The number of children taken into protective custody for mental health examinations has surged across the state and Tampa Bay.
According to Department of Children and Families numbers obtained by the Tampa Bay Times, the total of minors evaluated in Florida under the Baker Act increased by 50 percent from fiscal year 2010 to 2015. In Pinellas County, the numbers rose by 41 percent, while more than doubling in Hillsborough.
It's unclear what's behind the increase in exams under the state's Baker Act, a law designed to commit people thought to be mentally ill or a danger to themselves or others to an evaluation. Mental health professionals, law enforcement and school officials say it could be several factors, from more mental health awareness to the use of social media among teenagers, which can lead to cyberbullying.
"While we don't know exactly what's causing it, I like to believe that we're having an opportunity now to intervene maybe earlier," said Doug Leonardo, executive director of BayCare Behavorial Health, which operates several Baker Act intake facilities in Tampa Bay. "It's complicated. There are multiple drivers behind those numbers."
But Pinellas-Pasco Public Defender Bob Dillinger raised concerns about the high volume of Baker Act evaluations among children. Patient records are exempt from public record, so it's unknown if any evaluations are violating the law, he said. Dillinger has contacted legislators in recent years about amending the law to allow his office to contact children and their families.
"There's no oversight whatsoever by the court system," he said.
Here's how the Baker Act works: A person who appears to be mentally ill or wanting to harm themselves or others is evaluated by a law enforcement officer or a licensed mental health professional. If they meet the criteria, they're taken to one of five intake facilities for children in Tampa Bay. Pinellas, Pasco, and Hillsborough have their own centers; Hernando transfers minors outside the county.
Once at the facility, the patient is evaluated by a psychiatrist and can be held up to 72 hours.
Barbara Daire, president of the Suncoast Center, which provides outpatient mental health services, said specialists try to divert minors into alternative treatments to avoid the need for a future Baker Act exam because the procedure can be a "traumatic event for youth and their families."
"They're being removed from their family, put into a strange place that they have never been before, around people that they don't know," Daire said. "It can be very scary for a young person."
After the Baker Act period ends, a patient can be released with referral paper work for additional treatment, or agree to a longer stay. A third scenario: The facility can petition the court to keep them against their will, which prompts a hearing and the appointment of a public defender to the case. But only a few hearings have been held in Pinellas in recent years, said Dillinger.
The University of South Florida's de la Parte Florida Mental Health Institute receives statewide Baker Act data. A report compiled for the Tampa Bay Times includes totals, by county, of initiated Baker Acts in Pinellas, Pasco, Hillsborough and Hernando. The report notes that not all Baker Act exams end in admissions. The numbers also don't account for minors who are Baker Acted multiple times.
Across the area's counties, most evaluations began outside of school, foster care, or juvenile detention centers.
Hillsborough County saw the largest spike, from 1,205 cases in fiscal year starting in 2010 to 2,921 in fiscal year ending in 2015. The report shows that 69 percent of Baker Acts in Hillsborough were initiated at school in fiscal year 2015.
The numbers could be reflecting the emphasis on mental health training available to staff within Hillsborough County schools thanks to several federal grants the district received in recent years, said Dr. Myrna Hogue, supervisor of school social work services. With nearly 215,000 students, Hillsborough's school district is also among the largest in the country.
Students can present symptoms of needing help in several ways, Hogue said, from coming forward to a teacher or making a remark that raises red flags in a homework assignment.
Parents also alert the school their child might be at risk. A suicide hotline recently called the district that a student made suicidal comments in an online chat room. The IT department tracked down what school computer was used and the student received help, Hogue said.
"We're doing a lot of prevention and awareness," she said. "Just because the number is big doesn't mean that we're doing something wrong in Hillsborough County. If anything, it means we're trying to do something right."
The Pinellas School District has also received funding for mental health training. In 2015, nearly 11 percent of Baker Act cases in Pinellas were initiated at a school. Donna Sicilian, executive director of student services, called the Baker Act numbers "concerning."
"How are we as a community kind of supporting them and providing early intervention so that it doesn't get to the point where people feel so desperate that they make these kinds of choices?" she said.
At Gracepoint, one of two Baker Act facilities designated for children in Hillsborough, the center is expanding its crisis unit for minors from 14 beds to 28, said director of children's services Derek McCarron.
Cyberbullying could also be contributing to the increase, he said.
"When we were younger, if you were getting bullied at school, you can always be home and be insulated a little bit," McCarron said, adding that now, in the age of social media, "there's no boundaries."
Pinellas Sheriff Bob Gualteri said the surge could be due to a greater understanding among law enforcement about recognizing mental health symptoms. Crisis intervention training is offered to officers in Tampa Bay each year. The numbers could also be correlating with the decrease in juvenile arrests in Florida, he added.
"There has been a big push for law enforcement to do a better job of identifying behaviors being mental health related and diverting everybody, including kids, out of the justice system and into other places that are appropriate," Gualtieri said.
At PEMHS, a behavioral health nonprofit designated to evaluate children, CEO Jerry Wennlund said admission rates of children who meet Baker Act criteria have steadily increased in the past few years, but declined so far this year.
That decrease may be reflecting the center's priority in offering long-term services to juveniles, he said.
"How can we stabilize them in their living environment, where they are, rather than being Baker Acted?" Wennlund said.
Contact Laura C. Morel at firstname.lastname@example.org. Follow @lauracmorel.