Editorials

Mentally ill getting treatment, not jail

Miami Herald Editorial Board

Judge Steve Leifman, speaking with an attorney in his courtroom, created the Criminal Mental Health Program. The New England Journal of Medicine has held it up as a model for other large cities struggling with the revolving door of mentally ill people.
Judge Steve Leifman, speaking with an attorney in his courtroom, created the Criminal Mental Health Program. The New England Journal of Medicine has held it up as a model for other large cities struggling with the revolving door of mentally ill people. cjuste@miamiherald.com

The editorial headlines tell the story:

In 2004: Too many mentally ill in Miami-Dade [police] gun sights; in 2005: The revolving jail door; in 2007: Jail is no place for the mentally ill; in 2009: Early intervention works for mentally ill; in 2014: End this inhumanity: Give culpable corrections officers prison time; give mentally ill inmates treatment; also in 2014: Break the cycle: County Commission should give mental-health diversion center final approval; in 2015: Help for mentally ill Floridians: Lawmakers have passed beneficial legislation, but funding is needed, too.

And, finally, in March, Better way to treat the mentally ill, addicts, was the headline on a laudatory editorial that praised the state Legislature for seeing the light.

The strongest link, the most persistent voice — and now one that can claim a measure of victory — that ties together all these editorial opinions is Miami-Dade County Judge Steven Leifman. In his years on the bench he has evolved into a national expert in the treatment — and, at great cost, the mistreatment — of mentally ill people who get swept into the criminal justice system, often for frightening or dangerous behavior that has left families or law enforcement with few other choices. And jail is absolutely the wrong place for many of the nonviolent offenders, exacerbating their condition — bipolar disorder or schizophrenia, perhaps — rather than addressing it appropriately, humanely and with the goal of rehabilitation.

In his May 22 story, Herald writer Daniel Chang highlights Judge Leifman’s hard-won success in bringing some sanity to how Miami-Dade County — Ground Zero as the urban community with the nation’s largest ratio of people living with serious mental illness — handles affected suspects.

The story outlines the stunning costs, not just to the mentally ill, but to local residents whose taxes have been supporting a deeply flawed and ineffective system for too long.

“We were spending $218,000 a day, which is about $80 million a year to warehouse people in these really sub-par conditions,” Judge Leifman told the Herald.

In 2000, Judge Leifman, along with law enforcement, mental health providers and community leaders, launched the Criminal Mental Health Project, which diverts people with mental disorders from the criminal justice system and into treatment. It’s working: In 2008, there were, on average, 7,000 in county jails; in 2014, there were fewer than 5,000.

This year, state lawmakers, with the Miami-Dade delegation admirably in the lead, finally caught on and made what already was a national model, the statewide approach.

But after all these years, this juncture still represents the beginning, not the end. The most urgent need now, Judge Leifman told the Editorial Board, is to get the Mental Health Diversion Facility up and running. There’s $22 million set aside from a general obligation bond. However, various delays have held up construction for at least four years and, unfortunately, the bond money is now insufficient. According to Jennifer Moon, director of Miami-Dade’s Office of Management and Budget, the county, commendably, is just as committed as the judge to finding the additional funds needed for what would be a “one-stop shop” for mentally ill people cycling through the courts or brought in by police. Good.

Under one roof will be a courtroom, crisis stabilization unit, short-term residential facility, primary-care clinic to address psychological as well as physical issues; culinary employment program; and housing for some for up to a year.

“Instead of just adjudicating the most acutely ill and kicking them back to the street, we can slowly integrate them back to the community with support to stay in recovery,” Judge Leifman told the Board.

This will save Jackson Memorial Hospital, the county’s public facility, millions. This will save the county millions more in “jail avoidance” costs.

Finding the funds will be another big step toward ending the ineffective and expensive cycle of mistreatment of the mentally ill.

It can’t happen soon enough.

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