Wellness an intense 18-month program—assuming there are no sanctions while in the program. Program par-ticipation consists of judicial oversight, treatment, and probation. Participants are required to appear regularly before the presiding judge who imposes immediate sanctions for any violations. Treatment includes substance abuse education, group therapy, and peer support. Probation ensures the participants remain in compliance with the program’s conditions, like not testing positive for illicit drugs or alcohol. Court appearances and oversight wain as the partic-ipant moves through the five phases of the program. Upon completion of the program, the participant is sentenced with all-time suspended. social distancing measures, and mask mandates were imposed to stop the spread of COVID-19. Unemploy-ment in Virginia rose to 11 percent in April 2020 and many Virginians wondered if they could pay their bills, stay in their home, and afford food. 14 Uncertainty and isolation have led to a rise in reported mental health issues among all U.S. adults. In a study published in the U.S. Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, 40 percent of U.S. adults reported struggling with mental health or substance use from April to June of 2020. 15 There was an increase in anx-iety, depression, and symptoms of trauma and stress related disorders. 16 In particular, “[t]he prevalence of symptoms of anxiety disorder was approximately three times those reported in the second quarter of 2019 (25.5 percent versus 8.1 percent).” 17 Thirteen percent of U.S. adults studied had started or increased substance abuse to cope with stress and emotions during the pandemic. 18 Social distancing and quarantining meant participants were not able to have the face-to-face interactions with support groups or therapists. The increased isolation made those that already feel alone, retreat further into themselves. 19 Clients faced difficulty continuing their treatment via technology. Individuals had difficultly logging onto Zoom and with connectivity in general. Not everyone has access to stable internet connection. Some had to use their phone’s data. If individuals did not have unlimited data plans, the cost of keeping up with their treatment rose dramatically. The introduction of these additional stressors has made it difficult for individuals to focus on their recovery—leading to relapse and in some cases death. If individuals started using again, the social distanc-ing and quarantining measures also meant that a once communal activity, consuming illicit drugs or alcohol, became a solitary endeavor. As a result, no one was there to call for help or administer lifesaving care when someone overdosed. Individuals with mental illnesses are often dealing with this stressful time by consuming illicit and often dangerous drugs, such as fentanyl, alone, sometimes unaware of what exactly they are consuming. Once the mentally ill self-medicate, they often lose sight of who is helping and who is hurting them. So it is heartbreaking, but not at all surprising, that overdos-es in the Commonwealth increased 39 percent from January through June 2020 as compared to 2019. 20 Kathrin Hobron, Virginia Department of Health’s statewide forensic epidemiologist, predicted that fatal drug overdoses may be 2,053 by the end of 2020. 21 The predictions in this report would make 2020 the worst year on record for fatal overdoses in Virginia. In addition to having a mental illness, many men-tal health participants are also addicted to illicit drugs and/or alcohol. This is because many self-medicate in-stead of seeking clinical care. The challenge for many of these participants is to not only learn to deal with their mental illness but also overcome their addiction. Mental Illness in Virginia’s Criminal Justice System A 2018 report on Mental Illness in Virginia’s Jails highlighted the prevalence of mental illness in incarcerated individuals. Of the general population 19.84 percent, or 7,852 individuals, were known or suspected to be mentally ill. 10 The report also revealed that incarcerated women were more likely than men to have a mental illness with 34.38 percent of females reported as having a mental illness compared to 16.74 percent of males. 11 Individuals with mental illness comprise nearly 20 percent of Virginia’s incarcerated population. Cur-rently, there are only 11 authorized Mental Health Courts in the Commonwealth of Virginia that deal with these unique offenders. 12 Most of Virginia’ s 73 specialty dockets are Drug Courts, specifically 53. Seven of Virginia’s Drug Courts have a veteran’s spe-cific track embedded within them. 13 Compounding Effects of COVID-19 on Mental Health In March 2020, Virginians saw a dramatic change in the way they live their lives. Stay-at-home orders, 28 VIRGINIA LAWYER | JUNE 2021 | VOL. 70 www.vsb.org