TREAT MENTAL ILLNESS OUTSIDE PRISON

Annually, as many as 125,000 people with mental illness requiring
immediate treatment are arrested and booked into Florida jails. And on
any given day, more than 70,000 individuals with serious mental
illness reside in Florida's jails and prisons, or are under
correctional supervision in the community.

Frequently, these individuals enter the justice system as the result
of committing relatively minor offenses that are directlyrelated to
symptoms of acute, untreated mental illness.

Unfortunately, many of these individuals find that they are either
deniedcommunity-based care, or that the care they do receive is
fragmented and insufficient to adequately respond to their level of
need. Disabled and vulnerable, they recycle through the system,
creating a revolving door of criminal and legal involvement.

Measures have been taken in the past to reform this unsystematic
approach to Florida's mental health system, but to no avail. The
movement from institutional treatment to community-based treatment was
neverfully executed or funded, resulting in decades of fragmented
mental health care. The existing community mental health system leaves
enormous gaps in treatment and access, and is not designed to serve
the needs of individuals who experience the most chronic and severe
forms of mental illness.

Some of us have served on trial courts across the state and have
witnessed firsthand the problems that are created when courts are
forced to deal with mental health issues. Without propertreatment,
these individuals appear and reappear in court.

But all of us know that the problems with the current system weigh
heavily on law enforcement and the criminal justice system - courts
see increasingly high numbers of cases, and jails are continually
overcrowded.

Based on recent trends, Florida can expect the number of prison
inmates with mental illness to nearly double in the next nine years to
more than 32,000 individuals, with an average annual increase of
roughly 1,700 individuals per year. To keep up with such demand, the
state would need to open at least one new prison every year.

The state of Florida spends roughly a quarter of a billion dollars
annually to treat roughly 1,700 individuals under forensic commitment,
most of whom are receiving services to restore competency so that they
can stand trial on criminal charges and, in many cases, be sentenced
to serve time in state prison. Without a change to the system, the
state faces potential forensic expenditures of a half billion dollars
annually on by the year 2015.

But there is hope. A comprehensive plan was recently unveiled under
the joint leadership of all three government branches, and with
sponsorship from Chief Justice R. Fred Lewis and Gov. Charlie Crist.
The initial six-year plan would effectively respond to the needs of
individuals with mental illness by reorganizing services and service
delivery to reduce demand for costly and inefficient levels of care,
while reinvesting the savings in more efficient prevention and
community-based treatment services.

For the first time in decades, a solution is at hand: an
infrastructure for more comprehensive community-based treatment for
individuals and families, an opportunity for recovery, increased
public safety and savings of critical tax dollars.

Reform of our mental health system is crucial to ensuring humane
treatment of all the citizens of Florida. Our jails and prisons should
no longer be asylums.

Under this redesigned system of care, there will be:

Programs incorporating best practices to support adaptive functioning
in the community and prevent individuals with mental illness from
inappropriately entering the justice and forensic mental health systems.

Mechanisms to quickly identify and appropriately respond to
individuals with mental illness who do become inappropriately involved
in the justice system.

Programs to stabilize these individuals and link them to
recovery-oriented, community-based services that are responsive to
their unique needs.

Financing strategies that redirect cost savings from the forensic
mental health system and establish new Medicaid-funding programs.

We strongly urge the Florida Legislature to adopt and implement the
recommendations made for the transformation of the public mental
health system. In doing so, lawmakers will achieve the dual purposes
of addressing needed change and improvements in efficiency of the
mental health system, as well as reducing a costly and unnecessary
burden on all facets of the justice system.

The writers are retired justices of the Florida Supreme Court: Chief
Justice Stephen H. Grimes, Chief Justice Major B. Harding, Justice
Joseph W. Hatchett, Chief Justice Leander J. Shaw Jr., Chief Justice Ben
F. Overton, Chief Justice Parker Lee McDonald.