Sunday, February 04, 2007

Crist's mental health budget plan falls short

Gov. Charlie Crist's efforts to help the mentally ill packing Florida jails address the wrong end of the problem, says Mary Ruiz, CEO of Manatee Glens, the county's psychiatric hospital.

Less than one-third of a $79 million increase earmarked in the governor's budget proposal would go toward community programs that would keep the mentally ill out of jail, Ruiz said.

"It's backwards," Ruiz said. "Gov. Crist's budget addresses the crisis, but not the cause - the fact that Florida is 48th out of 50 states in per capita investment for mental health services."

"Mary is right on point," said Col. Brad Steube of the Manatee County Sheriff's Office. "There are people sitting in our jail who shouldn't be there, but they were arrested for some misdemeanor that wouldn't have happened if they had been under treatment."

Still, Ruiz said Crist's proposed allocation is welcome recognition of a serious problem too long ignored.

The mental health community has sharply criticized law enforcement and the state for mishandling the mentally ill in jails.

"Any change in the system that would allow for treatment for the mentally ill inmates is a tremendous advancement that is sorely needed," said Linda Davis, president of the local chapter of the National Alliance on Mental Illness.

"We have several families within NAMI membership who have had relatives in jail who had to go without medications," Davis said. "That doesn't do anybody any good."

While Ruiz lauded Crist for trying to solve a problem other governors have ignored, she criticized his proposals for falling short of the need, especially at the local level.

"It's disheartening for the families of mentally ill persons and for me as a local mental health advocate, to see that only $27.5 million of the $79 million in the governor's budget is directed to community treatment," Ruiz said.

Davis agreed more money is needed for treatment programs that keep the mentally out of jail before they get it trouble.

"But something is better than nothing," she said.

Ruiz hopes Crist will do more.

"Without a greater investment in community treatment services, we will certainly face a continuing and escalating crisis each year."

Steube echoed her concern.

"There is a great need for more state money for more treatment beds," Steube said. "There are no longer state hospitals for the mentally ill. They end up in our jails."

The solution, Ruiz said, is a sizeable investment in the mental health system over many years to bring Florida to parity with other states.

Davis believes that investment must be matched by a local commitment.

"It takes a commitment within the community to deal with the mentally ill before they end up in jail, rather than than after the fact," she said. "But it is still encouraging to me as a parent to know that if the mentally ill members within our membership find themselves in jail, at least there is a chance they will receive treatment."

All of Crist's $79 million increase is directed toward serving the jailed population, Ruiz said. Her analysis revealed the following:

• Nearly $49 million would fund 353 new secure treatment beds in state institutions.

• Another $2 million would cover operational costs for an additional 38 beds.

• A little more than $5 million would be spent on comprehensive community recovery enhancement teams to provide community services for mentally ill people who have been released from jail so they would not get re-arrested.

Crist's allocation includes almost $800,000 for 30-day medication supplies that will cover the cost of treating stabilized inmates who have been through treatment programs and are now deemed competent to stand trial.

Another $6 million would provide medical services and traditional housing for the mentally ill once they leave jail.

Ruiz likes the concept of the community teams who help former inmates who are mentally ill get medical benefits restored once they are free.

"When you are jailed, you are immediately dis-enrolled by Medicaid or Medicare, if you are in those programs," Ruiz said.

Restoration of those benefits is difficult and time-consuming, she said. Crist's comprehensive community service teams could help with that, she said.

But waiting until the mentally ill are jailed before offering these treatment options is not only backwards but more costly, Ruiz warned.

She cited Bradenton's recently passed camping ban ordinance as an example of the problem.

Mental illness is common among the chronically homeless, Ruiz said. Jailing them for sleeping on the streets does not solve the problem of why they are homeless.

"The cost of putting these people in jail is tremendous," Ruiz said. "There is the cost of incarcerating them, the cost of judges, public defenders and probation officers. In the end we have people who are not a threat to public safety using up resources that could be used on people who are a threat."

And when the mentally ill are turned out of prison they end up back on the street where the odds are high they will get arrested again, Ruiz said.

"The result is we criminalize mental illness and we don't go after the bad guys," Ruiz said. "We need to move toward prevention."

That move, Ruiz believes, must begin now.

"It's not a good statement about our country and state when we are dealing with mental illness by putting people in jail, instead of putting people in treatment," Ruiz said. "That is the wrong place to be as a society. There is something morally wrong and hurtful about that position."

Herald Staff Writer

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