'How is this acceptable?' Flaws in Louisville's mental health system draw federal scrutiny

'How is this acceptable?' Flaws in Louisville's mental health system draw federal scrutiny

Asleep in the rectory, the Rev. Gary Padgett was awakened about 5 a.m. in mid-April by the alarm at St. Brigid Catholic Church and a notification on his phone of "glass broken."

Heading downstairs, Padgett, pastor of the Highlands church, felt a rush of cold air from a broken window and saw shattered glass on the floor.

"I called 911," Padgett said. "It occurred to me if someone had broken in, they were in here."

Security camera footage revealed a suspect running away who was familiar to Louisville police and to Padgett, who also serves as pastor of the nearby St. James Catholic Church.

"The officer said, 'Oh, I know that guy,'" Padgett said. The priest recognized him, too.

The man had frequented the area around both churches, Padgett said, alarming staff with odd behavior, comments and handwritten notes with obscenities and symbols including Nazi swastikas.

Police charged Temont Cooper, 59, who has no known address and a history of serious mental illness, with criminal mischief over the rectory's broken window. But in what court records show is a pattern stretching back three decades, he was released within days and the charge dismissed after he was found not competent to stand trial.

Since 1990, Cooper has accumulated nearly 150 court cases, most for offenses such as trespassing or criminal mischief, many involving breaking glass in the Highlands, downtown or other areas.

Most charges were dismissed because of his mental illness after a short stay in jail or the hospital. He has been banned from multiple businesses including coffee shops, drugstores and banks for disruptive behavior.

He has been evaluated multiple times and each time found incompetent, according to a motion his lawyer filed in court in March arguing for Cooper's release from an already overwhelmed system rather than wait for another evaluation.

"There is no reason to have Mr. Cooper sit in custody when we know what the report will say," said the motion filed by Que Christian, an assistant public defender.

Padgett said he finds the history "astounding" and wonders why more can't be done.

"I agree that it's complicated," he said. "But I would think there would be some other solution than to say 'We can't do anything.' ... I think the goal would be to get him long-term help."

The plight of such individuals is attracting increased outside scrutiny.

In May, the U.S. Justice Department announced a civil rights investigation into services for individuals with serious mental illness and whether they too often are hospitalized or have excessive contacts with law enforcement. The investigation is ongoing, and a Justice Department spokesman in late September said: "We have no updates to share."

In August, state Supreme Court Justice John D. Minton Jr. announced the formation of a "Kentucky Judicial Commission on Mental Health" to find ways to help people with mental illness, intellectual disabilities and substance use outside the criminal justice system.

Minton said the crisis throughout Kentucky "is undeniable" and has a "disproportionate impact on the court."

"Our prisons and our jails, sadly, are the largest mental health providers in the state," Minton said.

While Cooper may have an unusually high number of cases, he is not the only person with mental illness to cycle repeatedly through hospitals and jail, said Jefferson District Judge Stephanie Pearce Burke, who oversees a limited number of participants in a court-ordered mental health program.

"We know that a number of them are in jail and keep having contacts with police," said Burke, who is among 72 lawyers, judges, advocates and others appointed to the new mental health commission by Minton.

Lack of resources, housing impede treating mental illness in Louisville

Mental health advocates in Louisville say there is extensive help available through Seven Counties Services, the regional community mental health provider, and through nonprofit agencies that provide therapy, supervised housing, day programs and outreach to people in need of care, including the many people with mental illness who are homeless.

Of the approximately 10,000 people considered homeless in Jefferson County, at least one-third are estimated to have a serious mental illness.

"How is this acceptable?" asked Katharine Dobbins, CEO of Wellspring, a Louisville-based nonprofit mental health agency. "Nobody wants to be in jail or the hospital or homeless for that matter. It just sucks the life right out of you."

"That's where I think we're really culpable," Dobbins said. "We don't want to hold people when they don't want to be in a hospital, but we've got to provide services for those folks when they leave, and there's not enough of it. That's why, in my opinion, we have so many people with serious mental illness living on the streets."

The key to convincing more people to accept treatment is persistence and patience in building trust with an individual refusing help. And that takes time and money in a system already short-staffed and underfunded, she said.

"You think about what it costs to be arrested, go through booking, spend a night in jail, have a day in court, potentially an evaluation?" Dobbins said. "It's expensive. You could put that money into services, housing, treatment, and you could keep people out of the hospital and jail and put their lives back together."

Burke, the judge who oversees a relatively new program to require some individuals with serious mental illness to participate in court-ordered outpatient treatment, said wider use of such programs is needed to address gaps in the system too many fall through.

This year, lawmakers expanded the measure known as "Tim's Law" to allow more people to participate, a change Burke said is overdue.

"Those who stand to benefit are the voiceless among us," Burke said, speaking at an event in June.

While such individuals may seem disorganized, confused or appear frightening, Burke said, "They continue to live among us. In all candor, they live in our streets."

Programs exist to reach people and help them better manage serious mental illness, including Seven Counties' ACT Team, which stands for assertive community treatment.

Wellspring also offers such a team, which visits clients in person at home, on the street or in homeless camps or shelters if necessary. Services generally are aimed at the most seriously ill clients who benefit from regular contact and intensive services − once a week or more − from a mental health or other professional.

Nurses provide care, including injectable medication some clients use to treat mental illness.

A Wellspring nurse "has given injections under the viaducts or in the homeless shelters," Dobbins said.

Both agencies also have outreach teams for people who are homeless, to offer treatment to those who are willing and try to persuade others to accept it.

Katherine Meyer, a case manager with the Seven Counties ACT Team, said she visits most clients at home but on occasion, has searched for them on the streets or in vacant buildings.

"You cannot force someone to have a meaningful engagement with a therapist," said Meyer, a licensed clinical social worker.

On a recent weekday, Meyer and other members of the team assembled for a morning meeting to coordinate their work before heading out to see clients.

Locations for several clients were unknown. One stopped making contact, another was thought to be at a local recovery center, a third at a shelter.

Meyer had several home visits scheduled that afternoon. As a case manager, she helps clients coordinate medical appointments, work schedules, housing issues, medication and and other needs.

The first stop was with Rod Matthews, 42, who lives in a spacious, sunlit townhouse with family members.

Matthews reported he had recovered from a back injury and was ready to return to work. He discussed lifestyle and exercise − he walks his dog, Hero, and would like to start riding his bike more.

He said he's eating well (spaghetti the night before) but acknowledged he skipped breakfast that morning.

Meyer and Matthews discussed medication to make sure he is current and has an adequate supply, which they check together.

He asked for the phone number of a lawyer helping with his guardianship case (he wants to move from having a guardian to being independent) and called to check on the status.

Meyer let Matthews direct their conversation, asking him what he wants to discuss. When done, she says she will see him next week.

The next stop was with Geeta Gaudam, a client who lives with her husband and child. The apartment is filled with boxes as the family prepares to move to a house.

Meyer reported that she resolved a dental bill Gaudam didn't understand. It was sent in error, and Gaudam doesn't owe anything.

Gaudam said she could use a new laptop, in part to attend online sessions with a mental health support group. Meyer said she'll help her look for one and any discounts available.

She is talkative, appears to be in good spirits and told Meyer she's looking forward to the move to a larger house.

The final stop was with a client in her 60s who lives alone and is trying to cancel her apartment lease in hopes of moving to a larger, nicer apartment. She has to cancel it to get approval for a "Section 8" housing voucher that helps low-income people with housing costs.

Meyer agreed to make some calls to the government agency and to the landlord.

They discussed budgeting money and the client's effort to reduce smoking.

While she's there, Meyer also reset the microwave. "Fixed," Meyer declared after the reset.

It's the small things in life that can be frustrating and seemingly unmanageable for people with mental illness, Meyer said. Her job, she said, is to help remove barriers as well as ensure they are getting all the care and services they need and all benefits to which they are entitled.

But the hardest thing remains finding a safe, affordable place to live for clients, most of whom live on limited income from disability and need housing assistance.

At St. Brigid, the Rev. Padgett said he hopes for some resolution of Cooper's case that will result in no more incidents at his two parishes but also some help for Cooper. Jefferson County Attorney Mike O'Connell's office has told parish officials it is trying to find a solution.

Cooper's next court appearance is Oct. 25 on trespass charges at Walgreen's and a Thornton's gas station.

Padgett, who earned a law degree and worked for the Justice Department before becoming a priest, said he understands the civil rights concerns as well as legal complications involved.

"I accept that it's really difficult," he said. "The question is, how do we help someone like that? That's a hard question for politicians, judges, even clergy."

Contact reporter Deborah Yetter at dyetter@courier-journal.com. Find her on Twitter @d_yetter.