Cooperation and Communication Often Are Missing In Mental Health!



1-8-2015  From My Files Friday:  More than four years ago, I wrote about how a lack of communication frequently prevents persons with mental disorders from getting meaningful help. Unfortunately, this continues to be a major problem in many communities. In a recent conversation, Judge Steven Leifman, who is featured in my book, CRAZY: A Father’s Search Through America’s Mental Health Madness, told me there are more than four dozen different mental health providers in Miami/Dade County and everyone one of them has a different way of handling patients. There is no sharing of information so a client may be diagnosed by one provider and given a prescription and then go across town to another, get a different diagnosis and a different prescription.

In this earlier blog post, I describe how Judge Leifman has been trying to bring order out of chaos.


During my travels, I’ve visited many communities where there is little or no communication. The police don’t talk to local providers who take care of persons with mental disorders and substance abuse issues. These providers don’t talk to each other. Because of HIPAA, no one wants to talk to parents. Oftentimes, patients and their advocates are not properly informed or asked their opinions.

In Miami, it took my good friend, Judge Steven Leifman, to use his office to force “stakeholders”to the table and once that happened, Miami was able to make progress in improving its mental health services. With help from other reform minded judges and members of law enforcement, Leifman spearheaded the creation of an umbrella group called Florida Partners in Crisis. Its members include private health care providers, criminal justice officials, consumer groups, various local and state officials and advocates such as the National Alliance on Mental Illness and Mental Health America.

By meeting together to discuss their individual services and problems, these different factions have been able to get an overall picture of what is happening in Florida instead of seeing only their small piece of the puzzle.

This cooperation is extremely important. Why? Because we have to understand that helping persons with serious mental disorders involves much more than simply issuing a diagnosis and sticking a pill into a person’s mouth.

We need to understand that you can’t talk about mental health reform without talking about affordable and safe housing.

You can’t talk about mental health reform without talking about creating job opportunities.

You can’t talk about mental health reform without talking about transportation.

You can’t talk about it unless you talk about veterans and their special needs.

You can’t talk about mental health reform without talking about access to affordable medication and evidence based treatment programs.

And you can’t talk about mental health reform without talking about getting people, who have brain disorders, out of our jails and prisons where they don’t belong and back in society where they can live meaningful lives.

In 2007, Florida Partners in Crisis helped push a grant through the state legislature that provided funding in 23 counties for programs that create alternatives to jails and prisons. How were those funds used?

*To create jail diversion programs that diverted persons who were clearly sick from incarceration into treatment programs.

*To create mental health courts where judges could send persons into treatment programs rather than having them get trapped in our prison system.

*To create re-entry programs that helped plug persons with mental disorders already in jails into housing and treatment programs after they were released rather than simply dumping them at night in a city park with no money, no help, and no hope.

In 2009, Florida Partners in Crisis created the Judicial Education Project, to develop educational materials for judges, court personnel, and private attorneys to educate them about mental disorders and how best to help get someone into treatment rather than prison. The project is creating a handbook for judges to use so that the state can begin having a standardized procedure when it comes to how judges treat persons with mental disorders or substance abuse problems.

Programs such as jail diversion, mental health courts, and re-entry programs not only are more humane, they also have been shown to reduce costs to taxpayers over time.

We know that persons with mental disorders and substance abuse problems cost taxpayers huge amounts of money. (Remember Million Dollar Murray? in The New Yorker?) Did you know that 5% of the persons with mental illnesses used 50 percent of services?

Having the different social service agencies that come into contact with someone such as Murray share their ideas about how to help him would seem to be simple common sense.

Yet programs such as Florida Partners in Crisis remain rare.

When I mentioned this to my friend, Judge Leifman, he told me that I shouldn’t be so pessimistic. There is going to be more communication, cooperation, and collaboration, he assured me. Not only because it makes sense, but because it will save communities money.

And during a recession, who can argue with that?

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.