Sunday, December 13, 2009

Justice for mentally ill must evolve:

It shouldn't require a hero to fix this.
Judge Steven Leifman certainly qualifies for the appellation, leading (or, more accurately, dragging) Miami-Dade away from ineffective, costly, cruel policies that turned the Miami-Dade County jail into the nation's second-largest mental-health ward (after the Los Angeles County Jail) .

Judge Leifman spoke at a symposium Wednesday morning about considerable progress that Miami-Dade has made these past few years, diverting the mentally ill, many of them serial recidivists, out of the criminal justice system.

Miami Police Lt. Jeff Locke talked about the evolution of police policies toward psychotic behavior. Before 1999, police essentially acted as ``goons'' when they dealt with mentally ill transgressors, he said, ready to answer violence with violence. And sometimes deadly force. ``I was one of those cops.''


Locke now trains local police officers in crisis intervention. Most police agencies in Miami-Dade County now have trained squads dedicated to defusing these confrontations. Judge Leifman talked about results: Half the subjects of police calls involving psychotic episodes are now diverted into treatment programs.

But it never should have come down to cops and jailers and a heroic judge to fix this medieval system. Leifman and Locke and the criminal justice system have been forced to deal with a massive community failure, 40 years in the making. As Florida closed its mental hospitals, most for good reason, the state failed to provide the outreach to keep the mentally ill treated, sheltered and safe.

We left them to their own devices. Until they became a police problem.

Here's what neglect got us: Some 125,000 of our mentally ill will take up space in Florida's jails and prisons this year, most for minor transgressions. Leifman said that on any given day, Florida houses 17,000 mentally ill prisoners in the state correctional system, another 15,000 in local lock-ups. Yet another 40,000 are on community control, and given the paucity of treatment, twice as likely to flunk probation.


Treatment costs behind bars devour budgets. Jails make for massively expensive, utterly ineffective mental hospitals. But for 40 years, Florida has cycled the mentally ill from the streets to jail to the streets to jail. With in-jail treatment mostly consisting of a regime of pills designed to keep them placid, not manage their illness.

Leifman said Wednesday that the fastest growing sub-set of prisoners in the state's corrections system are mentally ill defendants sent to a state institution until they're deemed competent to stand trial. He pointed out that competency training is not about treatment, but only about meeting the legal threshold necessary to try a prisoner. The overwhelming majority (currently occupying about 17,000 beds) finally will be hauled into court, then turned loose, sentenced to time served. And they'll be back.

In the next 10 years, Leifman said, their number will double to 35,000. They'll require 10 new prisons and an annual budget of $3.5 billion in a state that's going broke. ``It's insane,'' the judge said.

Yet a bill to divert these prisoners into community-based managed care, at a fraction of the cost, has languished for two years in the Legislature.

It shouldn't take a hero to fix this.

Posted on Wed, Dec. 09, 2009


No comments: