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Getting a grip on mental-health challenges is key

Senior Editor Regular News

One thing kind of leads to another.

In 1995, Fourth District Court of Appeal Judge Melanie May was a Broward County trial judge and was reassigned from juvenile court to the felony drug court, a change she did not want.

“I was told by my bailiff we were going,” May recalled, and that was that.

Despite initial skepticism, May kept her own numbers and soon discovered that drug court worked. And also found a corollary issue.

Judge Melanie May “In drug court, we used to say no one with mental health issues could participate and when we started addressing substance abuse problems. . . the mental-health issues began coming forward,” she said. “The real problem is our community mental-health and substance-abuse systems are not funded and therefore many of these people do not get the treatment they need. They wind up in the juvenile justice or the criminal justice system, and they become court problems.”

Dealing with the mental-health issues was the focus of a Criminal Justice Summit breakout session. The numbers aren’t encouraging.

May rattled them off. Florida has 2.6 million people with mental-health problems and only 38.2 percent receive treatment. Florida ranks 44th nationally in access to mental-health care, 49th in spending, and police initiate more Baker Act cases than arrests for robbery, burglary, and grand theft combined. Around 120,000 people with serious mental issues are arrested and booked into Florida jails every year, and 17,000 are serving time in state prison, while 9,000 remain in local jails. Another 22,000 to 37,000 are on some form of supervision.

“The total cost to us in Florida is $865 million a year, or $2.3 million a day,” May said. “We indeed have a problem.”

Tara Wildes, president of the National Alliance on Mental Illness, said several approaches are needed.

Serious offenders may need to be incarcerated, but require effective treatment while imprisoned “so they’re not worse than when they went in,” she said. Police officers need training to recognize mental-health problems and employ arrest alternatives. Mental-health courts need to be available for suitable candidates. Communities need mental health and drug abuse emergency rooms, similar to traditional emergency rooms, so people can find help 24/7.

“There is no one part of this system that can do it alone. We have to work together and we have to work with the people who have the expertise,” Wiles said. “Incarceration should be rare, it should be fair, and it should be beneficial. If it’s not these three things, then we’re not getting what we pay an awful lot of money for.”

Bob Dillinger Mental health diversion works, long-time Sixth Circuit Public Defender Bob Dillinger said. He said a Sixth Circuit program handled 6,395 individuals who had accounted for 51,431 arrests. After going through mental health court, they had 3,491 arrests, a 94 percent reduction.

“If there were sufficient community-based providers and community treatment, a lot of these people would never have been in the criminal justice system,” Dillinger said. “They get the label of criminal and mental problems. That’s hard for people who can’t handle a lot of problems.”

A continuing difficulty is resources for people who are found incompetent to face their criminal charges. If the charges are serious, the state has funding and competency treatment. But for people charged with misdemeanors, there’s nothing, Dillinger said. And a new concern is the rising number of Baker Act hearings for juveniles, which have doubled recently and have involved children as young as 2, 3, or 4 years old.

In the Miami-Dade County jail, corrections officers being punished used to be sent to work in the section housing patients with mental health problems. Don Horn, chief assistant state attorney for the 11th Circuit, said that was symptomatic of a former system-wide failure to adequately address mental health problems that included poor treatment, lack of training for police officers, lack of diversion, and little if any treatment for incarcerated mentally-ill patients.

Don Horn Horn said his three main, seemingly unrelated, duties are acting as general counsel to grand juries, reviewing police shootings, and overseeing mental-health programs. But they are all related because in the prior decade the grand jury issued four critical reports on mental-health care, a high number of police shootings involved people in a mental-health crisis, and the 11th Circuit has become a leader in addressing defendants with mental-health issues, although Horn said much more needs to be done.

With grand jury reports, “it’s like a pulpit we use. . . , but it gets things done,” he said.

Better training for police on dealing with the mentally ill and issuing tasers has drastically reduced police-involved shootings, he said.

And there is an active program to divert the mentally ill who are arrested into diversion programs, including some charged with felonies.

Horn said that takes careful screening. In some cases, the underlying crime may have been a misdemeanor, but when the police show up, the agitated person begins “flailing” and may hit a police officer. That results in a felony charge for battery of a police officer.

“There’s a fear factor involved here because all of the cases coming in are not people flailing or battery on a police officer, we’ve got people stabbing each other,” Horn said. “All it takes is one person we decided to divert and have them in the outside facility and something happens, and there we are up a creek without a paddle.”

In response to a question, Dillinger said more options are needed.

“We need something where people who are mentally ill can go to where they are safe, they are supervised, and they can get the treatment they need,” he said. “We have boiled it down to jails or hospitals, and we need something that is in between.”

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