Florida calls for end of trans-institutionalization
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| Topics: advocacy, community care, courts, diversion programs, housing, human rights
A commission of the Florida Supreme Court took a giant step forward to correct a human rights and mental health catastrophe, criminalizing people who suffer from a mental illness. Each year in Florida, 70,000 people with mental illness, three-quarters of whom have a substance abuse disorder, are arrested. Seven months ago, the Supreme Court of Florida named Miami-Dade County Judge Steve Leifman a special advisor to address “the response of both the public mental health system and the criminal justice system to people with mental illness.”
Judge Leifman has described himself as a “gatekeeper to the largest mental health facility in the state. . . . We have ten times more people in our jail with serious mental illnesses than any state hospital in Florida.” Failures to treat people who could have been helped in the community, and the disproportionate arrest of people with a mental illness -- often for petty offenses -- have resulted in prisons which have become "psychiatric warehouses."
Two weeks ago the Mental Health Subcommittee Judge Leifman chaired released a bold report, “Transforming Florida’s Mental Health System,” recommending a comprehensive re-design of Florida's system to keep keeping mentally ill people out of institutional care, notably correctional facilities or state hospitals.
The recommendations in this 170-page report could take up to six years to phase in. They address securing housing and medication upon release from prison, consolidating a fragmented system of providers, and restructuring finances. The commission estimates that the $48 million needed to pay for an additional 300 forensic beds, could provide a $300 housing subsidy for 15,000 individuals. It could also fund substance abuse services for 238,000 children or 372,000 adults, and add 37 teams to provide community support services 24-hours-a–day.
Leifman logical choice
Leifman was a logical choice to head the Florida reform initiative. Soon after a meeting in Miami, which was sponsored by the National GAINS Center in July 2000 and brought people nationwide, Miami-Dade’s 11th Judicial Circuit Criminal Mental Health Project was formed with Leifman at the head. At the time, Miami-Dade had the largest urban concentration of people with mental illness. The county alone was spending a half-million dollars a year on just 31 repeat mentally ill offenders. Within one year, the overall recidivism rate fell from 70 percent to 11 percent as a result of pre- and post-arrest diversion programs including crisis stabilization, psychiatric examinations, and housing.
Never really de-institutionalized
Leifman has been actively educating other judges about how the judiciary can divert mentally ill offenders into treatment. He has testified before Congress appeared on radio and television, and frequently speaks at conferences. Just last month he told a Washington gathering:
We never deinistitutionalized. What we, in fact, did is we transinstitutionalzed, we transferred people from really bad hospitals to really bad jails giving them criminal records making it more difficult to go into recovery because now they can’t get jobs, now they can’t get housing. And the second and maybe more sadder irony is that we have gone 200 years, and jails are once again the primary place for people with mental illnesses in this country. And is really the one area in civil rights that we’ve gone backwards on in this country, and it’s a shame on us.
On any given day in Florida, roughly 31,000 people with a mental illness are either in jail or prison. Nationally, half the prisons are filled with people needing mental health treatment, according to last year’s Bureau of Justice report. In some states, such as California where Gov. Arnold Schwarzenegger recently cut back on community based treatment programs, the problem is confounded rather than corrected. Others are building more prisons. Florida is taking leadership to tackle the problem with courage and honesty.
there are still so many 'forgotten' members of our society who are languishing in jails when they actually are ill and need treatment. Oh, how I wish I could move mountains and get consumers into those jail cells to 'preach' the overwhelming benefits of recovery. So many people who have been sick/in trouble/confused their whole lives simply have no concept that things can get better.
Posted by Sarah Ho | December 5, 2007 3:18 PMThanks for all you do to help get the word out and educate those who need to know. And hooray for Florida for taking a stand and making some steps.
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