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A Times Editorial

Small sum, vital need

Acomprehensive plan to begin sensibly addressing the growing problem of mentally ill people in the criminal justice system needs just a small appropriation of $8-million to get going. But it seems to be facing some legislative resistance in this year of no new money for anything. In truth, the state can't afford not to sign on.

Florida spends huge sums — $250-million annually — to fund about 1,700 forensic hospital beds that are used to treat mentally ill inmates awaiting trial. These are people who were generally arrested for low- and mid-level crimes resulting from their mental illness. After being determined incompetent to stand trial, they are sent to a forensic hospital until deemed mentally healthy enough to participate in their own defense.

The cost of this care is borne entirely by the state, and the numbers are escalating. Over the next nine years it is estimated that the number of mentally ill inmates will nearly double. By 2015, Florida will likely be shelling out $500-million a year to treat this population. It is a tragic waste of money because we know that after an acutely mentally ill inmate leaves the criminal justice system he or she is highly likely to reoffend, since no social services follow.

Bob Butterworth, secretary of Florida's Department of Children and Families, says these are the worst public dollars he has spent in his more than four decades of public service, because they are so wasteful.

But there is another way. In a commendable showing of cooperation, a bipartisan task force of stakeholders from all branches of state government and beyond has studied the problem under the direction of Florida Supreme Court Chief Justice Fred Lewis. Judge Steve Leifman, associate administrative judge of the Miami-Dade County Court, was appointed to manage the project. The resulting 170-page report, issued last fall, provides a sensible road map for the way forward.

Florida needs to move mental health resources from the back end to the front. Our state ranks nearly last in spending for community-based services. These are the kinds of interventions and services that keep the mentally ill out of the criminal justice system and allow them a modicum of a normal life, things like case managers, housing assistance, medication therapies, behavioral therapies and drug treatment.

These services cost far less than state mental hospital beds. Much of the cost of moving to front-end services would be picked up by an innovative use of Medicaid dollars — dollars that can't be used in jails, prisons or at state forensic hospitals. That means the federal government would be picking up a large portion of a bill that used to be the state's alone.

The Legislature is being asked to put up $8-million for a pilot program in two or three of the state's judicial circuits where forensic hospital use is high. Inmates who land in these hospital beds would, after their release from the criminal justice system, be given the means to address their disorders across systems of care in community-based settings. The goal is to turn recidivists who cycle regularly through jails into functioning and productive citizens.

This is a relative pittance of money for a project that is vitally needed. Florida can't afford its current system of dumping the mentally ill on our overstressed criminal justice system. This is a money-saving measure with the happy side effect of actually addressing a societal problem. We have no reasonable alternative. It's a matter of paying a little up front or a lot more later.

Small sum, vital need 03/26/08 [Last modified: Thursday, March 27, 2008 3:19pm]
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