I received word that the U.S. Department of Justice has reached an agreement with Miami Dade County that will end many of the abuses in Miami’s downtown pre-trial detention center chronicled in my book, CRAZY: A Father’s Search Through America’s Mental Health Madness.
As part of the agreement, the county must build a mental health treatment facility for inmates, estimated to cost between $12 million to $16 million, and make other changes in how it treats prisoners who have mental illnesses.
Miami Judge Steven Liefman got me into the jail more than six years ago where I observed prisoners with mental illnesses being held in overcrowded, unsanitary, abusive and dangerous conditions. After my book was published, he got Michele Gillen, an investigative reporter with the local CBS television affiliate, into the jail where she filmed what I had observed. Our joint efforts helped spark the Justice Department probe.
While I am happy that conditions in the jail are going to be improved, I am reticent about the Justice Department’s actions.
For the past four decades, the federal government has been the driving force behind forcing states to close their state mental hospitals. It has done this knowing that neither Congress or state legislators have been willing to adequately fund meaningful community mental health care services. The closing of state hospitals without a community safety net has resulted in a 400 percent increase in the number of persons with serious mental disorders ending up in our jails in prisons. Today, there are more than 360,000 persons with severe mental disorders, such as bipolar disorder and schizophrenia, behind bars. Another million are under court ordered control and all of us have heard how the Los Angeles Jail is the largest public mental facility in America.
The federal government’s continued insistance on closing state hospitals has forced large numbers of severely ill persons onto the streets. Many others are warehoused in substandard nursing homes, inadequate assisted living facilities, or jails and prisons. Now, the Justice Department is forcing jails and prisons, such as Miami Dade County, to improve the services that they offer psychotic inmates. It is trying to correct a problem that it helped create.
Here is a clever idea.
How about federal lawsuits that will provide persons with mental illnesses help without forcing them to get arrested?
The Justice Department needs to begin using it heavy hand in a more productive manner. In addition to requiring jails and prisons to improve conditions, it needs to stop shutting down much-needed state hospital beds until a real safety net can be established in our communities. In order to get meaningful services, it needs to file suits through the Americans with Disabilities Act to force states to create that safety net. We know that Housing First and Assertive Community Treatment can enable many persons with severe mental disorders to live safety in our communities. Shutting down hospitals under the assumption that people can get community help and then not providing that help has proven disasterous.
Fifty years ago, President John F. Kennedy envisioned a society where persons with mental disorders could live with their neighbors rather than being locked up, warehoused and forgotten. If the Justice Department succeeds in building better jails, it will not have accomplished Kennedy’s goal. It will simply have closed down the old state hospital system by shipping everyone through their communities into jails and prisons.
That is not something to celebrate.