Mental Health Issues, Legal Defense and Developmental Disabilities

We have another advocate, a legal advocate, Kara Chien, our next speaker, and Miss Chien if you’ll come to the podium. Kara is the managing attorney for the Mental Health Unit of the Public Defender’sOffice of San Francisco, so we are delighted to have her for the first time at our podium, and I know you’re going to be talking about a lot of topics, mental health issues, legal defense, and developmental disabilities, and bullying, and all sorts of things, so educate us, thank you.

Thank you, and Jeff says hi.- Thank you. – Good morning. Thank you for having me. I love to attend medical conferences, even though I’m not a doctor, but I grew up with 12 doctors. My grandparents, my parents, my uncles, and aunts, and each time I attend(clearing throat) conference, I always feel very hopeful, warm and fuzzy, because I get to learn all the innovative treatment techniques, best practices. It’s very inspiring, but when I attend the legal conference, it’s a little bit, (laughing)(audience laughing) I hate to say it, cold, hard, impersonal sometimes. We talk about justice, deterrents, lack of confidentiality, and really whether you are a defendant, an offender, or a victim. It puts the person in a very traumatic position, where at the end of that legal experience, it’s tough to make them go back to the status quo. I’m going to share what I know because that’s what I do for a living. I represent clients with mental disorders, which is psychiatric… Psychiatric diagnosis, or the clients with developmental disabilities, and I also represent clients who are in the criminal court who are found not competent to stand trial, who may or may not have developmental disabilities. So, I’m gonna go in and we’re gonna talk about, first of all, bullying.

Now, I would like to have one of the audience. Laura, are you here? Laura, can you read the definition of bullying for me? Let me see, thank you.- You’re welcome. Not sure how to do this. Hello?- Okay. – [Laura] Bullying, any severe or pervasive physical or verbal acts or conduct, including electronic communications committed by a pupil, or pupils, that has, or can be, reasonably predicted to have the effect of one or more of the following: reasonable fear of harm to a person or property, substantially detrimental effect on physical or mental health, substantial interference with academic performance, substantial interference with the ability to participate in or benefit from school services, activities, or privileges. – Thank you, Laura.- You’re welcome. – (clapping) Give her a hand.(audience applauding) For a non-lawyer, you’ redoing a great job, so it’s a mouthful, just bullying, you bully someone. Somebody got upset as a result of just the act of bullying, the bullying act, that’s it, but this is the definition, and we have to break it down. I share with you because this is codified in the California education code, and also, this is posted in San Francisco Unified School District. So, I saw some of the attendees’ name cards. I know you’re not from California, or maybe from another county, so welcome to San Francisco.

So, it’s always a good idea to go to your local area to look up your unified school district, what are their policies, what are their rules, what are their definitions? So, even in California, it’s very county-specific. So, in San Francisco, if you go on their website, they will define different types of bullying, and I don’t see it on the Alameda County website. In San Francisco, they mention cyberbullying, which is very, we read about it all the time, Facebook, through social media, of text, an image, a sound or a video, that counts cyberbullying, if that triggers upset on the person who’s receiving the message and the verbal bullying, that’s very obvious. Physical bullying, it’s the act of fighting or hitting. Social or relational bullying and that’s kind of like people have a clique and try to be exclusionary, excluding someone into that social group. That act is also considered bullying. Non-verbal bullying is a gesture, staring, stalking, and destruction of property, so it’s not a verbal, not a physical, but its something that kind of latent. It’s difficult to detect. The last one is indirect bullying. It’s intimidating or peers pressure on someone to cause harm to a third party, so it’s indirect bullying. If my child goes to school and someone bullies her. She comes home really upset, and this child cut in front of me, we were standing in the cafeteria. Is that bullying? Well, that’s rude behavior, so we need to sort of pay attention when we get the message, when we want to make that report of that incident, we need to think about it and organize our facts.

So, if it was just one isolative incident if the incident is done unintentionally to cause someone else to be upset, such as saying oh I’m great and you’re not smart ’cause I got an A today. So, that may not be constituted bullying. That may be just somebody being inconsiderate. So, what we look for is this conduct that is a pattern. Yesterday he said this, today he did this, and in the afternoon he said the same thing. So, when you make your reporting, then people will pay attention, not just one isolative incident, so that’s – Speak a little more inhere so the overflow room can hear you thank you so much. – Sorry. (laughing)- No problem. (audience laughing)- Alright. – Was that bullying?- (laughing) No! That was a very helpful hint. (laughing with the audience) See, that’s, so we need to, it’s really hard when it’s my child and when it’s the victim. So, when we go to the school board, when we go to the teacher, we make the reporting, write it down. Documentation is very important, and especially clients, or patients, or your loved one, who is non-verbal, and who is constantly being picked on, someone who’s really bad, and there’s nobody to defend this child, and this child cannot express how she feels, but you know that she’s upset. You know her daily routine has changed.

My daughter studies cognitive behavioral science, and she wants to use our therapy to help with trauma victims, so having a piece of paper, say draw what happened, tell me how you feel, that’s important, or if we’re very lucky, we ask questions around our child’s friends, peer provider, see if there’s a third-party witness who saw the incident. That will be very powerful, so documentation, searching for third party witness, and then make your report, and in San Francisco, once you make your report, they have two days to ask you to file a complaint, and they will investigate, and they will do a resolution of the complaint, and that, sometimes, in SanFrancisco, it’s counseling, therapy, behavioral modification of the wrongdoer. For severe and pervasive bullying that triggers a lot of harm, then that student may face expulsion or suspension, and if that comes, if your loved one is the offender, you can contact the San Francisco Public Defender’s Office or your local public defender’s office. They may have a juvenileunit, and the juvenile unit, they have an educational expert who goes to the school, or maybe advise the family how to do these administrative hearingsso you can prevent your child to reduce from expulsion to a suspension. Maybe a suspension to somethinga little bit more be not because if my child has special needs, I need to let them know,and they should not penalize like a child who iswithout the special needs.

So, they need to take those mitigating factors into consideration, so that’s very important. And, if there is no criminal code that says if you commit a bullying act, you’re gonna be prosecuted. So, the act of bullying, depending on how it’s done, for example, I’m gonna kill you, I’m threatening to kill you, or actually hit somebody. If it’s serious enough, if there’s a physical, like a bite mark, or if there is, like cutting that requires suturing, then the report will escalate to be San Francisco Police Department or the local police department for an incident report, and they can file charges, excuse me, against the individual who committed the act. So, it could be an assault, battery, or terrorist threat, or hate crime, so if that does happen, if your loved one, or your patient, or your client is a (clearing throat) victim, then it’s best to contact a local district attorneys office to make sure that (item dropping loudly)the that’s okay, the individual gets support from the, oh thank you, I’m sorry, thank you.- Mm-hmm. – Make sure the individual gets support from the victim services and advocacy unit. So, when I contact their office and I say what kind of services you can offer? Well, we will pay for the mental health counseling, we will pay for relocation, we will pay for, sometimes, vicarious victims, the family members are also traumatized, so they will give support.

For example, if the regional center, through Medical, pays for the counseling, but if you have to pay anything out of pocket, you can submit the bill and say please reimburse me, and also for victims if they are uncomfortable testifying in a courtroom, they have therapy dog to assist the victim, to feel more comfortable so they can testify, just to calm down their nerves a little bit. So, that’s from a victim perspective. If the victim, unfortunately, is non-verbal or have a lot of difficulties expressing his or herself, it’s very important to contact the provider and let the district attorneys office is the victim service caseworker, that probably or she needs trauma to inform the approach to help her through the case during litigation, and use trauma specific intervention so the victim will not be impacted, and scared, and feel stress duringthe pendency of the case. In the unfortunate event, ifthe person is being charged for a crime as a result of bullying or other serious criminaloffense, please don’t be afraid, and it’s always, just take a deep breath. How many of us, in our car,we have an emergency kit? Can you raise your hand? Yes, so if your child, yourclient, or your patient has developmental disabilities,it’s very important to have a fact sheet,the name, the provider, the case worker, medication,what are the triggers, what are the things thatcalm him or her down, what are the thingsthat this person needs? And if, in the unfortunateevent, my client, at the time of the arrest,it’s very important for the family to comeforward and fax that letter to the attorney, or faxthe letter to the people who are in charge of theinvestigation of the case. And, in San Francisco, wehave two pilot projects. One is called Law EnforcementAssisted Diversion. So, let’s say the case,it’s being reported to the school district,it’s pretty serious, but this is the first time.

So, when the police come to the school and gather information and they say, well, it’s a very low level criminalactivity, it’s upsetting, but we’re gonna give this person a chance. They will not be booked,and they will be diverted in the community to dotherapy, counseling, or community service work,and after a period of time, and there is no recidivism,no re-offending, then they will let this case go, so that’s one of the legal remedies. The second one, it’s calledPre-arraignment Release Unit, PRU, it started last October,and when people are booked in the county jail,public defender’s office, we have two attorneysand one investigator, we will interview the client,review the discoveries. When we say discoveries, police report, chronology investigation, asmuch as we can get within hours of their booking, we try totake photos if our clients are being beaten, so we’llpreserve the evidence, and then we will try toget the clients released before their court date, soshorten their stay in custody, and that will definitely reallyhelp to not have our clients with special needs beingtraumatized in such a horrific setting, and if theperson does not get released, sometimes maybe the charges are serious, or maybe the victim’s familyare pressuring prosecution. We also have a bail unitthat will file bail motions to try to reduce the bail. A judge should not seta bail that is so high somebody could not affordit, so it is a big thing in California rightnow, it’s a bail reform, so that would help the client to post bail if it’s affordable sothey can litigate the case and out of custody, andallow the client to reconnect with the provider, gettreatment, get counseling while the case is pending, so that’s, it’s very important becauseit reduces the stress of the clients, and alsoit helps the attorney to connect with theclient’s support circle so we can figure out a defense. If the case goes to court,and if we have gathered enough information,and convinced the judge to allow the client to,what we call diversion, it’s kinda similar to the Law Enforcement Assisted Diversion, butthis is already booking, and formal complaint has beenfiled, and allow the client to do therapy, to do communityservice work, and also our San Francisco DistrictAttorney likes to do restorative justice, somaybe everybody sit down, the offender apologizes to the victim, and the victim accepts theapology, or if they destroy some property, theywill repay the property, and afterwards, everybody shakes hands and have a nice closure, andthe case will be dismissed.

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