It will take big policy changes, money to fix state mental hospitals, lawmakers say
As a yearlong investigation into Florida’s state mental hospitals by the Tampa Bay Times and Sarasota Herald-Tribune is published, state lawmakers point to two changes that should be made, and neither is simple.
Leaders on the House panel responsible for mental health issues said Tuesday that the keys to improving mental health care and stopping the neglect and abuse chronicled by reporters are comprehensive policy changes in the entire system run by the Department of Children and Families — and more money.
“I think they really bring into focus some of the tragedies that have happened in the system, and you can’t help but be very upset by reading them and seeing the videos, especially. It’s very, very distressing,” said Rep. Gayle Harrell, R-Stuart, chair of the House Children, Families and Seniors Subcommittee. “There are funding issues and appropriations issues that need to be addressed.”
The investigation — "Insane. Invisible. In danger." — shows how violence plagues the state mental hospitals, where $100 million in budget cuts and years of neglect have put patients and staff in danger. Further, reporters found cases where details about patient deaths were sealed by the department, even when employees made mistakes, or delayed calling 911.
But on Tuesday, when John Bryant, DCF assistant secretary for substance abuse and mental health, came to the House Children, Families and Seniors Subcommittee to present about the state’s mental health system, just one lawmaker asked a question about the new reports.
Rep. Kathleen Peters, R-South Pasadena, referred to “the articles” and asked why the state has seen such an increase in the number of people sent to state hospitals after charged with a crime and found mentally incompetent to stand trial or found not guilty because of insanity.
Three-fifths of the state hospitals’ beds are taken by such cases, called “forensic” cases, Bryant said. This leaves just 40 percent for civil commitments.
“I think to a large extent, the increase in forensic clients has a lot to do with the absence of community services where they reside,” Bryant said.
Peters, who is the subcommittee’s vice chair and has visited mental health facilities across the state, sees that as a problem as well.
“Why are we bursting at the seams suddenly with people who are incompetent to stand trial?” Peters said. “What are we doing or not doing on the preventive and interventive side if we could catch something earlier? Just like any other chronic disease, if you do prevention and intervention, we don’t have people in the deep-end services suffering.”
She said the key is to have more people across state and local government thinking about mental illness.
“What we have to do is look at a very comprehensive system,” Peters said. “It can’t be just Corrections, and it can’t be just Juvenile Justice, and it can’t be just Health. It’s got to be (the Agency for Health Care Administration), and it’s got to be Education. It’s got to be all of those.”
But increasing access to preventative mental health services and decreasing stigma against mental illness — both concepts that Peters advocates — are focused on the longer-term. Training local law enforcement to recognize the mentally ill and send people to get treatment rather than taking them to jail in some cases takes time, too.
The Times and Herald-Tribune reporting, however, found pressing problems at the hospitals: Violent patients roaming hallways unaccompanied, suicides and deadly attacks by other patients, and a lack of regulations from the state.
Harrell says she will be pushing for minimum standards in the facilities.
And Peters says the best thing that can be done quickly to help the hospitals is to fix the staffing shortfalls.
“We have to ensure staffing is adequate, but that being said, we have a significant problem with workforce shortages, and I don’t know if everyone truly understands,” she said.
She said there aren’t enough people who want to work in the hospitals, calling it a “crisis” of staffing. New budget items — like more staff or higher pay to encourage existing employees to remain in the state of Florida — are always hard-fought battles.
“We’ve got that salary piece on almost everything we do, quite frankly,” Peters said.