Monday, April 6, 2009

Early intervention works for mentally ill

OUR OPINION: They belong in treatment facilities, not in jails and prisons
You see them all the time: People who aimlessly wander the streets, obviously homeless and obviously in need of attention for their mental illnesses. Ever wonder what happens to them? Far too many end up in jail or prison, at great and unnecessary expense to taxpayers.

To keep just 1,700 of these people locked up, as Florida currently does, costs $250 million each year. When they are released from prison, as inevitably all of them are, their mental-health conditions have worsened.

There is a better way. Instead of warehousing these people in prisons, the state can diagnose and treat their illnesses. It can use supportive diversion programs in community-based facilities to put them on a path of recovery. This can be done at a fraction of the cost of locking them up.

This is what can be accomplished if state legislators approve HB 7103 and SB 2018. The legislation carries the ponderous title, Community Mental Health & Substance Abuse Treatment & Crime Reduction Act. Yet it represents years of work by a coalition of public and private leaders, including Gov. Charlie Crist, former Florida Chief Supreme Court Chief Judge R. Fred Lewis, Miami-Dade Circuit Court Judge Steve Leifman and others.

A Senate committee considers the bill this week and other committee hearings await before a floor vote is taken. The bills deserve the enthusiastic support of all lawmakers. If it becomes law, the proposal would achieve that legislative rarity of doing a public good while being revenue neutral (meaning it doesn't require new money) at the outset, and save the state hundreds of millions of dollars in the long term.

This would be possible because the state would begin to reverse its extraordinarily wasteful practice of putting mentally ill people who commit crimes in prison instead of treating their illnesses. Florida is not alone in doing this, but it would become the model for other states to emulate.

The law would allow Florida to use community-based mental-health resources to intervene with the mentally ill before they go to jail or prison. This is what typically happens:

A mentally ill person commits a minor offense, say being disorderly. A police officer arrives, and attempts to calm the situation. The person, under emotional duress, is unable to comply, becomes more disruptive and is arrested on a more-serious charge.

This is where the legal insanity begins. Because the mentally ill person is unable to understand the charges, he is sent to a criminal-forensic hospital where, with the help of medications, he is calmed enough to face trial. If convicted, he is sent to prison where there is no treatment for his mental illness. If exonerated, he is released, untreated, and certain to suffer another emotional episode, which starts the process anew.

The proposal would authorize pilot projects in Miami-Dade, Tampa-St. Petersburg, Leon County and the Pensacola area. The programs would use managed-care principles, using appropriate diagnosis and medication, trauma services, drug and alcohol intervention and rehabilitative services such as education and job training. The intervention will give the mentally ill the help they need to everyone's benefit.

No comments: