For many years the Sheriff’s Office, the Courts, Mental Health Professionals, and advocates for those with mental illnesses in Seminole County have collaborated to produce innovative policies for people with mental illnesses who get caught up in the criminal justice system. On October 18, 2011 the League sponsored a Forum: “Mental Health, the Justice System…and More” to discuss what these “partners” are doing–especially the policies and programs in Seminole County that can keep people out of jail, but in treatment. Brochures and lists of resources in the community were also available.
Moderator for the discussion was Jim Berko, President/CEO of Seminole Behavioral Healthcare. Panelists were Major Dennis Lemma of the Sheriff’s Office; Judge John Woodard, III; Joe Mendoza, Executive Director of NAMI-Greater Orlando; and Dr.Valerie Westhead and Charlotte Giuliani from Seminole Behavioral Healthcare.
Topics covered included the Mental Health Court grant recently received by the County, Assisted Outpatient Treatment, Crisis Intervention Training, the embrace of evidence-based programs and the overwhelming evidence that dollars spent up-front in the community save many times that amount in incarceration costs later on.
The first speaker, Major Dennis Lemma, stated that there has been a change in the paradigm for law enforcement. The aim now is to prevent crime before it occurs, to address problems on an individual basis in order to keep from making arrests. Mental illness is something that often ends in an arrest; the solution is to correct these problems rather than waiting to arrest. Ten per cent of law enforcement encounters are mental illness-related and 20-30 per cent of the prisoners in jail have some sort of mental illness. Baker Acts are more likely than an arrest.
Judge John Woodard, III, the second speaker, said that attitudes are changing, not just in law enforcement, but in the judicial system as well. He pointed out that the courts have dealt with mental illness going back in history—and it has often been punitive rather than rehabilitative. Just recently, sociology and psychology have been added to the tools of the courts. Since the deinstitutionalization of the 1960s, the largest system of mental health facilities has become the county jails. Seminole County recently received a Mental Health Court grant. After a mental health evaluation, the forensic team, led by Dr. Westhead, can ask for special consideration for an individual. An assessment is done by Seminole Behavioral Healthcare and this can lead to diversion programs rather than the person being locked up in jail.
Joe Mendoza, the third speaker, executive director of the National Alliance on Mental Illness, Greater Orlando (NAMIGO) described himself as a “consumer” of mental health services, but he also holds an executive position and has done so most of his life. He said that in a year 26.2 % of all adults in the US are affected by a mental illness, that taking care of a mental illness should be the same as taking care of a physical illness. Support, Education and Advocacy are the key words for NAMIGO. Mental illness not only affects an individual—it affects the individual’s family and friends as well. He said that some people come to NAMIGO through the courts; he would like to have NAMI groups inside the jails, and would like to have a peer to peer class for veterans.
Dr. Valerie Westhead, the fourth speaker, stated that so many people are affected by mental illness—60 million in the US in a twelve month cycle. There are many more people with mental illnesses than with such high-profile diseases as muscular dystrophy. She thinks it would be cost effective for Community Mental Health providers and groups like NAMIGO to work together more. The cost of an inmate in jail is ca $65 a day; cost of an inmate in jail with a mental illness is approximately $100 a day—and it’s more expensive if they go to a state hospital. The Seminole County jail currently has three mental health providers, but there’s only so much that they can do. With $36,000 a lot can be done in the community. Mental illness usually starts in the mid-teens to mid 20s. It stops the trajectory of a person’s life—whether it be high school, college, or career and marriage.
She also discussed Assisted Outpatient Treatment, a community-based program that came into being with the 2005 Baker Act Reform. It costs $14,000 per patient per year if you use community services, versus much more in the cj system.
The last speaker was Charlotte Giuliani, who described her experiences training law enforcement officers in crisis intervention. A program in place for a number of years, the program has been expanded to include others, like code enforcement personnel. Training includes signs and symptoms:
• Co-occurring disorders
• Baker and Marchman Acts
• Suicide assessments
• Children’s issues
• Autism symptoms
A module on elder issues has recently been added.
In Seminole County the stigma of mental illness has been reduced somewhat, and law enforcement has become much more sensitive. On the first day of the week of CIT training, the personnel come in ready to sleep through it, but by Wednesday, they’re on time, ready to find out more. Law enforcement officers’ attitudes toward those with mental illnesses are changed by this training.
Questions
After the speakers finished, the audience peppered the panelists with questions, including ones on trauma-informed treatment, the plight of homeless individuals (according to Joe M., “without stable housing, it all falls apart.”) elder services, and services for children. One audience member stated that Seminole County was “light years ahead of most other counties” in its collaboration on mental health.
