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Moving toward a better mental health model

At a time when it seems the art of the deal has replaced the art of collaboration and antipathy eclipsed empathy, it was a pleasure to attend the Mental Health Court Seminar organized by 12th Judicial Circuit Court Judge Erika Quartermaine and hosted Tuesday by Vincent Academy, Sarasota’s vocational training center for adults in recovery from serious mental illness.

Quartermaine, who presides over Sarasota’s Mental Health and Comprehensive Treatment courts, brought together 150 of the state’s most committed mental health advocates for the daylong workshop, which highlighted progress toward and continuing challenges to reversing a national culture of criminalizing mental illness that has resulted in skyrocketing prison and homeless populations.

Among the rock stars of Florida’s mental health world who attended was Judge Steven Leifman, credited with turning around Miami-Dade County’s treatment of mentally ill inmates by spearheading a jail diversion project and a soon-to open facility — the first of its kind in the country — that will provide a one-stop shop of services for individuals with acute mental illness.

Evidencing a great sense of humor even as he shared a raft of depressing statistics, Leifman documented how “we’ve made mental illness a crime in this country” and how, by doing so, we are not only being inhumane, but profligate.

According to Leifman, we spend $260 for every person in this country on correctional costs. In Florida prisons, the mentally ill population has increased by more than 150 percent over the past decade. If that rate continues, the state would need to build 10 new prisons over the next 10 years, at a cost of $2.2 billion.

“There’s something wrong with a society that would rather incarcerate people than help them recover,” he said. “If it doesn’t pull at your heartstrings, it should pull at your wallet. With that $2.2 billion we could revamp this entire system and make it healthy.”

Florida is particularly egregious, not only because it trails almost every other state in mental health funding, but because it pours the majority of its dollars into restoring the “competency” of offenders so they can have the legal trial to which they are entitled. Leifman said the state spends 22 percent of its mental health budget to restore competency to less than 3,000 individuals, while more than 150,000 others go without any treatment at all because the community services that could help them aren’t funded.

“It’s kind of like the chicken and the egg,” Leifman said. “One reason we haven’t been able to build a continuum of care is because so much of our money goes to restoring competency. It’s about fixing the community system so they don’t end up in the competency system.”

In recent years, Sarasota has made strides toward doing just that. By establishing an impressive array of “specialty courts” — Mental Health Court, Comprehensive Treatment Court, Drug Court, DUI Court, Veterans Court and TYLA Court (for victims of sexual trafficking) — ill or traumatized offenders are offered a program of supportive services rather than jail time. The Comprehensive Treatment Court — created by Quartermaine based on Leifman’s model — has a 68 percent success rate in its first year of diverting repeat offenders, most of whom have been mentally ill and homeless for decades.

The city and county are at last on the same page in addressing homelessness and, bolstered by private philanthropy, the first new units of affordable housing have been approved by the city. Almost all local law enforcement personnel now receive training in how to deescalate crisis situations. And, according to Chief Justice Charles Williams, bills will reach this year’s legislature that are aimed not at “punishment, but understanding, treatment and justice.”

The foundation has also been laid for a network of community care, said Mark Engelhardt of the University of South Florida Criminal Justice, Mental Health and Substance Abuse Technical Assistance Center who last year led a “mapping” process that identified local resources and brought all local stakeholders to the table together for the first time.

Many in this collaborative of unlikely bedfellows — officials from city and county governments, the judiciary, law enforcement, and corrections; clinical providers and nonprofits, among others — took part in the seminar. So did the members of Vincent Academy, who helped organize the program, introduce speakers and serve a lunch they’d made from scratch in the facility’s commercial kitchen. To see the shared commitment and feel the spirit of determination and hope among this disparate group was, given the tenor of our times, especially heartening.

However, in light of increasing evidence of the role childhood trauma plays in developing mental illness, it was disappointing that members of the juvenile justice and public school systems weren’t also represented. Their inclusion will be critical as Sarasota moves toward a comprehensive mental health model.

“Sarasota is so far ahead,” Quartermaine said. “But we should be. We are an affluent community with a lot of passion. This is exactly what we should be doing.”

There are still missing links. Among them: Standard screenings for trauma and early intervention by schools and pediatricians. Sufficient psychiatrists and immediately available crisis care that isn’t one-size-fits-all. A holistic approach to wellness that integrates the physical with the spiritual and insists health insurance cover both. Legislative reforms that prioritize healing over punishment and technological advances to unify best practices and align agencies.

I’m not a mental health “expert.” Yet, as for so many, mental illness has significantly touched my life. And when I think about my journey with my son’s illness; the stories I’ve heard from others with mental health challenges; or the dozens of interviews I’ve conducted with authorities, I always end up at the same conclusion.

What someone with a mental illness wants is what anyone wants: To feel good about themselves and appreciated by others; to have a place to call home, friends to enjoy and a sense of purpose in life. This isn’t rocket science. In fact, I believe we learned all we need to create an ideal mental health system in kindergarten.

Do unto others as you would have them do unto you.

Original article can be found here.

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