Disrupts the Hidden Impact of Serious Mental Illness
By: Anna Eileen White
When individuals with Serious Mental Illness (SMI) enter the justice system, it’s often the beginning of a vicious cycle.
Frequently, that cycle results in a lifelong criminal record, unresolved mental health concerns, and ongoing interaction with law enforcement and the justice system. Recent research cited in a press release from Horizon Behavioral Health affirms that individuals with SMI are more likely to be arrested, spend time in jail, and have higher recidivism rates. Often, they can’t access mental health treatment while incarcerated.
A new docket program in Lynchburg is interrupting that cycle. Through the efforts of a multidisciplinary team, the program paves alternative pathways through the justice system for individuals with SMI.
“Everybody could see that the traditional approach was not solving anything, and everybody knew what the issue was,” said Aaron Boone,
Chief Public Defender at the Lynchburg Office of the Public Defender.
According to Boone, the Lynchburg Behavioral Health Docket (BHD) addresses the core issue that brings this population into contact with law enforcement in the first place. With the help of community organizations, they provide access to appropriate mental health services. They hope the outcome is threefold: improved mental and personal well-being for participants, increased public safety, and reduced costs associated with arrests and incarcerations.
Renee Roberts, Senior Mitigation Specialist at the Lynchburg Office of the Public Defender and Acting Lynchburg Behavioral Health Docket Coordinator, says the new program is “diverting people that do not belong in the justice system out of it and actually getting them help.”
Boone said the program began as a collaboration between several initial stakeholders, with Roberts spearheading development. The stakeholders now comprise an Advisory Committee that includes the Lynchburg Office of the Public Defender, Lynchburg General District Court, Lynchburg Office of the Commonwealth’s Attorney, Lynchburg Community Corrections & Pretrial Services, Horizon Behavioral Health, Blue Ridge Regional Jail, and the Lynchburg Police Department.

In collaboration, Horizon Behavioral Health, the Lynchburg Judicial System, Commonwealth Attorney’s Office, Public Defenders Office, the Lynchburg Police Department, the Department of Community Corrections, Liberty University, and Centra Health, seek to provide an alternative pathway through the judicial system for individuals who are diagnosed with a Serious Mental Illness (SMI) and whose crime or offense is tied to their mental illness while balancing the need for public safety. Horizon Behavioral Health will be the primary treatment provider for the Mental Health Docket, utilizing two evidence-based models for providing care which include Assertive Community Treatment (ACT) and Illness Management Recovery (IMR). Photo by Ashlee Glen.
Boone described a “very thorough application process” before the Virginia Supreme Court that included 23 hours of training for all stakeholders and a detailed review of an extensive application drafted by Roberts.
On August 18th, 2023, the Virginia Supreme Court Advisory Committee approved the docket’s operation, making it one of 21 Behavioral Health Dockets across Virginia.
The docket accepted its first participant in March 2024. It’s a four-phase program with an anticipated minimum length of nine months that can extend to eighteen or more months.
“It’s not like a Get Out of Jail Free Program,” Boone shared. “The program is rigorous.” He continued, “This requires real effort from these participants to enhance their mental health and work with the court system and work through the particular issues.”
Chelsea Webster, Assistant Commonwealth Attorney at the Lynchburg Office of the Commonwealth’s Attorney, reviews cases from a prosecution standpoint to determine if they qualify for Behavioral Health Docket participation.
She works together with the Behavioral Health Docket team to determine eligibility. “We have to have consensus from all the parties for somebody to enter into the docket,” Webster explained. “We’re essentially putting the case on pause to see if they can comply with the behavioral health docket.”
A 16-page Participant Handbook outlines everything participants must do to enter and stay in the program.
Once participants have met all eligibility criteria, they begin to move through the four stages of the program: Orientation, Stabilization, Achieving Goals in Community Reintegration, and Maintaining Recovery Practices and Graduation.
Participants move through the program at different paces. “Progress for one person is not necessarily always going to be progress for another person.” Webster explained.
The program begins with bi-weekly court dates, drug screenings, weekly meetings with a peer recovery specialist, mental health treatment, and more. Gerrie Hodge, Assertive Community Treatment Program Manager at Horizon Behavioral Health, explained that the program uses two evidence-based models for mental health care: Assertive Community Treatment (ACT) and Illness Management Recovery (IMR).
ACT is for individuals with psychotic diagnoses. It’s a wraparound service that teaches easily adaptable, everyday life skills in the context of the community or the patient’s home.
“It’s much different than coming into the office and receiving office-based therapy and then having to go into the community and try to make that work for them in the community,” Hodge shared. “Instead, we’re right there with them, often side by side, modeling social skills, modeling activities of daily living.”
To graduate, participants must create a recovery plan and present it to Horizon Behavioral Health or the court. According to Hodge, the plan outlines how they’ll care for themselves and avoid future legal interactions. Webster explained that completing the program will resolve the participant’s legal charges either as a dismissal or not as a felony.
So far, the Behavioral Health Docket has seen one graduate, one dropout, and four ongoing participants.
The BHD team recently received grant funding and will hire a full-time BHD coordinator, allowing them to accept more participants. “We foresee this docket just really blowing up then, because then we’ll have someone that’s solely dedicated to making this thing grow,” said Roberts, who currently serves as acting Docket Coordinator.
Webster says they’ve already seen a positive impact in cases where individuals with SMI voluntarily sought out mental health care, avoiding an emergency commitment and police involvement.
Boone lauded the commitment of BHD participants, saying, “It shows that a lot of people suffering with mental health issues, they truly do want to get help and want to be able to manage their mental health.”
For Roberts, the most encouraging part has been seeing key players in the judicial system get to know the Behavioral Health Docket clients. She said that where traditional pathways don’t often allow judges or attorneys to “really get to know them, to hear their story, to kind of walk through the process with them,” the Behavioral Health Docket does.