Florida Judge Strives to Heal Rather Than Jail the Mentally Ill
Every day, in every community in the United States, law enforcement agencies, courts, and correctional institutions are witness to the impacts of untreated or under-treated mental illnesses that lead to multiple incarcerations at a high cost to taxpayers.
Judge Steven Leifman, a criminal court judge in Miami-Dade County’s 11th Circuit, has made it his mission to treat, rather than punish, the mentally ill. In 2000, he helped create the Criminal Mental Health Project, a groundbreaking program that diverts individuals with serious mental illnesses who don’t pose significant public safety risks away from the criminal justice system and into comprehensive community-based treatment and support services.
According to the National Alliance on Mental Illness, 40% of adults who experience serious mental illnesses will come into contact with the criminal justice system at some point in their lives. Unfortunately, these contacts result in the arrest and incarceration of people with mental illnesses at a rate vastly disproportionate to that of people without mental illnesses.
In Florida alone, it is estimated that 130,000 people with mental illnesses requiring immediate treatment are arrested and booked into local jails annually.
Although these national and statewide statistics are alarming, the problem is even more acute in Miami-Dade County, Florida, which has been described as home to the largest percentage of people with serious mental illnesses of any urban community in the United States. As a result, law enforcement and correctional personnel have increasingly become the lone responders to people in crisis due to untreated mental illnesses.
Individuals unable to access treatment in the community are at increased risk of coming into contact with the criminal justice system; often as the result of low-level, non-violent offenses that are directly related to symptoms of untreated illnesses. Consequently, the county jail has been forced to absorb increasing numbers of individuals in need of intensive psychiatric treatment while incarcerated.
The Miami-Dade County jail currently serves as the largest psychiatric institution in Florida, containing almost as many beds serving inmates with mental illnesses as all state civil and forensic mental health treatment facilities combined. On any given day, the jail houses approximately 2,400 individuals requiring psychiatric treatment while incarcerated. The cost to taxpayers is $180 million annually, or nearly $500,000 per day.
2. What is the Criminal Mental Health Project and why was it created?
The 11th Judicial Circuit Criminal Mental Health Project (CMHP) was established in 2000 to divert individuals with serious mental illnesses, who do not pose significant public safety risks, away from the criminal justice system and into comprehensive community-based treatment and support services.
The CMHP’s success is built on active collaboration among a diverse array of community stakeholders from the criminal justice and public health systems, as well as local government, community advocates, and consumers and family members of people with mental illnesses. To date, more than 6,000 law enforcement officers from all 36 municipalities in the county have received 40-hour CIT training.
Among the nearly 3,500 individuals diverted from the jail post-booking, rates have been reduced by approximately 75 percent and it is estimated the county has saved more than 25,000 jail bed days, more than 68 years. As a result, the average daily jail population declined from 7,200 to 4,000 inmates – a 45 percent decrease – and Miami-Dade County was able to close one jail facility resulting in $12 million in annual savings.
3. Do you know of any other cities in the U.S. that has implemented such a program?
Because of the shared prevalence of people with untreated mental illnesses within the criminal justice system among communities across the United States, there has been increased interest in identifying and developing effective strategies to reduce unnecessary incarceration and improve access to community-based treatment. While Miami-Dade County has been particularly effective in designing and implementing these types of programs, many communities find it challenging, both politically and economically, to make the types of policy changes necessary to implement such programs. Fortunately, there is a growing community of support that is working to provide resources to create sustainable, data-driven approaches within communities.
As part of a nationwide effort to reduce the over-representation of individuals with mental illnesses in jails, Miami-Dade County has actively participated in the planning and implementation of the Stepping–Up Initiative, which was launched in May 2015 by the Council of State Governments Justice Center, the National Association of Counties, and the American Psychiatric Association Foundation. To date, more than 420 counties across the country have passed resolutions or proclamations committing to acting on this issue. Miami-Dade County was selected as one of four launch sites for the nationwide initiative because of the strong progress our community has made on this issue.
On May 16, 2018, Stepping Up is hosting a national Day of Action, during which counties are encouraged to hold an event or participate in local activities to share with constituents the progress they have made toward reducing the number of people who have mental illnesses in their jails, raise public awareness and understanding of this important issue, and emphasize their commitment to creating data-driven, systems-level changes to policy and practice to achieve their Stepping Up goals. For more information, please visit stepuptogether.org.
4. Can you give an example of someone who has successfully navigated your system?
In 2007, Justin Volpe became an all too common statistic. Living in Miami without medication for his diagnosis of schizoaffective disorder, he descended into a haze of hallucinations, paranoia, and substance abuse. As a direct result of symptoms of untreated mental illness, Justin’s thoughts and behaviors eventually lead to his arrest and incarceration in the Miami-Dade County Jail.
Although it was the first and only time in his life he has been arrested, Justin became tangled in the downward spiral of the criminal justice system where he remained languishing for an extended period of time. He was placed on a psychiatric unit in the jail – notoriously known as the Forgotten Floor – which was reserved for individuals with serious mental illnesses. The cells, which were designed for single occupancy, were often crowded with multiple individuals held in unsanitary, cold, and perpetually lit conditions; often for weeks or even months on end.
Fortunately, Justin was identified by staff from the 11th Judicial Circuit Criminal Mental Health Project (CMHP) as a candidate for diversion from the jail into community based treatment and support services. After 6 months of court mandated treatment and monitoring Justin’s illness was stabilized, he was living in a supportive environment in the community, and was beginning to get his life back on track.
After closing out his case, Justin was offered employment through the same program that helped him get into recovery. He has now been an employee of the CMHP for 10 years. He has helped countless people with similar situations get out of jail and reintegrate back into the community with hope and recovery. Drawing on his unique perspective and life experiences, Justin is able to connect with CMHP program participants in a way that other staff members could never do.
5. What is your vision for the future of your community?
While existing diversion programs and community partnerships are producing remarkable results in reducing the unnecessary involvement of people with mental illnesses in the criminal justice system, there remains many individuals whose needs continue to be unmet because adequate treatment and service capacity in the community simply does not exist.
To address this need, Miami-Dade County is currently in the process of creating a first-of-its-kind mental health diversion and treatment facility which will serve as a comprehensive and coordinated system of care for individuals with serious mental illnesses who are frequent and costly recidivists to the criminal justice system, homeless continuum of care, and acute care medical and mental health treatment systems.
The project consists of renovation of a former state forensic treatment facility to house a variety of treatment and support services, operated by community-based organizations, which provide a full continuum of care to assist individuals with behavioral health disorders diverted from the criminal justice system. The building – which encompasses approximately 181,000 square feet of space and has capacity for 208 beds – will include a central receiving center, an integrated crisis stabilization unit and addiction receiving facility, various levels of residential treatment, day treatment and day activity programs, outpatient behavioral health and primary care treatment services, vocational rehabilitation/supportive employment services, and classroom/educational spaces. The facility will also include space for the courts and social service agencies, such as housing providers, legal services, and immigration services that will address the comprehensive needs of individuals served. It is anticipated that construction will begin by June 2018 and last approximately 20 months.
By housing a comprehensive array of services and supports in one location, and providing re-entry assistance upon discharge to the community, it is anticipated that many of the barriers and obstacles to navigating traditional community mental health and social services will be eliminated. The services planned for the facility will address critical treatment needs that have gone unmet in the past and reduce the likelihood of recidivism to the justice system, crisis settings, and homelessness in the future.