LA public defender forms pilot program designed to help defendants with neurocognitive disorders
As the head of the Los Angeles County Public Defender’s Office, Ricardo García knows innovation typically doesn’t come from upper management. Instead, he challenges his hundreds of public defenders to bring him ideas on how to better represent indigent clients.
Five years or so ago, Noah Cox, a seasoned public defender in the office, eagerly told García about a population of clients he felt were being overlooked and underserved.
Cox had long noticed that certain clients had trouble expressing themselves and navigating the complex legal system they were facing. Many had a traumatic brain injury, dementia or a developmental disorder. Some were being misdiagnosed with mental health conditions or simply tagged with a low IQ.
“I had no vocabulary, no background in psychology or psychiatry to be able to talk about it as a systemic concern,” Cox says.
He and García went on a journey to better understand what they were seeing.
Across the country, people with disabilities are victimized, arrested and incarcerated at disproportionately high rates.
People in jail are four times more likely to have a nonpsychiatric disability than the broader population, according to data cited in a report by Activating Change, a disability rights group. Those with cognitive disabilities are in jail at a rate seven times higher.
A note published in the Stanford Law Review examined data from the National Registry of Exonerations and found that as of June 2017, over one-quarter of the 245 individuals who had falsely confessed had displayed indicia of intellectual disability.
“They all have different life paths, but they’re all still trying so hard and by and large succeeding,” Noah Cox says. “And by the metric that I think is most important, which is: Is the community better off having them as a part of it?” (Photo by Sara Randazzo)
Through the cracks
By late 2021, Cox had educated himself enough to launch a pilot program: the neurocognitive disorder team.
The team provides comprehensive support for clients with neurocognitive disorders and focuses on how to set them up for successful lives during and after their legal cases.
The effort involves tapping into a complex patchwork of public and private community groups that provide mental health support, rehabilitation and help finding jobs and housing. Some clients can also go through diversion programs that redirect offenders into treatment rather than prison.
“Every single one has been cycling in and out of the criminal justice system,” García says of those being helped by the team. “For the first time, they feel heard and feel opportunity.”
Cox says he wants to reinvent the idea of coming to court, likening it to a hospital being thought of as a place you go to get well.
“You go to court to get socially well, or legally well,” he says. “The goal is not just to get you out quickly now, but to make sure you have the tools and are doing the things so that you don’t go back into custody—ever.”
The team, which has received local and national attention, has had to be scrappy from the start. Without extra money to commit to it, García says he encouraged Cox to hand off responsibilities to paralegals, law clerks and social workers. They’ve also forged partnerships, like with the local branch of the Chicago School, which sends psychology students to do client evaluations.
At first, Cox says they didn’t even have a space for the students to conduct interviews, so he would vacate his office. Now there’s a dedicated room in the 19th-floor lobby of the downtown Los Angeles criminal courthouse, an inviting space with couches and patterned carpet that feels more like a doctor’s office waiting room than a municipal building.
The more than 640 lawyers in the LA Public Defender’s Office can request a consultation from Cox’s team through an internal case management system. Clients could be facing barriers because of a brain injury caused by a gunshot wound or a coma; or because of a lifelong developmental disorder stemming from, for instance, fetal alcohol spectrum disorders.
Kaitlin Kall, a project director at Activating Change, says people with disabilities encounter challenges at every point in the criminal justice system. It starts with police encounters: Disabilities can be misinterpreted as being evasive if, for instance, someone takes too long to answer a question or doesn’t make eye contact. People with intellectual disabilities may be accustomed to nodding along or saying “yes” even if they don’t fully understand what’s being asked.
Kall says she recently spoke to a public defender in California with a client whose best outcome was pleading to a 30-year sentence. After the plea, he turned to the lawyer and expressed relief at getting to go home. The lawyer realized the client had an undiagnosed intellectual disability and hadn’t understood the ramifications of the plea.
“Even if it’s on your radar, it can slip through the cracks,” Kall says. “Especially when people who are entering the system don’t have a formal diagnosis.”
Disability rights advocates say specialized programs can help but that people with disabilities are so prevalent in the criminal justice system that systemic changes are needed. Ariel Simms, the president and CEO of advocacy group Disability Belongs, says the legal system needs its own “curb-cut effect,” which is the idea that a change that helps the disability community—like rounded sidewalk curbs—helps everyone. Simms says more court systems and cities need dedicated Americans with Disabilities Act coordinators and processes to make legal documents understandable and accessible to those with disabilities.
In Los Angeles, Cox measures success by pointing to client photos on his office wall. He recalls one who had three strikes and is now working two jobs, and another who picked up criminal cases around the country but now has stable housing and no new cases for three years.
“They all have different life paths, but they’re all still trying so hard and by and large succeeding,” Cox says. “And by the metric that I think is most important, which is: Is the community better off having them as a part of it?”
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