One of the biggest challenges for criminal justice agencies across the U.S. has been a tidal wave of mentally ill defendants who are jailed because of a lack of treatment resources.
A judge in Miami-Dade County, Fla. – which has the country’s highest concentration of mentally ill residents – has revamped the city and county’s approach to the problem, creating a national model and starting a nationwide reform movement in the process.
Judge Steven Leifman has developed “crisis intervention training” for police officers; created a program to divert people with mental illnesses from the criminal justice system to community treatment; and helped direct appropriations to convert an unused jail into a mental health care facility.
Part of the Miami-Dade County plan is to convert 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.
The county hopes to select contractors and start the renovation by April, with an 18-month time frame for completion, says John Dow, president and CEO of the South Florida Behavioral Health Network.
The 801,000-square foot facility will house a variety of inpatient and outpatient programs for mental health and substance abuse treatment services, Dow told The Influence. Its capacity will depend on how much space is devoted to which types of programs.
The county already has a short-term mental health facility to provide treatment to mentally ill defendants, rather than incarcerating them or sending them to a state mental health facility for long-term care, he says.
The Miami Dade County jail serves as the largest psychiatric institution in Florida, containing nearly half as many beds for individuals with mental illnesses as all state civil and forensic mental health treatment facilities combined. On any given day, the jail houses approximately 1,200 individuals receiving psychiatric medications
Leifman, an associate administrative judge for the Eleventh Judicial Circuit Court of Florida, is a leader in Stepping Up, a national initiative by The Council of State Governments (CSG) Justice Center, the American Psychiatric Association Foundation, and the National Association of Counties, to reduce the number of people with mental illnesses in jails.
In 2000, he started the Eleventh Judicial Circuit Criminal Mental Health Project, to divert mentally ill people who might otherwise end up in the criminal justice system into treatment centers.
Before the project started, about 20 percent of the 100,000 people booked each year in the county jails needed intensive psychiatric treatment, according to Leifman. Many of those had committed misdemeanors or non-violent felonies, from drug possession to petty theft to trespassing,
Under the county’s revamped approach, the number of people incarcerated in in Miami-Dade jails dropped from a peak average of about 7,000 in 2008 to about 4,700 in 2014. More than 4,600 police officers have been trained to identify and help those with mental illness. In the process, the county has saved millions by diverting people with mental disorders out of the criminal justice system, the Miami Herald reported.
Nationally, the Stepping Up initiative asks counties to develop an action plan that makes more efficient use of budgets, promotes access to treatment and support services, and encourages research-based and data-driven practices. Stepping Up counties receive technical assistance and other tools
In a little more than two years, more than 400 counties—representing 43 states and 40 percent of the U.S. population—have joined Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails.
An estimated 2 million people who have serious mental illnesses like schizophrenia, bipolar disorder, and major depression, many of whom also have substance abuse problems, are jailed annually. Once incarcerated, people who have mental illnesses tend to stay longer in jail and are at a higher risk of rearrest.