The seven-story building near west Wynwood looks like what it is: an abandoned psychiatric treatment center. The rooms are bare, with worn-out mattress bolted to the colorless concrete floor adjacent to metal toilets. An X-ray scanner sits in an otherwise empty treatment room, surrounded by dirty-white cinder-block walls. The entrance to a cavernous gym is blocked by uprooted wooden floor planks, where two deflated, dust-covered basketballs sit mid-court.
For Steven Leifman, this is a dream come true.
On Sept. 7, the Miami-Dade County Commission will vote whether or not to approve renovations to the building — formerly a facility for inmates who were too unfit to stand trial — to create a first in the country: A standalone treatment center for the mentally ill, especially those who have run afoul of the criminal justice system and would otherwise end up behind bars or on the street.
Leifman, a Miami-Dade county court judge who has spent much of his life working to change state laws for mentally ill inmates, will lead the effort to take the former South Florida Evaluation and Treatment Center and turn it into a state-of-the-art mental health diversion facility. If they meet certain criteria, people can be housed, treated, and taught to manage their illnesses and their lives.
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“I want to treat the people no one wants,” Leifman says. “The most sick and the most recycled through the system.”
For Leifman, a criminal court judge for 21 years, the need was obvious. He saw episodes of psychotic behavior in his courtroom that he said were traumatizing to see, and the numbers reflect his concerns: Miami-Dade has the largest percentage of people with mental illness of any urban area in the U.S., according to the Criminal Mental Health Project, which Leifman established 17 years ago to divert non-violent offenders with serious mental illness away from the criminal justice system and into treatment.
Before the project started, Leifman said of the 100,000 people booked each year in the county jails, 20,000 needed intensive psychiatric treatment. Many of those committed misdemeanors or non-violent felonies — from drug use to petty theft to trespassing, and the current system has only one way to deal with them: Jail.
A study by the University of South Florida showed that over a five-year period in Miami-Dade, from 2009-2014, recidivism had a significant effect on one particular group. It discovered that 97 people were arrested a combined total of 2,200 times, spent 27,000 days in jail and 13,000 days in crisis units, hospitals and emergency rooms.
The majority were classified as homeless and had a past diagnosis of schizophrenia.
“Nowhere in the U.S. does anyone have the capacity to treat that population,” Leifman said. He set out to change that.
In 2000, Leifman started focusing his efforts on what he could do to start reversing the trend. That year, he created the Criminal Mental Health Project. The program eventually inspired Leifman to seek to create the diversion facility.
The county, taking notice of the extreme mental health epidemic plaguing its streets, asked its residents in 2004: Should we spend money to house and treat the mentally ill. Voters agreed and the county put aside $21.1 million to build a diversion facility.
“Leifman is an advocate for mentally ill people and has been the person who has supported the concept of this type of facility since the beginning,” said Jennifer Moon, county budget director.
But it was not to be — at least not right way.
After the money was approved in 2004, Leifman spent the next few years looking for an appropriate building to lease within budget. By 2011, Miami-Dade County Jail’s ninth-floor psychiatric ward came under federal investigation into claims of maltreatment and poor living conditions. The county, under intense scrutiny, was hesitant to move forward with the diversion facility, which kept delaying the project.
Then the County Department of Corrections suggested an alternative to Leifman’s facility: a new jail for inmates with mental illness — not a treatment center.
“That is the exact opposite of what you want to do,” Leifman said. “The stay for inmates in that condition is 4-8 times longer because no one knows what to do with those cases.”
Leifman’s argument: Treating those adults in a jail setting would not help them to become self-sufficient once released.
The old psychiatric facility was locked in a legal battle for years over what entity would renovate and operate the structure — Leifman’s diversion facility or the Department of Corrections. In late 2015, the case was settled and Leifman’s facility won.
The decade-long delay boosted the cost of the renovation by $20 million, Leifman said.
In 2016, he set out to find an additional $20 million to move forward with renovation plans for the 181,000-square-foot building on Northwest Seventh Avenue between 22nd and 23rd streets that the county leases from the state for $1 per year.
In January, Leifman met with Mayor Carlos Gimenez to figure out the money. Gimenez told him that if the facility showed it would save at least $2 million a year over what the county was already spending for jailing and treatment, he would find a way to get the $42.1 million to renovate the building.
“We showed him it could save at least $8 million per year,” Leifman said.
So the county kicked in an additional $12 million and Jackson Memorial Hospital, which serves as the largest psychiatric receiving facility in the county, donated $8 million.
In September, the county commission will vote on whether or not to approve the transfer of $42.1 million to the South Florida Behavioral Health Network, which is the state managing entity and public provider that does the behavioral, mental and substance abuse care for Monroe and Miami-Dade counties. Leifman is the chairperson of the executive committee at the network.
The network would not run the facility, but would use the $42.1 million to hire contractors for construction and would also find providers to manage the in-house treatment programs.
“Because this isn’t a county responsibility, it makes sense for an outsider to develop, operate and manage it,” said Moon about the unusual transfer of county money. “If the contract is approved, funding would become available as soon as the contract is executed.”
If the commission doesn’t approve, Moon said the funding would be reallocated to another public-service project for people with mental illnesses.
Leifman said the mental health diversion facility isn’t based on anything that has been done before and that everyone is looking to see how it turns out. His plans include softening the white walls to a calming color, maybe yellow, and bringing in new furniture that doesn’t represent a jail cell. He wants it to be an overall family-friendly environment.
“You don’t become a judge to be a part of the problem, and up until these changes started happening in Florida, we were enabling it,” Leifman said. “This facility started as a vision, and for the first time I can see the end.”