Mental Health Implementation: In Pursuit of a Central Receiving Facility
Mental health treatment in the United States has been provided primarily at the community level since a “deinstitutionalization” movement was initiated in the 1960’s. The idea was to move away from committing people with severe mental illnesses to the often barbaric conditions they faced in psychiatric hospitals, state hospitals, and what once were called “insane asylums.” Institutionalization was supposed to be replaced by comprehensive community-based services that would provide a more humane approach.
However only about half of the anticipated number of Community Mental Health Centers were ever constructed, and they were never fully funded. Assuming these Centers would spring up across the country, many state governments responded by eliminating the state mental hospitals that had for generations provided the primary treatment facilities for thousands of individuals with severe mental illnesses. An unintended result of deinstitutionalization was that many people with mental illnesses ended up homeless, or in and out of jails and prisons which are ill equipped to provide the comprehensive mental health services required.
As Judge Steve Leifman (11th Judicial District Court in Miami-Dade County) pointed out at the recent Florida Mental Health Summit in Jacksonville, the U.S. has 5% of the world’s population, but a shocking 25% of its inmates.
This is not because we have a disproportionate share of criminals compared to the rest of the world, but because we have failed to address the underlying issues of mental illness and substance abuse that impact a large percentage of inmates. An alarming 65% of all inmates in jails and prisons have diagnosable mental illnesses, and on any given day, over 500,000 individuals with mental illnesses are incarcerated.
With a critical shortage of mental health providers and services, our jails and prisons have thus become the defacto “treatment centers” for thousands of individuals living with severe and persistent mental illness who have no other options. Highlighting this point is the fact that people with mental illness are 14 times more likely to be incarcerated than hospitalized.
“A jail is not a therapeutic community,” said former Jacksonville Sheriff John Rutherford. “It’s never going to be, and it can’t be. Our priority needs to be diverting people with mental illnesses away from the criminal justice system.”
To that end, JCCI’s Mental Health Implementation Task Force has been focused for over a year on finding effective ways to decriminalize mental illness. The group has been working closely with the Criminal Justice Mental Health Collaborative, a wide-ranging group of concerned Jacksonville stakeholders, on development of a plan for a Central Receiving Facility in the city, designed to channel those with mental illness into treatment facilities, keep them out of jail and hospital emergency rooms, and save taxpayers millions of dollars. Orange County (Orlando) has a model Central Receiving Facility that is estimated to have saved taxpayers and hospitals $50 million since 2003.
The concept is gaining significant momentum in Jacksonville, and it is hoped that an important first step in decriminalizing mental illness will soon be realized with a Central Receiving Facility of our very own.
