Welcome to the Reality Check podcast. Psychosis is Real, so is Recovery.

On this episode, co-founders Dr Ashley Weiss and Serena Chaudhry speak with The Honorable Judge Calvin Johnson.

Judge Johnson established the first Mental Health Treatment Court in the State of Louisiana in 2002. By 2005, this Special Court was selected as one of four demonstration courts in the Country. Prior to establishing the first Mental Health Treatment Court, Judge Johnson served as Drug Court Judge from 1994 until 2002. On this episode, we find out more about his work and perspective on mental illnesses and the judicial system.

For more information about Clear Answers to Louisiana Mental Health (CALM) and their Early Intervention Psychosis Program (EPIC NOLA), visit the website: www.calmnola.org

Find out more about Judge Calvin Johnson here: https://louisianajudgesnoir.org/judges-profiles/judge-calvin-johnson/

Podcast produced by Red Rock Branding – www.redrockbranding.com

Serena: Welcome to the Reality Check. Psychosis is real. So is Recovery podcast.

Ashley: I'm Dr. Ashley Weiss. I'm a child adolescent psychiatrist. And I'm Serena Chaudry.

Serena: I'm a clinical. Social worker

Ashley: and we are the co-founders of Epic nola, which is the Early Psychosis Intervention Clinic in New Orleans, and also the co-founders of Calm, clear answers to Louisiana Mental Health.

Serena: Welcome to Reality Check. Psychosis is real, so is recovery. We're super excited today to have the honorable Calvin Johnson with us. Can you, your Honor, please.

Judge Johnson: Middle aged and very happy. I refuse to use that O word. I am middle aged. This is my middle aged, and I'm very happy. Yes, I'm, I was in court today until about, oh, an hour ago that this is a great time though to be involved. That's in this kind of conversation. I am actually back in court as an ad hoc judge.

And what I have seen in the last almost 40 days is just a repeat of how we were not doing these things correctly 30 years ago and still not doing correctly.

Serena: Tell us more

Judge Johnson: to see the disconnect. Between that, for instance, lawyers who represent people with the illness that disconnect are still lack of true understanding about the illness itself and especially how to treatment modalities can be accessed and use to those clients in those clients' best interest.

Ashley: What do you think will, what do you think has changed for that shift? Because I just, when I did my forensic P fellowship. We, now that I think about it, we had a lot of aching from the law students about testifying. And not that mental illness is only represented in the forensic world, but you do have a lot of mental illness that represent, that is represented in that world.

But now that I'm thinking about it, I don't know if, I don't know how many like educational sessions that they have about. Serious mental illness and the specifics at all.

Judge Johnson: They're correct. And on my side of it would be those who do those matters generally lawyers who do them, but not necessarily looking at it from a holistic or, or a.

A real treatment perspective. They're looking at it from their normal legal lens and how to effectuate what they believe is the best interest of the client, but not really understanding what the realities of the client actually are. And so that, that type of piece. Now that's more public defenders who do so much of this work.

Serena: So can you tell the listeners a little about your history in the courtroom and your connection to mental health court?

Judge Johnson: I was a public defender in the late seventies, and then I became a law professor actually at Loyola Law School running the criminal clinic program. But it's there that I started to really see the connected the, the connections between clients and illness, be it mental illness or be it addiction issues or, but to see the connectivity between behaviors.

Of pieces, but again, not necessarily seeing it. Other than I gotta get my client the best thing possible in terms of deal, although in terms of work, but not necessarily seeing from any kind of treatment perspective. Didn't see it from that. It really didn't. I'll be honest with you. I became a judge in 91 and then started, of course to see much, much more of this now because I'm looking at it every day in the C.

So seeing so much more necessarily. This is a safe space. So let me be truthful, not thinking at that stage. It's not my fault, it's not my problem. See, I'm a judge, but that's not my problem. Right. That's your problem. But as the judge mm-hmm. That's not my role. Even that I, and as my, my, my wife was. That his words were, he's not a social worker.

That's not what, that's not what he does. And that's how he messaged it. And I did. That's how I messaged it. This is 91, 92, but that's how I messaged it. But then growing in terms of my own, my own career as a judge, but growing in. My understanding, real understanding of the, of behavioral issues and criminal justice and the fact that the criminal justice system, the way it acted, the way it is designed is wasn't designed to be, IM to be really impactful across those issues because as I just said, it wasn't our problem.

And so that's how we thought about it and that's how we went at it. And so we had to change our way of thinking.

Ashley: So when you, going back to something that you said about like a holistic approach and, but also from the legal side, wanting like the best outcome for your client and sometimes like the best deal and.

But also wanting to take into account the treatment perspective. I guess like in an ideal world, how would those two merge? Because they seem they could have, you could have similar desires for the best deal, but also for somebody to get care. And ideally, how do we bring those together or also what do you see as the disconnect?

I think about some of my own. Some of my own experience with competency restoration and trying to get people into the best situations where I was finding that they were not gonna ever become competent to stand trial and, but that would actually mean that they were gonna be in a treatment facility indefinitely, that you'd find yourself sometimes not knowing which part was like carrying the most weight.

'cause sometimes treatment can almost seem more confining than Absolutely. And so it's hard

Judge Johnson: and it's absolutely hard to do, especially when the, the, this three gets to that treatment lawyering defense and judging. Right? That's a three-legged stool. And to make it balanced is very difficult to do. The judges that just on that side.

Also are miseducated as regards to their role. What is my role as a judge in this e Even if we are at 25 and it's still not clear to, to that side of the state what the actual role is and criminal court judges invariably get into to start that. My role is simplistic. That is, is I, I let go. I keep 'em in.

I say some magic words.

Public safety

being. Being connected to the realities that's outside of my room, my courtroom, but being connected to those realities and recognizing that if I'm going to be impactful as regards this community, which I'm supposedly serving, and as regards even public safety, but I have to work and know more about and be better connected to that side of it.

I have to do that if I'm really, if I'm really gonna do this and do it correctly. Otherwise, the system will constantly implode, fail, constantly does. And but to recognize that and to really go at that, it's hard. You, we go, lawyers go and judges go every year. To their conflicts at conference in Louisiana.

We go to Florida the first week of June and we say judges, they stay there for a week and they talk about all of the legal issues that they have to, they're concerned with, have to deal with, and so they can learn better about that. It's a rarity with this kind of peace. On conference, regardless of what I would say, working without knowing completely, but guessing, regardless of what state we are in, whether you're going to see and on test CLE in that conference, something about, we'll be talking about, it's a rarity and we still could, we still act as if it's a rarity when in fact it's something we do regardless if it's civil or.

Aspect of this on a regular basis. We don't study, we don't talk about it. We don't do that.

Serena: That's wild to me that this isn't part of the conversation. At the very least. You reminded me of I work in immigration, or I'm an expert witness in an immigration court for people looking to improve their immigration status.

And I remember working with Doctors of the World or Physicians for Human Rights. At some point they were providing trading to immigration judges on the mental health issues that migrants were facing. And I was so impressed by that and I think just assumed that happening a.

Judge Johnson: I, again, my guesstimate is, no, it's not, don't mean me wrong, but generally speaking it's just not on, on day one or three or five of one of those conferences, will there be an hour and a half or uh, a more of conversation around what we're talking about? That would be a reality. That's just not, now. It might happen every other three years or so, you might see something.

Right, but to engage, have it in place and everyone recognizing health issues is something the legal community is faced with and must deal with. Because this reality court day, yes, no matter what kind of court you're at, practice, no matter where I a number, for instance, when I was doing nationalized illness and I did a there, but in terms of trying to, trying to get pieces, parts, or systems engaged in mental health first aid.

Mental Health First Aid, not just a, it's just a little piece, a little bandaid kind of thing. I mean, it's not that big deal at all, but it has value,

Ashley: right?

Judge Johnson: Mental Health First aid, it has, okay. Judges, legal community. Let's come and this is that N but let's, we put on this piece on Mental Health First Aid is an eight hour.

Saying it's it dependent upon how it started, it could be two or three days of it, but to have a person trained in your system, trained in mental health first, a person now it was and is so difficult to get those systems to recognize that if you operate in reality, it is anything. You have crowds and crowds of people coming, you ought to have a defibrillator,

Ashley: right?

You have, so

Judge Johnson: yeah, the deescalation. The deescalation, but that's, oh my God,

Ashley: tire extinguisher in there. I'm sure extinguish.

Judge Johnson: You don't have anybody traded Mental Health First State, but I wasn't doing the City Hallin and I was the Criminal Justice Commission at City Hall. Okay. Again, we are going to get someone trained in this building on mental health First Aid. Couldn't get it done.

Ashley: Is it because people didn't want, no one would volunteer to do it or just

Judge Johnson: volunteer?

No.

Ashley: Yeah, that's wild that it was not mandated. We have to do it annually at the state hospital.

Judge Johnson: Yes, but what about the state court?

Ashley: Yeah. I don't, I can't, it seems like

Judge Johnson: that's my point,

Serena: right? Like a no brainer. I can't help but wonder to what extent stigma plays a role here and

Judge Johnson: Yeah.

It's an infection that all of us have.

Ashley: It's an infection. That's a great way to to say it. I think that's a great way to think about it. And I think one of the challenges that I'll hear is when we say behavioral health, it implies choice of health because there's the that like I'm choosing to behave a certain way and I've worked with people that have major behavior problems that are not linked to underlying psychiatric.

And then you have people that display behaviors that are occurring doing due to underlying psychiatric illness that is impacting the way they see the world, which are two very different things and completely different things. And so I'm even like not into saying behavioral health, just for that reason.

Serena and I work mostly with psychotic disorders, which you. We have to even think about the everyday behaviors of our own patients. And if those behaviors are coming from, they're doing what they love, what makes them happy, and they're, or they're making some not so great decisions, maybe because they're being a little rebellious.

And what like behaviors are coming just from like life and personality versus what behaviors are coming. If somebody's having more symptoms and the court. I guess yes, you get asked that question in NGRI cases. Like, I feel like that was the only time where it was like, so was this decision a decision based in a mental illness or was it a decision based in, I'm just choosing wrong.

That was like the Insanity Commission work was the one place where it was really like drilled down of like where, what is, what trigger. This action, but otherwise, even in a mental health court or even in our assisted outpatient treatment with our patients that are in a OT, those conversations aren't really happening either.

And their mental illness is the primary reason that they're actually in an a OT program.

Judge Johnson: When I so agree with you, when I was doing a Metropolitan Human Service district.

14. But at the end of that, that conversation started to become about behavioral health and not almost to the point where we get 25 and mental illness. We don't wanna say mental illness. Oh

Ashley: no.

Judge Johnson: We wanna say behavioral health. We don't wanna say mental illness. I don't understand why it.

Mental illness, this is an illness, and at court, whatever I am now there or in some other environment. When I'm talking about this, I talk about it from an illness perspective. I don't talk about it from a behavior perspective. This is an illness and this is an illness that we have to treat and deal with, like we deal with illnesses.

And I don't use, I don't really use behavior. Mm-hmm. I use it in the sense of

Ashley: Yeah. A

Judge Johnson: descriptive piece of what you're talking about. I don't,

Ashley: there's, yeah, there's, so there's an assumption, and I think that this is probably due to stigma and, and due to the fact that historically. Healthcare communities have made some bad decisions when it comes to how they treat and manage people with psychiatric illnesses.

But now when you say illness, there's an assumption that there's only a medical model being applied and that's just not, I get that. There are definitely places out in the world that. We'll treat what we're talking about maybe from a very one-sided way. But most people, most people that we're in contact with in the mental health community down here are not just, are not approaching mental illness like with just medication, and they're not just seeing it from a medical model, but when we completely ignore that side, then it just goes sideways.

Judge Johnson: Yeah.

Ashley: Not even within psychiatry, but just as a physician in general, because I consider myself a physician before a psychiatrist. Like the assumption that all I'm doing is like cranking out medications is so just not consistent with reality. Like people go to the doctor plenty of times and don't get medication and might talk about their health, or talk about relationships or talk about exposures, that so many things.

There's so many ways that you're in touch with patients beyond just like writing a prescription. Um, absolutely. It's

Serena: shortsighted and yeah, it's not holistic. And it gets to the point that I was gonna make, or the question I was gonna pose is, can you see a world in which the legal system and the healthcare system work more closely and more intimately?

And if so, what does.

Judge Johnson: I think it starts with, again, on those, in those places where we educate people, be it the law, be it the be it college, be it the hospital, be it those places, but where we educated them and as we do in stages to towards their end of that educational process, but at all stages of it.

This is a poem of it. Regardless if you are there for. If you, if you are really there for one aspect, for instance of medicine, but recognizing even there that you, you have to also be trained in and educated about this illness because regardless of who you treat, they may have as a part of them this illness, they may be there for a toothache.

But as a part of it is there's illness, it doesn't matter. And, but then the same thing goes into, to the legal profession doing just accident cases and all you're doing, that's your practice is accident cases. It doesn't matter. Because those people you are going to walk in your place, they will come with an accident and they will come with this illness.

And so for, to recognize that across structures and those, again, on that stool, the legal system, and all aspects of it. It all aspects of the system, not just a judge, but all aspects of it should have some kind of familiarity. Mm-hmm. With this as a part of the other, the day to day stuff that need, because this is a, it has to be, must be, it will be a part of the day to day stuff that they do.

So what if we start to go at IT perspective. To We get to, we need to be, but

Ashley: you say speaks to. Still the sort of lack of really believing that it is imperative to my job. And so even though I teach things to you in a classroom, you're gonna be accountable throughout your career in whatever field to be responsible for that knowledge and to apply that knowledge when appropriate.

And this is challenging coming from. People coming from different backgrounds and experience that might still hold a lot of uncertainty or mistrust or misunderstanding of certain mental illnesses or preconceived notions about certain mental illnesses that are hard to shake. That's, it seems like within medicine, coming into having experiences with someone that had cancer or someone that had a heart attack brings up this like passion about it and in the mental health community, having that experience brings up.

A lot of mixed feelings about that topic or about that illness in particular, and just stigma. Yeah,

Judge Johnson: stigma. Again, it's hard for us, and I can sit here in this chair and I can say all of the wonderful stuff that I say and I'm saying, but the fact of the matter is that it, I'm no way supposed to perfect person and I too sometimes.

Sometimes conflicted or sometimes in capable of taking that third breath and recognizing that Calvin, you're dealing greater person with an illness, you dealing with a SY system. That also is I. So you, you have to take some deep breaths. Yes. We

Ashley: all need to be wearing masks. Like it's the Yeah, it's like the infection that breeds the infection.

Judge Johnson: Yeah. It, it's, it just is it it? But we are all of this better off right now. We are better right now, keep in mind than we were 40 years ago. We are better off right now. That's also true. It's also true, and sometimes we have to take a, both breaths, but also recognize that we are, and we ought with some things better than we did decades ago.

We are, and we at least have conversations now a, about how to do even more do it even, and so.

When we talk about issues, especially this kind of issue, it's to not just stay stuck in the weeds of it, but also recognize what, where we are in terms of positive pieces that's involved with it.

Ashley: Yeah. Sometimes I feel like I'm. Clinging to the bottom, clinging to the bottom of the weed at the bottom of the murder.

Serena: Yeah.

Judge Johnson: But of course that that ended the day came to me. This is over. This is not where this belongs.

Ashley: What did you do?

Judge Johnson: This belongs in the civil structure. In the civil system. It belongs over there. It doesn't belong over here. Y'all.

Ashley: Yes.

Judge Johnson: Come on. That's just, but that's true story. That's wild. That's, that's bad.

How bad we could be.

Ashley: Yeah,

Judge Johnson: yeah,

Ashley: yeah. Like I have patients and have had patients at the like state hospital who were on the forensic side, the criminal side for forever and like finally after that happens, like situations like you just described, they're just like, this is not like we're just gonna do it.

This is a civil thing. The person's not getting unable to take care of themselves. They just need to be in a comfortable, safe place where they can do life and not keep having to go back to work,

Judge Johnson: right? Yes. And again, this is where the justice system gets confused by itself. So in terms of you, you can't, and you're not supposed to be a treatment entity for people with illnesses, that's not your role, right?

No, that's supposed to be over there. That's such a role.

Serena: But it's their role now, unfortunately. And that's the problem.

Judge Johnson: Yeah. But yes, like AOT for instance. AOT is a wonderful thing, but you have to recognize the justice systems knee jerk at least. Somewhat as goes, how you deal with, how you have, how you get people in aot, how you structure that to work correctly with whatever you're doing in justice, but how you do it.

This is where again, I go back to education. Yeah. And being educated around legalities of law. Again, criminal court, but what you have to deal with being educated.

Ashley: So the main themes are right, if you think about it, continuing to

Serena: educate.

Judge Johnson: Absolutely. Absolutely.

Serena: Yeah.

Judge Johnson: We have to add that

Serena: is low hanging fruit, so to speak.

It's an easy in it's preventative. If we can do that and see the ripple effect through different systems, it's really not that hard.

Judge Johnson: It's not that hard. And when you have something, what y'all are doing, and with First Break, for instance, you now know First Break Works. Tell me it does. I know it does first break kind of treatment modality works.

Okay, so how then can we go to those places where you first see. That happen. How in in those places do they recognize that this person needs to get to care now? Yeah, that person needs to get the care now, but how do they get, how do we get that to happen? More education. There you go.

You have to, you have to get, but of course, it, it always goes back to stigma. About it, how we feel about it. It just, it constantly goes. Yeah.

Serena: Going back to what you said, you mentioned something, having to hold onto hope. Something that makes me hopeful is that you're back in the courtroom. Yeah. You're an advocate, you're passionate and you're able to see things and maybe you don't wanna be there, but I'm happy for New Orleans

Judge Johnson: that you are there.

I'm a hundred years old, and if I'm only, if I. We like the,

Ashley: that was an eye roll though, from a healthy 3-year-old.

Serena: Thank you so much for taking the time for navigating technology. Talking.

Ashley: Yeah, so we've gotten far, three of us, made it with headphones and microphones and can see each other. And

Judge Johnson: I I, but I'm so happy for y'all. I really thanks for what y'all do. I really am happy too. Happy about that. And of course, I talk about this piece over and on.

But this piece and the fact that we have to be better at generating funds sufficient. Yeah. To make it more part of our, of the treatment teeth, to make it more part of that, to get, you got good money for that.

Ashley: Having healthcare, having the public health education part be a part of healthcare is so important and

Judge Johnson: yeah.

Ashley: Hopeful. Mental health care, it's, I think it's caught up a little bit with maybe cardiovascular disease, maybe with some cancer education where there's a lot more knowledge floating around about preventative measures and. Know how to care for yourself. Early and early. I, early identification, early detection.

We need that same enthusiasm with psychosis. Early detection.

Judge Johnson: Yes, we do.

Ashley: Yes, for sure. Yeah. So whoever's listening that needs to drop funds our way, we would love to.

Judge Johnson: Oh yes.

Give

Serena: you a really good sweatshirts and

Judge Johnson: yes.

Serena: Thank you so much. So

Ashley: good to thank you all. I really

Judge Johnson: appreciated it. Thank you. November, November 7th.

Judge Johnson: Alright. Yeah. So maybe I could get you guys to come on my radio show.

Serena: Oh yes.

Judge Johnson: We're gonna talk about November 7th.

Serena: Yeah. Yes, for sure. Yes. Send us a link. Okay,

Judge Johnson: I'll,

Serena: okay. Alright. Thank you.

Judge Johnson: Take care y'all. Bye-bye.

Serena: Bye-bye. Bye-bye. Until next time. Thanks for taking the time to get your reality check and remember, psychosis is real. So is recovery.

Ashley: If you have enjoyed this episode or found it, use.

Please subscribe wherever you get your podcast from and check out the website. Call nola org.