LOS ANGELES — The defendant was in an undisclosed jail.

The judge was in Department 213 of the Hollywood courthouse, where he could see the defendant on a video feed.

"All right, listen," said Judge Ronald Kaye, who runs one of four mental health courts in the building. "So a couple of weeks ago, I made this ruling to get you out of the jail … and get you in a hospital for your mental illness."

But there'd been a change of plans, Kaye explained, because the defendant had been taking his meds and the psychiatrist reported great progress. So Kaye was sending him to a residential treatment facility instead of a locked hospital.

"You won't be in a jumpsuit. You'll be in regular clothes. You'll be able to go to the store after a while. You'll be able to reconnect with family. ... It's just going to be a lot more freedom," Kaye said.

However:

"There'll be a lot of opportunities, but here are the rules, and these rules don't bend for anybody. No. 1, you cannot leave the house without permission … [or] I issue a bench warrant and put you back in jail."

The defendant listened intently, then interrupted.

"What happens if I mess up or something?" he asked. "Like, what are the consequences? I'm just wondering. I'm not trying to say I want to go mess up, but … what if somebody attacks me or something?"

Kaye smiled and said he didn't often get such a question.

"If somebody is giving you any kind of stares or conflict, you've got to talk to the staff. You can't use your fists or your feet," Kaye said. "No violence … and then you can't use meth. No meth, and no marijuana, and no alcohol. Nothing."

It was a fairly typical day in Kaye's courtroom, and he was looking forward to one of his favorite activities — graduation ceremonies for people who completed the treatment plan he was describing.

I met Kaye 13 years ago when he represented the family of a mentally ill 23-year-old man who hanged himself in his cell at L.A. County's Men's Central Jail. The victim was one of 10 people who died by suicide that year while in custody.

Back then, the county jail system was referred to as the largest mental hospital in the country, and little has changed. Early last year, the Sheriff's Department put the number of inmates with mental health needs at 46%. Meanwhile, about 25% of the homeless population is dealing with mental illness, and many of them tumble repeatedly through jails, hospitals and courts at great expense without positive outcomes.

All of that is unacceptable and depressing, which is why I accepted Kaye's invitation to have a look at something that works. The mental health courts deal with various legal matters, but one function is to handle the cases of defendants who committed misdemeanors or felonies, have a serious mental illness and have been judged incompetent to stand trial in criminal court.

"No. 1 is, do they understand the judicial system?" Kaye said. "The second one is, can they rationally assist their attorney?"

If they can't, they may be sent to a state mental hospital or they could be eligible for a mental health diversion that generally involves a two-year treatment regimen. The mental health courts partner with the Office of Diversion and Re-entry, or ODR, which has steered more than 15,000 defendants with mental, physical and behavioral needs into housing and treatment since it was established by the county in 2015.

The office "has access to acute care facilities where people get locked, and then they ultimately, with medication and treatment, get stepped down to residential," Kaye said. "And in residential they get to pursue their dreams of, like, getting a GED … but they're on mandatory medication. … It's just the game changer of game changers, and we are the envy of every county in the state of California."

Judge James Bianco, a former mental health court judge now on the bench in ODR court, has advocated for expansion of the program.

"We're doing really good work, but at a small scale compared to what is needed," Bianco said. Community-based care was part of the plan when mental hospitals were closed half a century ago, but "the system has been so under-resourced … and we're still playing catch-up."

Bianco and I were part of a delegation that traveled to Trieste, Italy, in 2019 to study a mental health system that builds lasting therapeutic relationships with patients and serves as a model for decriminalization of mental illness. That trip was orchestrated by Kerry Morrison, founder of Hollywood 4wrd, who was looking for answers to the epidemic of severe mental illness and homelessness. Morrison has visited Kaye's courtroom on several occasions and watched him build connections with clients.

"He'll have notes he refers to. 'Oh, last time you were in here, you mentioned a birthday, or you worried about your mother being sick,'" Morrison said. "I call it radical hospitality. ... He's really listening to what they say and if there has been a setback, I find him to be highly encouraging. 'This is what you need to do. Do you think you can do this?'"

Mental health diversion doesn't always work. Some clients break house rules, turn to meth or go AWOL. Some get second chances; some don't and return to lockup. Even the graduates have challenges ahead, because generally speaking, although severe mental illness can be managed, it doesn't go away.

But Kaye said roughly four out of five people complete the diversion program, and he celebrates with them when they do. Sometimes therapists and family members join the party, and Kaye leads the festivities, waving a diploma up on the bench.

There were four graduates the day I visited, including two who were going to electrician training school and one who was on his way to ODR housing. I agreed not to use their names or the specifics of their cases.

"You split on the program, and you were AWOL … and I gave you a second chance … and you did great," Kaye told one of the grads, who said he had been sober for two years.

With another grad, a clinical supervisor from his treatment facility sang his praises.

"He's never been in trouble. He's never not taken his meds. He's been a role model honestly for other clients in the program," she said.

Kaye congratulated the client and a wave of applause filled the courtroom.

When it was time for an elder gent to step to the podium, the judge brightened.

"Look who's here," said Kaye, who had monitored the man's progress through periodic video conferences.

"You're an inspiration," Kaye said.

"Thank you so much, your honor," the defendant said. "I'm at a loss for words. You've been there for me the whole time, encouraging me. I'm just so thankful."

Kaye noted that the man had been a good mentor to younger residents at his treatment facility.

"You were just this voice of reason, voice of commitment to treatment," Kaye said. "So it's with a heavy heart that I'm graduating you because I wish you'd be right by my side for the rest of my time on the bench."

The defendant's brother checked in by video and thanked the judge. It felt as if they were at a family reunion.

Kaye then turned his attention once more to the defendant, who was headed to Knott's Berry Farm to celebrate his graduation with family. The judge asked the bailiff to deliver him the graduation certificate.

"You are the man," he said. "I'm so proud of you."

"Thank you, your honor."

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