Friday, March 07, 2008

Keep mentally ill in proper treatment, not cells

Annually, as many as 125,000 people with mental illnesses requiring
immediate treatment are arrested and booked into Florida jails. On
any given day, more than 70,000 individuals with serious mental
illnesses reside in Florida's jails and prisons or are under
correctional supervision in the community. Frequently, these
individuals enter the justice system as the result of committing
relatively minor offenses that are directly related to symptoms of
acute, untreated mental illnesses.

Unfortunately, many of them are either denied community-based care,
or the care that they do receive is fragmented and insufficient.
Disabled and vulnerable, they recycle through the system, creating a
revolving door of criminal and legal involvement.

Measures have been taken in the past to reform this unsystematic
approach to Florida's mental health system, but to no avail:

• The movement from institutional to community-based treatment was
never fully executed or funded, resulting in decades of fragmented
mental healthcare.

• The existing community mental health system leaves enormous gaps in
treatment and access and is not designed to serve the needs of
individuals who experience the most chronic and severe forms of
mental illnesses.

Some of us have served on trial courts across the state and have
witnessed firsthand the problems that are created when courts are
forced to deal with mental health issues. Without proper treatment,
these individuals appear and reappear in court. But all of us know
that the problems with the current system weigh heavily on law
enforcement and the criminal justice system. Courts see increasingly
high numbers of cases and jails are continually overcrowded.

Based on recent trends, Florida can expect the number of prison
inmates with mental illnesses to nearly double in the next nine years
to over 32,000 individuals, with an average annual increase of
roughly 1,700 individuals per year. To keep up with such demand, the
state would need to open at least one new prison every year.

The state of Florida currently spends roughly $250 million annually
to treat about 1,700 individuals under forensic commitment. Without a
change to the existing system, the state faces potential forensic
expenditures of $500 million annually by 2015.

But there is hope. A comprehensive plan was recently unveiled under
the joint leadership of the three government branches and with
sponsorship from Chief Justice R. Fred Lewis and Gov. Charlie Crist.
Under this redesigned system of care, there will be:

• Programs incorporating best-practices to support adaptive
functioning in the community and prevent individuals with mental
illnesses from inappropriately entering the justice and forensic
mental health systems.

• Mechanisms to quickly identify and appropriately respond to
individuals with mental illnesses who become involved in the justice

• Programs to stabilize these individuals and link them to recovery-
oriented services that respond to their unique needs.

• Financing strategies that redirect cost savings from the forensic
mental health system and establish new Medicaid funding programs.

We strongly urge the Florida Legislature to adopt and implement the
recommendations made for the transformation of the public mental
health system. In doing so, lawmakers will achieve the dual purposes
of addressing needed change and improvements in efficiency of the
mental health system, as well as reducing a costly and unnecessary
burden on all facets of the justice system.

This article was written by six former Florida Supreme Court
justices: Chief Justice Stephen H. Grimes, Chief Justice Major B.
Harding, Justice Joseph W. Hatchett, Chief Justice Leander J. Shaw,
Jr., Chief Justice Ben F. Overton and Chief Justice Parker Lee
McDonald. All are retired. Posted 3/7/08

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