At any given time, Judge Shukura Ingram handles about 250 cases involving defendants deemed mentally incompetent to stand trial. That’s in addition to her normal caseload as a superior court judge.
But Ingram said she doesn’t mind putting in the extra effort. In 2023, she and Fulton County’s other superior court judges voted to streamline the way they handle felony cases involving defendants who are severely mentally ill.
Known as the “competency docket,” such cases are now assigned to a single judge who meets regularly with mental health professionals, prosecutors and the defense attorneys representing these clients.
The goal is to connect the defendants, most of whom are in jail, with treatment and mental health services to get their cases resolved sooner.
Ingram said the idea originated with the Fulton County District Attorney’s office, and she’s optimistic that Fulton’s model could spread to surrounding jurisdictions.
“I think we’re doing good work,” Ingram said.
Credit: Miguel Martinez-Jimenez
Credit: Miguel Martinez-Jimenez
While many criminal defendants struggle with varying degrees of mental illness, Ingram said Fulton’s competency docket is only for those deemed “severely and persistently mentally ill.”
“They do not have the ability to understand what is happening, the role of me, their lawyer, the prosecutor,” Ingram said. “They couldn’t meaningfully help their lawyer during a trial.”
The crimes they’re accused of run the gamut from shoplifting to murder. But the majority of competency cases handled by Judge Ingram involve nonviolent quality-of-life offenses, she said.
“A good number of people I deal with are unhoused or were unhoused when they came into the jail,” Ingram said, noting at least 70% of her competency docket involves people struggling with homelessness. “You keep breaking into this vacant house to sleep, but you also have a mental illness, and it’s hard for you to comprehend that you cannot continue to do that.”
The judge said many of her cases are indicative of broader systemic issues seen in major cities across the U.S. Most of the defendants on her docket are unhoused and typically lack the family support or resources to get mental health treatment in an outpatient setting.
“It is sad because the mental illness problem in this country is impacting public safety,” Ingram said.
Time is of the essence
When dealing with cases involving defendants who are severely mentally ill, Ingram said quickly getting them the help they need is paramount. It can take months or even years for some people to get people well enough to stand trial, and they often languish in jail while waiting for their cases to be handled.
If their mental health does improve, Ingram said it’s important to get them into court as soon as possible so their cases can be resolved. Otherwise, there’s a risk their conditions could worsen again, prolonging the process.
“If you don’t move on them quickly, they can decompensate,” Ingram said. “Part of what this docket is designed to do is prevent that.”
She said she has one murder case where the suspect has been waiting 10 years. The case has been passed from judge to judge, and the defendant has been admitted to mental health hospitals repeatedly for treatment.
The problem, Ingram said, is that Georgia’s behavioral health hospitals are consistently full. It can take a year or longer for space to open up, making it easy for someone to regress while they’re on a waiting list.
If a bed opens up anywhere in the state, defendants in need of in-patient treatment are transferred from the Fulton jail’s competency restoration pod to that hospital, even if it’s down in Middle or South Georgia.
“Wherever the bed has opened up in this state, that’s where you go,” Ingram said. “But that wait, no matter where you are, is a year.”
To streamline her competency cases, Ingram sets aside time to hold regular meetings with jail staff, social workers, public defenders and a mental health administrator. She dedicates one day of each week to focusing solely on the docket.
Problems at the jail
Fulton’s competency docket was put in place well before the U.S. Department of Justice issued its scathing report into conditions at the county’s troubled jail.
Released last November, the findings detailed what federal officials called a “pattern of dangerous and dehumanizing conditions” that left detainees at serious risk of violence. Inmates suffering from mental health issues are even more prone to violence, the investigation found, noting there were more than 300 stabbings at the main facility on Rice Street in 2023 alone.
“We cannot turn a blind eye to the inhumane, violent, and hazardous conditions that people are subjected to inside the Fulton County Jail,” said Assistant Attorney General Kristen Clarke of the DOJ’s Civil Rights Division. “Detention in the Fulton County Jail has amounted to a death sentence for dozens of people who have been murdered or who died as a result of the atrocious conditions inside the facility.”
Credit: John Spink / Jspink@ajc.com
Credit: John Spink / Jspink@ajc.com
Ingram said the justice department’s findings highlight the importance of getting defendants with severe mental health issues treated as quickly as possible so they can have their cases resolved and get out of jail.
Putting their cases onto a single docket with her as the judge helps ensure these people receive the care and attention needed to move their cases forward, she said.
“The DOJ report confirms that our establishment of the competency docket was a move in the right direction and we hope to continue to find additional mechanisms to more quickly address this vulnerable population,” Ingram said.
Credit: Miguel Martinez-Jimenez
Credit: Miguel Martinez-Jimenez
Superior Court Judge Robert McBurney agreed, saying that while not all defendants with severe mental health issues can have their cases diverted, their incarceration “should be as brief as possible, as jail is never the ideal environment for providing mental health care.”
“The Competency Docket ensures that one judge (instead of fifteen) and one team of lawyers (instead of fifteen) can be laser-focused on deadlines, care provision, and building partnerships with state and local resources that can be used to restore these individuals to competency and, ideally, to stability,” McBurney said in an email.
If the program works the way it’s intended, Ingram said she will see far fewer cases on her mental health docket.
A step in the right direction
Victoria Roberts, an Emory University School of Medicine employee who serves as court liaison director for the Psychiatry and Law Service, praised Ingram’s “human approach” to the competency program, calling it a step in the right direction.
“Judge Ingram really stepped up because she has her own caseload, plus she does all of this,” Roberts said. “She’s fantastic to work with and very sensitized to these types of issues.”
She said Ingram’s compassion and her ability to empathize with others are traits that are largely missing from the modern-day criminal justice system.
“Jail is the wrong place for people with mental illness,” said Roberts, who is a licensed professional counselor. “It does not help them in any way. And not only that, they usually go backwards.”
Like Ingram, Roberts said a major barrier is that many of the people charged are part of vulnerable and historically underserved groups: They’re unhoused and suffer from persistent mental illness.
Getting them connected with the treatment they need is an important first step, said Roberts, who worked about two decades with the Georgia Department of Behavioral Health and Developmental Disabilities.
But in an ideal world, people would be able to get treatment outside of a jail setting, she said.
“In Georgia, we are still prosecuting people for quality-of-life offenses,” Roberts said. “The numbers are staggering.”
Partnering with stakeholders to find treatment and housing for as many people as possible would go a long way toward reducing the number of mentally ill people behind bars, she said.
She and McBurney, the Fulton judge, both said they’re optimistic about Atlanta’s new Center for Diversion and Services at the city-run jail.
The goal of the program is to divert nonviolent individuals out of the criminal justice system and into a place where they can receive treatment without the involvement of the courts or the jail, McBurney said.
“Such a treatment approach has reduced recidivism, resulted in healthier outcomes and cut costs for other large metro areas; we hope for the same here,” McBurney said.
Dr. Tracey Elam, the health program manager at the Fulton jail, said one major barrier is the perpetual shortage of funding and mental health resources in this country for those who need it most.
In the jail setting, people with severe mental illness tend to stay behind bars far longer than they otherwise might.
“When people talk about the criminalization of mental illness, it does seem like another layer of punishment,” she said. “They’re in jail on these simple offenses, these lower-level charges sometimes, yet they kind of get stuck here because they have mental health issues.”
Elam said the competency docket makes things easier, not only for mental health professionals but for the people they’re tasked with helping. Instead of reaching out to a dozen or more judges and waiting to hear back, Elam said having one sympathetic judge is a far better system.
“Judge Ingram is the type of person who will reach out to you personally when she has concerns, and it’s easier when you have one judge who can do that,” Elam said.
She also praised the mental health providers, saying it takes a special person to be willing to walk into the jail each day with the goal of helping others.
“We don’t get to choose who our patients are,” Elam said, adding that most of the time she won’t even look to see what someone is charged with. “We’re focused more on how they’re functioning and what their symptoms are, not why they’re locked up.”
Roberts said there needs to be more funding allocated for mental health treatment, behavioral hospitals and community housing. Until that happens, she said jails will remain full and mental health advocates hoping to make a difference will continue like “hamsters in a wheel.”
“Change like this comes slowly and methodically,” Roberts said. “That’s how this works, but I really believe we are on the right path. We’re going to make a big impact in the metro area.”
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