. and it's one of the most intense programs I've ever heard of. And, in California, it has this reputation of like, if you go to drug, if you get sentenced to drug court, basically all you're doing is buying time because everybody fails. Yeah. It's like a very, it's like a setup almost, know, like everybody wants to avoid going to jail right now. So they'll take drug court to kind of like offset the amount of time that they're gonna do or whatever, but it's very hard to complete it in California.

Judge Mallia (12:05)
It surprises me because in Texas, from the ones that I know of, they're pretty successful programs.

Matt (12:06)
Yeah. Yeah, no, when I found out about Texas Drug Court, I thought it was just the same thing. And then I started hearing about it and talking to judges and talking to people that are participating. I was like, this is totally something totally different, totally different, very successful. Okay, so were you guys keeping track of numbers and like watching success rates and outcomes and doing all that when you were dealing with mental health?

Judge Mallia (12:43)
So on the mental health area that I handle, I have several different programs. One is on the felony level, there was the mental health specialty court. And so that's just like the drug court, same idea, except we're dealing with people with mental health challenges. And then on the misdemeanor level, then we have the misdemeanor mental health docket. And it's different from the specialty court in one, couple of differences are the specialty court is voluntary. So the person has to voluntarily come into the court. They have to want to come into the court. And that's based on the law too. And then also a big difference with the felony specialty court, we're maxed out at 30 participants. So once we reach 30, we're capped out. And then, but on the misdemeanor law.

Matt (13:35)
Do have waitlists for that then?

Judge Mallia (13:40)
Actually, no, we don't. We've been pretty, keeping it below 30, anywhere from 20 to 28 at this point. So that hasn't been a problem. But on the misdemeanor level, misdemeanor mental health docket is almost just the opposite. It's not voluntary. If you're charged with a Class A or B misdemeanor and you have a mental illness, you're routed to that docket in front of me. And so it's big difference between the two. But I think it's a good way to address the different populations, the felony versus misdemeanor.

Matt (14:15)
Yeah, I mean, so the whole court system in Texas kind of blows my mind. Cause I'm just used to, is no, everybody's, there is no like elected judges in California, right? It's like, I think, I think like the county, there might be a couple positions of judges that are elected, but the average judge is appointed. And then all of these specialty, there are no specialty courts. It's just, these are, specific courts, right? There is no like specialty juvenile court. We actually have a full juvenile court system. But you have to get these approved, right?

Judge Mallia (14:56)
So yeah, they are, you have to file with the state that you are, that you're a specialty court and you have to meet certain characteristics and elements to be a specialty court.

Matt (15:08)
Okay. And it's just like, as you see a need, then you can be like, I need to do this. Or like, I want to do this, right? ⁓So as far as the mental health, so the mental health component of SUD is, in my opinion, right, this is my opinion, is that we aren't as efficient as we could or should be, right? Ultimately, what ends up happening is that there's recidivism inside of the treatment world too, right? Where people, there's this statistic out there right now that says that one out of 10 people will get clean for one year. And then of that 10%, one out of 10 will stay clean for 10 years, but they have to go to treatment seven times first. So it's 98.5 % of people will relapse six or seven times before they ever get clean for one year, right? And at that point, what ultimately is signaling to me is that either treatment is ineffective or there's something that's being unaddressed. And I think that it's a little bit of both, but one of the things that is going severely unaddressed is the mental health part. You go to treatment and they want to talk about the spiritual side or like the decision side, the actual, the decision-making process of addiction, right? But there is mental health parts where this is what typically happens. Somebody will go to treatment and they will come out with five diagnoses, right? It'll be like depression, anxiety, and then a few other ones. And then they're on the medication to reflect these diagnoses as well. So then what ends up happening is somebody that's been clean for two weeks that gets a depression, anxiety diagnosis. Well, everybody that's kicking drugs is depressed and has anxiety.

So then they put them on these medications that are for depression and anxiety. But then the way that these medications work is if you don't actually have clinical depression or clinical anxiety, they will give you anxiety or depression. And so now you've got a bunch of people that are dealing with downstream effects of medications that don't actually have the diagnosis, they were just coming off drugs. Does this make sense? Yes. So then these medications were typically designed for anywhere from six months to two years and people are on these medications for 10 years plus, right? And so there's a bunch of things that are going on within the SUD world that are exacerbating mental illness, right? And my criminal experience and like my criminal career, it really, really took off after my addiction, right?

I wasn't getting arrested before I was doing drugs. I started getting arrested after I was doing drugs. But one of the things that definitely happened was as my addiction kind of plateaued, my criminal behavior skyrocketed, right? And I think that there's something going on that's similar with a lot of mental illness where people's addiction kind of plateau, especially as things get worse, right? They find this like happy medium of like, I don't want it to get worse, but I don't really want to stop doing drugs enough to make it get better. But then their mental health just skyrockets. Like their mental health symptoms skyrocket. Right? And so there's all of these things that kind of I point to as far as these conversations and at least what we're trying to do at Harmony Grove is like, we're trying to stop certain things from happening. And one of the things that we're definitely trying to stop from happening is people getting on medications that they don't need to be on, right? With mental health court, are you guys dealing with the medication or like, you advocating for medication or how are you dealing with?

Judge Mallia (19:11)
Yeah, so when the person is being screened to come into the mental health court, we have a clinician who does an evaluation and will diagnose them about whether they have a mental illness and if they do what the mental illness is. then, of course, from there, they'll rely on a psychiatrist or somebody who's qualified to prescribe the medicine to decide what medicine to prescribe. And then so whatever the doctor prescribes, then we will require the participant to take that medicine. the, I think that's what makes the specialty court, especially mental health specialty court, ⁓ unique and more helpful than just your other standard criminal justice processes where you put somebody on probation and they have a probation officer and the probation officer may say, okay, well, you're, I want you to go to this therapy or whatever you want. We have the clinician who's part of what we call the mental health court team. So we review all the participants on a weekly basis and they come to court at different periods of time. So we're monitoring them very constantly about how they're doing, not just with the mental illness and taking their medicine, but how are they doing if they have substance use challenge that they have to overcome? How are they doing on that part of the, of the challenge that we need to help them get through. And then we're also helping them, or if they need housing, we're helping them try to get housing. Anything you can possibly think of, they being able to eat properly? If not, we try to help them get enough money to get food. In order to get all that, we're helping them get jobs if they don't have jobs already. So it's kind of what we call a wraparound service with them.

It's the wraparound service and it's the constant monitoring of them and having them come in and when I say monitoring it's also a different kind of monitoring because it's not just a probation officer who does the monitoring the whole team which consists of the judge, the prosecutor, assistant DA, clinician, case manager, a peer support specialist. have one which is kind of unique for our court and which really is very helpful. And so we have that and it increases the chances of them being able to successfully complete the program. And not only do we want them to successfully complete the program and doing that, we want them to become productive citizens and we want them to have a higher quality of life than what they had when they first came in. And I think if you have those two things and you're much more likely to get out on your own, like I said, and become a productive citizen and get out of the criminal justice system.

Matt (22:06)
Yeah, I've seen it a couple of times where probation really, really benefited certain people. And I've also seen it where I'm actually one of them, right? Where like going to jail completely changed the trajectory of people's lives. Obviously not the first, second, third, fourth, fifth, probably not the first 20, 30 times, but one of those times really made a big change. probation, I've seen it kind of in Texas at least. It's not used as like a punitive tool as much as like more of like a way to help people that are under your guys's supervision.

Judge Mallia (22:47)
Yes, exactly. the whole concept isn't a punitive tool in and of itself. I tell the participants quite often that when they do slip up and we have what the technical term for specialty courts is response, there's a response to that. But it's a consequence, right? And it's just, tell them it's like life. Everybody messes up and everybody has consequences for the mistake. I say, when we have a response for you, we talk about as a team, what is the best way to get you back on track? It is not. It is not a form of punishment. We're here to help you. We're here to help you get through this program successfully. And then when we're talking about what the response is going to be, that's what we're talking about. How are we going to help you successfully complete this program? It is not. And you got to keep repeating it to them. It is not punishment.

Matt (23:39)
What does sanction mean?

Judge Mallia (23:42)
So sanction is for example, let's say you test positive for drugs. So we'll say right now you're going to NA meetings twice a week.

Matt (23:53)
Okay, so it's literally your sanctioning specific programming.

Judge Mallia (23:56)
Yes, we're going to address what the mistake was and how are we going to help them keep from committing the same mistake again. Whether it's more AA meetings, whether it's more intensive outpatient treatment, or maybe if they're at a point where this has happened quite a few times and we're concerned about them in their use, we may have inpatient treatment.

Matt (24:20)
Do you guys ever send people to jail?

Judge Mallia (24:23)
Sometimes, unfortunately, if we've tried all the softer sanctions, so to speak, and it's not getting through to them, then I'll put them in jail for a couple of days. And it's not, it's something we as a team and I personally try to avoid as much as possible. But the last thing we wanna do is to put them in jail. And because best practices is don't use that as a sanction because it re-traumatizes them, send them back to jail. we're coming up with ways, we're kind of what I call a young specialty court. So now we're thinking very hard about ways to come up with alternatives to jail. One thing I've used recently with someone who just wasn't getting it is I had them come in at eight in the morning and then they'd be let loose at six o'clock at night for several days.

So we try that and you can try things like ankle monitors, curfews, you can try things like that. And they're good ideas. My concern is always when you have somebody who's using and they just can't seem to stop no matter what, everybody knows about fentanyl being out there. You never know when they're going to be getting the fentanyl and whatever the drug of choice is.
On a personal level, I would definitely feel responsible if I had somebody come into my court I knew was using. said, just go on home. the next night they do some drug that has fentanyl in it and they overdose.

Matt (26:04)
Yeah, the fentanyl situation's crazy, right? So I got out of doing drugs at about the same time that fentanyl really became a problem. Fentanyl kind of hit early in 2020, late 2019, early 2020, and I went to jail December 28th of 2020. So, but I'd watched that whole year, probably 12 to 15 people overdose and die. And then I went to treatment. My best friend kind of followed me into treatment. And I went to treatment for three years. After about a year and a half, he was like, I don't gotta be here. The treatment facility that we went to was insane. And so he was like, I don't gotta be here. He left and OD'd a couple of weeks later. Like a couple times got high and died. It happens that fast. And so yeah, I totally get why you would definitely feel responsible. Have you had anybody overdose on your watch?

Judge Mallia
No.

Matt
Okay, that's good. Yeah, that's, I know for people that are in our space, it's just a matter of time, I feel like. Especially as it becomes more prevalent. I've heard this, I'm not like hyper aware of the drug market right now, but from what I hear is that it slowly fentanyl is edging everything else out, that it's like only fentanyl that's available now. The people that were historically doing heroin, now all of them are doing fentanyl. People that were doing X, they're all doing fentanyl. Z, they're all doing fentanyl. It's just taking over everything. It's crazy. So what is that list there?

Judge Mallia
So this is a list of all the different programs I've preside over, worked on.

Matt (27:52)
Okay, let's hear it.

Judge Mallia (27:53)
So I've been over to the felony mental health specialty court in the misdemeanor mental health docket. we, in between the specialty court getting that up and running and getting the misdemeanor mental health docket up and running, we got a grant for a misdemeanor mental health public defender's office. So basically what that office does is they represent anybody charged with a class A or B misdemeanor. They have a mental illness and they cannot afford an attorney. So they have three attorneys, a chief and three caseworkers, and then administrative assistant in that office. And that's a very helpful office to the misdemeanor mental health docket. So because you're adding three caseworkers to help anybody on that docket out as far as getting to different appointments, getting them started with our local mental health authority as far as treatment and medication. so it's just, of course the attorneys, they're experts at dealing with individuals charged with misdemeanors and they have a mental illness now. And being under just one judge, all of them come to me. So there's that consistency. And consistency is very, very important.

All these programs, I think the keys to all of them are centralization and collaboration. What I mean by collaboration is not only do the public defender's office work well with the assistant district attorney in the court, we have our local mental health authority who's there at the docket also. Part of local mental health authority is a clinician, another case manager. And then, course, the peer support specialist is also at the Mr. Mead or Mill Health docket. So all that really makes it more effective and efficient.

Matt (29:57)
Is the peer support worker really, just there as like an advocacy role?

Judge Mallia (30:02)
I wouldn't phrase it advocacy. They're there more for support for the individual, for support. of course, they're people with lived experiences. Our particular peer support specialist had both a substance use challenge and a mental health challenge that he overcame. And now he's given back, so to speak. He's a great guy, productive citizen, living very well. And he's just a he's a prime example of what you want people who are going through the system to become

Matt (30:39)
Yeah. Was he, was he a product of your court as well or no?

Judge Mallia
No.

Matt
Okay. That'd been, that would have been.

Judge Mallia (30:46)
Right. Yeah, definitely.

Matt (30:48)
Okay, so back to like statistics. Do you keep numbers on outcomes for for the people that come through your core?

Judge Mallia (30:56)
Yes. So on the felony mental health specialty court, we do keep the numbers. And the way we kind of analyze that is first, when you start a specialty court, you have what we call a process evaluation. And you do that after two or three years of being up and running. And the process evaluation is to basically look at, are your processes correct? Is what you're doing going to be helpful in the long run for the participants. Is it according to what we call best practices? And if it's not, our evaluator is Dr. Cleet Snell. He's a professor at the University of Houston, and he's done a lot of specialty court evaluations, I think, for over 20 years. So he's very good, and he's very thorough, and he had a lot of things he pointed out that were doing very well and he had some things that he thought we could improve on, which was helpful. So we can focus on what are the important things we can improve on. And then after you're up and running for a while, Dr. Snell said, you want to wait until you get about 30 to 35 graduates, and then you do what's called an outcome evaluation. That's when you really get into the stats. How many, what's the success rate, how many are not succeeding things of that nature.

Matt (32:24)
What was the initial findings of the first 35? Or have they done that?

Judge Mallia (32:30)
We haven't had 30 graduates yet.

Matt (32:32)
Okay, okay, how long has it been going on?

Judge Mallia (32:34)
Since February of 2021.

Matt (32:38)
Okay. And so, and that's the felony.

Judge Mallia
That’s the felony.

Matt
Okay. How many graduates have you had of the misdemeanor court?

Judge Mallia (32:43)
I couldn't tell you. So the misdemeanor court, we don't really have graduates, so to speak, but the way it works is in most cases, the DA makes the decision, what we call the plea bargain offer, so to speak. for most cases, they'll tell the defendant, make two or three appointments with the local mental health authority or any, if it's a private provider, that's great. We don't care, as long as you're on your medicine and you're going to those appointments, then we'll dismiss the case after you complete those appointments. so 60, 60, we were, we're at about 311, uh, defendants on that docket in averaging in 64 % of those end up being dismissed because they comply with the program. Yeah.

Matt (33:42)
Okay, that's a pretty decent

Judge Mallia (33:45)
And then, and we do, we do have a set of individuals who we keep coming back time and time again. And out of the 300, so defendants on the docket, would say that's consistently about 50 individuals who keep coming back. And the other stat we have is with the Mr. Mead or mental health public defender's office because they got a grant from the Texas Indigent Defense Commission. They're required to report certain numbers to the commission on a regular basis. so consistently, there's been a 21 % re-arrest rate for a six-month period of time. Pretty low. It's pretty low. Yeah. Yeah. And so, yeah, I think it helps. And even with the 50 individuals that keep coming back, and it's frustrating for everybody, public defender's office for me, for the assistant DA. But my theory behind that is we're dealing with misdemeanors, one. They're not, the ones that keep coming back, they're not violent offenses. They're gonna be your criminal trespass charges almost all the time. Homeless people. Okay. Nowhere to go. They have nowhere to go but where they're getting arrested for being trespassing. For sure. But at the same time, I do appreciate the business owner's concern.

It's usually a business owner who's going to call them. They have a right to run a business and they don't need somebody there who's scaring off their customers or maybe asking for money from the customers, making them uncomfortable. So I get that and I appreciate it. But my theory behind it is I will, part of the misdemeanor mental health docket program, part of that concept is I will let that individual out on a bond.Either, you know, what was called mental health bonds, which basically you don't have to pay any money in order to get out on bond. So a lot of them are that type of bond. But with that special bond, tell them you've got special conditions of bond you have to follow in order to be able to stay out on bond. And so basically the conditions are the first few are just basically going either to a local mental health authority, keeping your appointments, all follow-up appointments, take the medicine that's prescribed.

No firearms, no weapons, no illegal drugs, no alcohol. You submit the random drug and alcohol testing. And we have a dedicated probation officer who does that. monitor the testing and they have them check in with them once a week. then, it's the testing and then the other part about the program that I think helps is when I do release them on a bond. I require that there be someone who was there to pick them up and take them wherever their next move is. And usually that's going to be a caseworker with the public defender's office. And usually where they're going to take them is straight to the local mental health authority to either set up an appointment or a first appointment or set up getting established with them or set up another appointment if they missed them before because of being arrested and things like that. But we're trying to get them connected back into services, make sure they stay on their medicine. the good thing about what kind of an offshoot of focusing on getting these individuals on medicine is the county jail. We have a great psychiatrist who comes twice a week, I think, to the jail. And she's the one who will prescribe the medicine and make sure they're taking it.

They'll know with our 50 frequent customers what their medicine is. So they know automatically, they don't have to wait until they tell them to get them on the medicine. So when they come in front of me, they're on their medicine quicker also. just all kinds of things like that side benefits from just all you gotta do is focus on the problem, start addressing it, and other things start falling into place to help.

Matt (38:03)
Okay, two questions. How robust is the mental health system in Galveston County?

Judge Mallia (38:08)
Well, like our local mental health authority, it's great. I mean, it's excellent. I can't say enough good things about them. When I was first looking into starting the felony specialty court, I went around, first I studied it, what is the mental health specialty court, what's it do, are they successful in general? And I went to different counties around like Fort Bend County, Montgomery County, Harris County and talk with their judges and their teams and watch some of the courts. But a common theme when they were first getting started was there was friction between getting the specialty court started in their local mental health authority. But with me, I just went to a local mental health authority. The head guy at the time that was in charge of that type of stuff was Jerry Freshour.

I was preparing myself to have to convince him that this is a good thing to do and we can work together. And I just said, this is my idea and this is what I know about it and what I've heard about it. And he says, okay, we're on, we're on. What can we do to help? Every everything I've done, it's been the same attitude. Okay, so we've also started a clubhouse. I don't if you've heard of clubhouses for the mentally ill, you know, it was some very new for Galveston County, never been done before. And, you know, I went to them and again, same question.

Matt (39:47)
Oh yeah, yeah, clubhouse. I've seen the, there's like lawn signs, right?

Judge Mallia (39:53)
Could be, they could be advertising with law and science. So basically what a clubhouse is, for someone with a mental health challenge, and they don't have to be going through the criminal justice process. It doesn't matter one way or the other. The only two requirements to join a clubhouse is that you have a mental illness, that you have to be over 18 years of age. And so the concept is that what it is, is the membership, the members of the clubhouse run the clubhouse. They're responsible for keeping it up, doing all the daily chores anybody would do in any other household or business to keep it up. And they're responsible for that.

Matt (40:33)
Where is it located?

Judge Mallia
So ours is located in the community center off Broadway in Galveston. yeah.

Matt.
Okay, so mental health, at least services are decent in Galveston. So what are the services for homeless that are available? Is there housing? Is there anything like that? Because it kind of goes hand in hand, right?

Judge Mallia (40:59)
Exactly, that's a very important piece to get them on the right track to have stable housing. So the main place most of our homeless individuals go to is the Salvation Army. And now if they join the Clubhouse, then of course part of the concept of Clubhouse is not only are the members working together to keep that Clubhouse going and taking responsibility for it, which leads to, of course, the camaraderie, the socializing. Community, yes, community, very good. We call it an intentional community. So they're supporting each other, they're talking about each other's challenges and supporting each other. As they are doing the chores, so to speak, and seeing results of the chores, they build up self-esteem, self-confidence, so they're getting to a point, you hey, I can do this. can go out and get paid to do this. We have resources to help them get jobs. We have resources to help them find housing and just anything any person needs just to live a decent life.

Matt (42:06)
Do you have a census of how many homeless people are in Galveston County?

Judge Mallia (42:12)
I'm sure there's a number out there, but I don't know it off the top of my head. But Galveston, it tends to, or appears to me, it tends to more congregate on the island, Galveston Island. And we theorize part of that is because that's where the county jail is. So they could get arrested off the island, anywhere on the mainland. They go to jail, then they're let out, and have no transportation to go anyplace else, or maybe not even live any place else. Also, there's UTMB hospital, a very big hospital that serve indigent individuals. And so maybe they go to the hospital, they could be taken by ambulance to the hospital and they get treated and the hospital says, okay, you're well now, And then just walk outside and now what?

Matt (43:03)
Okay, so just kind of circumstantially, a lot of them end up congregating on the island. Correct. Would you say that has crime rates as that has, how long you've been, so you've only worked in Galveston. Have you seen an increase in numbers of homeless people? And would you say that the crime rate has risen with that increase?

Judge Mallia (43:32)
So, there are definitely a large number of homeless individuals on the island. Being an increase is kind of hard to say because I think it's always been a challenge for the island and for individuals who are homeless on the island. Increasing crime to an extent, I would say that the increasing crime is more on the misdemeanor level than a felony level.

Matt (44:01)
Yeah, I think there's a misconception that the general public has around homeless people and crimes that they commit. I know that where I came from, the average crimes that people were being arrested for, if it wasn't drug sales, was low-level misdemeanor stuff. And whether it was panhandling, trespassing, like you were saying, there was, you there was like some breaking and entering type things, but it was like, if there is a fence up and you cross this fence, they were calling that a breaking and entering. Right. But I feel like a lot of people think that just homelessness necessitates violence. Violence. Yeah, violence. That's true. And I just don't think it's as true or as prevalent as most people would think. What do you think?

Judge Mallia (44:57)
I'm like, yeah, I would just say more prevalent on the misdemeanor level than the felony level. No, you're saying no. Hardly any of the charges are violent. And typically if we're going to get the assault, misdemeanor assault, it's going to be a misdemeanor assault. If it's going to be an assault, it's kind of perception from, from since I've been doing all this, it's probably going to be against another homeless individual.

Matt (45:28)
Okay, yeah, that makes sense. And those disputes are typically about random things, right? Yeah, I was homeless for a long time and there's very little interaction. When I was homeless, I was trying to interact with the general public as little as possible. I was just trying to live in my own little world and the only time that I was ever really interacting with the general public is when they kind of, interacted with me. And that necessitated that most of my interactions was gonna be with a lot of other homeless people. Also though, there was 2,500 homeless people downtown San Diego. So there was a huge community of homeless people. It's a lot. Yeah, it was a lot. And it was like different pockets. There was different communities of different homeless people. Like this type of drug addict, they were homeless over there and this type of drug addict, they were living over here. And it was like the heroin, the heroin Canyon, the meth downtown, like it was literally congregating around drug types. what, at least from what you're seeing, is there like specific drugs that are more prevalent in the homeless population that you're seeing? My assumption would be meth.

Judge Mallia (46:56)
So meth is very common. I can easily say meth is a very common drug. Yeah. Come to think of it, meth is probably the most common. mean, cocaine, there's a lot of cocaine. Yeah, but I would say that. And then some individual forces marijuana.

Matt (47:22)
Yeah, marijuana is an interesting one. They just made it illegal again here, right? Right. What happened when, because it was for a very brief amount of time, it was less illegal. Right. Right. Did that affect what you guys were seeing, because it was still illegal it was just less illegal.

Judge Mallia (47:47)
Right, just less. To me, just from my viewpoint, from where I'm sitting, I didn't notice much of a difference.

Matt (47:56)
Yeah, that's a, marijuana is an interesting one. And then now with the federal legalization that's kind of on the chopping block, it'll be interesting to see how that works out. So what other courts?

Judge Mallia (48:13)
So we talked about the clubhouse. We have another smaller type program, the felony mental health attorney wheel. So basically what that is is a list of attorneys who voluntarily applied for the list and who will represent individuals charged with felonies and cannot afford an attorney and have a mental illness. So basically what the concept behind that is is get the attorneys who
want to represent someone with a mental illness on the felony level. they're trained to represent them, know all the ins and outs of how to help them and get a rapport with the local mental health authority, also the case managers and the clinicians so that they have a communication line that's open up, how can I help this person who's charged with a felony? One, I want to try to get them out on bond if I do, How can y'all help them? How can a local mental health authority help them? Then, so just the expertise, the experience goes a long ways in helping the better outcome for those individuals charged with the felonies. And then I do hear what we call felony mental health bonds. It's a special type of bond. Again, you don't have to pay money to get out on that bond.

Obviously, you have to have a mental illness in order to be eligible for the bond. Also, just in short, it's going to exclude any violent, most violent type of offenses. You're not going to be eligible for it. So I hear those bonds and when I, if I grant a bond for someone or a felony mental health bond, it's the same concept when I grant somebody for a misdemeanor bond. They're going to have the same basic conditions and those on the felony level we may specialize them even more if they have a drug problem, okay, you got to go get an evaluation, follow the recommendation of the evaluation. We also have the same probation officer who does the misdemeanor, monitors the misdemeanor bond, also does the felony bonds. Usually if I'm going to have a hearing on a felony mental health bond, the local mental health authority clinician is going to be there and a case manager. So there's a, you know, they're, you know, they're able to see what's going on. Who are they going to be looking for? Who are they going to come, know, tell the attorney, you know, what needs to be done from the next step on. And also the same requirement when I let them out, there's got to be somebody responsible for picking them up and we got to know where they're going after being picked up.

Matt
As far as funding for, so as far as addressing their, so two questions, I guess most people that are kind of accessing these levels of services obviously gonna be indigent, right? Right Would you say that the services that they are receiving is like a high-level quality?

Judge Mallia (51:33)
So in the service part of it, you're talking from the local mental health authority?

Matt (51:38)
Let's talk about, I guess, from arrest to actually coming back to their first court date, right? They're gonna be seeing mental health professionals. They're gonna be seeing, who all are they gonna be seeing? And is that, within the, we live in a strange time, right? Where it's like, if you don't have money, you're kind of relegated to what a lot of people assume is a lower level quality of services.

Judge Mallia (52:07)
So I would say there's a definite no, as far as our local mental health authority is concerned. I'm like, you know, very high quality level of service and they take pride in their work and they just do a really good job. You know, one of the ways I know that is because, well, on the misdemeanor level, you know, a lot of the individuals that come back in front of me when, you know, I have them come back about every 30 days to check in with me and see how things are going, how many appointments they've made and things like that. And they'll, you know, all ask me, how many appointments have you made? How are, how are things going? then 90 % of the comments are positive about the gulf coast center is the name of our local mental health facility.

Matt (52:51)
Okay. Does substance abuse disorder qualify as a mental illness?

Judge Mallia (52:57)
No. Okay. Of course, I mean we have a drug court that's run by another Judge, Judge Alisore. But at the same time, for the mental health court, if your primary diagnosis is a mental illness, then you can also have a substance use disorder. Secondary. Correct.

Matt (53:13)
Yeah, secondary. Okay. And then about the clubhouse, there is no like county employees there.

Judge Mallia (53:24)
No, it's a nonprofit. We have a nonprofit board. There's another support, I call it support program. Consider the Clubhouse a support program. And again, I stress that you can be a member of the Clubhouse and not be justice involved. But at the same time, you can be justice involved and be involved with the Clubhouse. And there's a program, another nonprofit, it's called Justice Forward, started in Harris County. And what Justice Ford does is they raise money to give to all kind of specialty courts. I think in Harris County, I want to say they have at least 16 different types of specialty courts. They help those specialty courts fund things that the county doesn't fund, doesn't have a budget for. So the county, you can't expect the county to pay for everything for the specialty court. There gotta be limits, right? And they've gotta be physically responsible.

But what the Justice Forward Program does is fill in those gaps that the county budget doesn't cover. Things like temporary housing, very important. Very important to get people on their feet again. Groceries, more long-term things. They'll pay for tuition for an individual to go to either get a GED or go to higher education. They'll pay, we've had them buy a bicycle for one, one participant because they were the representative was in the courtroom with the individuals will say if I just had a bike that's all I need I can get around and I can get a job and so on and so forth and so very very important gap filler I guess you would say. And they they came to us in Galveston County actually Judge Ellis or invited him to come talk to us his wife read an article about him in the in the Chronicle and said you know, told him, hey, why don't you are doing this? And he said, I don't know, I need to look into this. So he did. And they've just been super about helping us and get our own board started and get it going. And I think also they're doing it at Fort Bend County. I just can't stress enough the help that they are. a lot of really motivates the participants when they're able to, you know, they're down because they're running out of money. They're not going to have enough to stay where they are. Justice Fordard will fill in for a short period of time. It's temporary, but that goes a long ways.

Matt (56:00)
It really can, yeah.

Judge Mallia (56:02)
And they'll also pay for sober living when somebody comes out of like inpatient. They'll pay for a certain amount of time for sober living also. And the good thing about them is they don't just limit it to the participants while they're in the program. If anybody's a graduate of the program, they still help.

Matt (56:20)
That is cool. Yeah, that is really cool. Being able to have somebody... Homelessness, it's pervasive. Mental illness doesn't just go away, right? It's not something that it's like you're gonna deal with it in this one episode and then it's just over, right? It's possibly and most oftentimes a lifelong situation that you're gonna have to deal with. And so what other, are there additional nonprofits that you're working with?

Judge Mallia (56:53)
No, no. No additional programs that I'm over. There are, we have two brand new programs that probably the local mental health authority is most credit goes towards as far as getting started up. And one is a jail reentry programs. So the golf coast center got a grant from the BJA Bureau justice assistance, I think. Basically, that grant pays for a case manager or clinician and a peer support specialist. And their goal is to catch individuals while they're in jail to start getting them lined up for services. And when they get out of jail, they have the case manager who can follow them through to make sure that they're following up with the services that they recommend. And they'll follow them for up to a six-month period after they're released. And this program is going to be very helpful to the misdemeaner mental health docket, because that's going to be one of the populations that they're going to target as far as helping. So that's going to be a big boost in helping those individuals get connected to services and actually stay in services.

Matt (58:11)
Yeah, so is the continuity of these services based on compliance.

Judge Mallia (58:16)
So the thing with the misdemeanor mental health docket is what we're requiring is two appointments. And once they finish those appointments, the case is dismissed. So as far as us monitoring them, our monitoring is done. So with this program, though, the monitoring will go on for a longer period of time.

Matt (58:37)
Okay, so let's say that somebody is not compliant with whatever it is that they're trying to help them with. Do they continue with the service or is it just like...

Judge Mallia (58:45)
Yeah, that's a good question. So they won't be under my authority or jurisdiction anymore, so we won't have any leverage as far as you need to do this or folk your bond or whatever. So it's just going to be more of the case manager and the peer support specialist building rapport to help the individual understand how important it is to follow through.

Matt (59:09)
Okay, so it's like based on assessment type thing? Right. Okay.

Judge Mallia (59:14)
And then the next thing is we're going to be opening what we call, we're calling it the Wellness Center. And basically it's a, it's a, it's a, it's a point where the main purpose is for peace officers to be able to take an individual that they arrest, that it's obvious to the peace officer that they have a mental illness and they could be in a crisis at that particular point in time. So instead of taking them to jail, they take them to the wellness center. And the wellness center has nine beds for what we call extended observation, which is 24 to 72 hours.

And so basically the purpose of that period of time is for they have the personnel on board at any 24 hours a day to assess them to see what it is they need to either stabilize them or just even if they don't need stabilizing, what is the medicine that they need so that the police officer is not going to be picking them right back up again. And if there's during their assessment that the condition is so serious, they feel like they need to go to the hospital, then they'll make arrangements for that individual to go to the hospital.

Matt (1:00:31)
Okay. Do you know what the Florida Baker act is?

Judge Mallia (1:00:35)
I've heard of that.

Matt (1:00:36)
Yeah, it's the involuntary commitment based on what an officer is witnessing. Okay, sure. And I know Texas doesn't really have anything like this where an officer can't be like, okay, this person is obviously either gonna hurt themselves, hurt somebody else, or they don't realize what's actually going on with them. So in Florida, they can Baker act them. And it isn't just cops actually. There are actually like vans going around, like to homeless camps and like they're assessing people in the field and they're able to actually get them to receive services immediately based on whatever symptom it is that they're, and so do you see a time, it already sounds like what you're talking about is moving in a direction towards something like that.

Judge Mallia (1:01:29)
So actually Texas does have laws that allows a peace officer to what we call emergency detention orders. If the peace officer in their contact with them feels that they're a danger to themselves or to others, another prong is, have they degraded to such a point where they're no longer able to take care of themselves?

Matt
And what is this called?

Judge Mallia
Emergency detention order. Emergency detention order. And of course that order, only last for a very short period of time, and then you have to have like a psychiatrist or someone to get it. Do they need to be held for a longer period of time because the same two things, two problems. And this wellness center is actually a point. before the wellness center, in a while back, the only place our peace officers in Galveston County could take an individual, they felt met that criteria was either to the emergency room or St. Joseph's Hospital. So now they have this option to take them to the Wellness Center. And again, like I said, the Wellness Center does the job of trying to get them stabilized and figuring out do they need further services, like more intense services in a hospital. And they also have 12 beds for what they call it respite, is the name for it. So basically the purpose of that is they're stepping down from a more intensive program and they have a place to stay while they're getting adjusted, so to speak. I'm trying to remember the period of time.

Matt (1:03:11)
Like two weeks?

Judge Mallia
At least two weeks, it might be up to 30 days. Up to 30 days to get stabilized, find a place to live or stay or whatever it might be. And that's also going to be helpful. Again, for the misdemeanor mental health docket for these individuals who just don't have anywhere to go at the time.

Matt (1:03:33)
I mean, it'll alleviate pressure of like, if you can help them immediately, then they don't have to go to the jail to wait until.

Judge Mallia (1:03:41)
Exactly. hopefully that's going to cut down on the number of people we get on the misdemeanor docking. Or even the felony level, hopefully. Because if they commit a felony, maybe they fight with the peace officer and injure the police officer. That's a felony charge. And maybe the police officer maybe is not that serious, they recognize it's a mental illness issue, not a personal issue.

Matt (1:04:06)
Right, it's a symptom of an underlying issue.

Judge Mallia (1:04:09)
Well put exactly. And then they can, they have that option to take them to the wellness center.

Matt (1:04:16)
Do you, as far as the people that can get involved with these levels of services that you guys offer, is there a way for like just, you know, like a family member who had dealt with this in the past, like if I wanted to get involved with this, is there a way that I could get involved with this? Is there like a citizen branch of this?

Judge Mallia (1:04:39)
No, there's not, but that's a good question.

Matt (1:04:42)
Yeah, I would be hard pressed to say that people don't want to get involved with this. I bet you more people want to get involved with this than don't. I read something recently that said that every American adult is one or two degrees away from somebody with substance abuse disorder, which is a mental health thing, right? And so that means every American adult either knows a family member or a friend who is dealing with these issues. And the majority of us want to help. They want to get involved in some way or another. And if that isn't an option yet, how do we get that going?

Judge Mallia (1:05:23)
Yeah, that's a, know, like I said, very good question and very good point, something to explore. And right off the top of my head, one area I could see individuals helping with the jobs. Maybe they're a business owner and can help a person get a job to get on their feet and get into the routine of what a job is about, the responsibilities of a job and either stay with them or be ready to move on somewhere else being prepared to what what the responsibilities of the job and what that takes, getting up in the morning, going to work and things of that nature. even if that individual isn't a business owner and doesn't have a job for them, most people are gonna know other people who they have jobs for.

Matt (1:06:10)
So is there like a mentorship program that Galveston has?

Judge Mallia (1:06:13)
No. have the peer support specialist, and so that's about the extent of it.

Matt (1:06:21)
Okay, do you think that that would be beneficial?

Judge Mallia (1:06:26)
Yes, yes, definitely.

Matt (1:06:29)
Because that's something that the judge that was recently in here, she does juvenile courts. But it's something that we're talking about, some kind of implementation around mentorship. And whether it's people who have either been there and done that, or just people who understand the options. But, you know, like in California, they've got Job Corps, where it's like, it's a program that people can enroll in, where they give them job training, they give them, they actually like go to a facility and they’ll give them like basic job training and they'll give them like key points of responsibility of having a job and stuff like that. And it's a nonprofit based type thing where somebody started something that said there's a deficiency and there's a gap. Basically, if these people knew what to do, they would do better. Right. Right. But, Yeah, I'd be interested in if that's a conversation that we can have later, I would definitely like to have that with you.

Judge Mallia (1:07:31)
Sure. Yeah. And then just to back up a little bit on the Wellness Center, the local mental health authority was kind of like the lead in getting all that done. I got to stress again, the county judge, Judge Mark Henry, all the commissioners, the commissioners court, they're 100 % behind trying to address the issues with people with mental health challenges. the commissioners court, the county judge backed it up with money for this facility. Also, Dr. Craig Bonnen, Representative Craig Bonnen helped with the legislature to also get even more money to back it up. So it was kind of that collaboration between the...

Matt (1:08:12)
Which is not easy in this state from what I hear.

Judge Mallia (1:08:15)
No, it's not. No, it's not at all.

Matt (1:08:16)
Because everything has to go through Austin,

Judge Mallia (1:08:18)
Right. Well, the funding part of it. then the chief executive officer for the Gulf Coast Center is Felicia Jeffrey. And she's just amazing.

Matt (1:08:31)
Okay, and that's awesome. Very rarely have I heard of a mental health, at least a court situation that deals with mental health that sounds as effective or as like robust or at least caring as what I'm hearing from you. A lot of other places, it's just kind of like they're lost in the general population of the jails.

Judge Mallia (1:08:58)
So, and I would say, I think Texas is really forward thinking in this area. There's an entity called the Judicial Commission on Mental Health that has been formed, has been around, well, at least since I started up, that was working on the specialty court. And they basically, what it is, they have commissioners, other judges, probation officers, attorneys. You name anybody, people from local mental health authorities on the commission to brainstorm how can we improve our system as far as addressing people with mental health challenges. They put out information, booklets, how do you start a mental health mission or they put out booklets, howto do other different programs that address the mental illness.

Matt (1:09:52)
Have you heard this guy's name? He, I'll talk to you about him after. Okay. He just came on and I recently found out that, so he is a survivor of a bunch of different stuff, but he's also in recovery and he's a huge advocate within the system in general of getting like specific programming started in Texas. And he like writes different, helps write different laws in Austin. And I told him about Judge Griffith here in Harris, and he was like, dude, get me involved. Like, let me talk to her. And so I'll definitely talk to you about him after. Great. But, okay, is there anything else?

Judge Mallia (1:10:41)
I think that wraps it up. Covers it.

Matt (1:10:44)
Yeah, yeah, I really appreciate your time. Thank you very much.

Judge Mallia (1:10:47)
Thank you.

Matt (1:10:51)
Thanks for listening to My Last Relapse. I'm Matt Handy, the founder of Harmony Grove Behavioral Health, Houston, Texas, where our mission is to provide compassionate, evidence-based care for anyone facing addiction, mental health challenges, and co-occurring disorders. Find out more at HarmonyGroveBH.com. Follow and subscribe to My Last Relapse on YouTube, Apple Podcasts, Spotify, and wherever you like to stream podcasts. Got a question for us? Leave a message or voicemail at mylastrelapse.com. If you're feeling overwhelmed or struggling, you don't have to face it alone. Reaching out for support is a sign of strength, and help is always available. If you or anyone you know needs help, give us a call 24 hours a day at 888-691-8295.