A few years ago, the Hillsborough County system that helps mentally ill people in crisis was so overloaded, some patients had to be strapped to gurneys in area emergency rooms until psychiatric care beds became available.
At times, people detained against their will remained tied down for days.
After much lobbying about an intolerable situation, mental health professionals got more money and built more beds.
But now the system is overloaded again and dangerously close to shutting down. The county has grown, the economy soured and more people than ever need crisis services.
For some mental health workers, it's a bad case of deja vu.
"We will get near the point, if we don't get more resources, where we were several years ago with people strapped to gurneys for several days," said Ray Himebaugh, director of the agency that handles Baker Act cases.
The difference this time is the existence of a coordinated effort by mental health agencies and hospitals to manage the growing number of patients.
The Baker Act spells out how mentally ill people in danger of harming themselves or others are to be handled. In Hillsborough County, the system is coordinated by Mental Health Care Inc., a private, non-profit agency.
Many of those subject to the Baker Act are dangerous and violent, Himebaugh said.
"Remember Billy Ferry?," he said. "That's what dangerous could mean." Ferry is the man who walked into a Winn-Dixie grocery store in 1983, splashed gasoline across a counter and lit a match. Five people died in the fire.
When the system works, people deemed mentally ill and dangerous are picked up by police or social workers and brought to hospital emergency rooms or Mental Health Care's intake facility. They are evaluated and held for up to 72 hours.
About 6,000 people are committed each year in Hillsborough County. The county paid $2.1-million last year in matching funds for the Baker Act program. The Department of Health and Rehabilitative Services finances the balance of Mental Health Care's $8-million budget.
Unfortunately, the system often doesn't work well.
"Officers drive around with these people in their cars for two or three hours until they can beg and plead with someone to take them," said Tampa Police Department spokesman Steve Cole.
Mental Health Care has 91 beds for adults and juveniles. For the past year, the agency has had more patients than its license allows about 50 percent of the time, Himebaugh said.
A particularly busy weekend in February put the system in "condition red," meaning Mental Health Care could not legally accept any more patients.
When that happens, Himebaugh said he has two options: find other beds or break the law.
"We continued putting them to bed in cots or on the floor," he said. "I just had people stacked on top of each other. It becomes uncomfortable. It makes quality care a real issue."
At area emergency rooms, indigent patients with nowhere to go were put in private beds to ease the backlog.
"I don't know if we need more beds in this area, but at times like those it certainly seems we do," said Lynn Erickson, administrative director of St. Joseph's Hospital.
The state has already spent all the money allotted for Baker Act programs in Hillsborough County for the fiscal year. So the county plans to ask the governor for extra money to alleviate the crowding, said county budget analyst Vince Ferlita.
"We're asking the governor to intercede for District 6," Ferlita said.
In the meantime, Himebaugh said he will continue to make do.
"We met the crisis, but we haven't done anything about the resources we need."