Prior to 1971, the laws in Florida regarding due process and civil rights of persons in mental health facilities – which dated back to 1874 – were in a sorry state of affairs. With signed affidavits by three laymen and the approval of a county judge, you could be committed to a mental health hospital. There was no specific period of commitment before a person’s confinement would be reconsidered by a judge. The standards were so lax that, reportedly, the crony of a local judge would periodically have his wife committed so he could carry on a dalliance with another woman.
All this ended in 1971 due to the work of Florida state representative Maxine Baker, who spearheaded the passage of the Florida Mental Health Act. Referring to the treatment of persons with mental illness before the passage of her bill, Representative Baker stated, “In the name of mental health, we deprive them of their most precious possession – liberty.” The Baker Act, as it would come to be known, prohibited the indiscriminate admission of persons to state institutions or the retention of persons without just cause. The law also prohibited the placement of persons with mental illnesses in jails, unless they had committed criminal acts.
Which sometimes happens. And frankly, the court system is often uncertain and inadequate to deal with these situations. Punishing a criminal act that was committed as the result of mental illness seems pointless at best, and mean-spirited at worst.
A solution that has been implemented in courts across the country, including Sarasota, is called Mental Health Court. The driving force behind the local court was Judge Andrew Owens. In Mental Health Court, a judicially supervised treatment plan is developed jointly by court staff and mental health professionals. Defendants participate in individual and group therapy, administration of psychotropic medication, life skills training, and case management. In a hearing before the judge each week, staff reports on the defendant’s compliance, and the judge decides upon rewards and sanctions.
Opponents say programs like this — sometimes called outpatient commitment or assisted outpatient treatment — infringe on civil liberties of people who have not been involuntarily committed to hospitals. But a new analysis, led by researchers at Duke University and published in The American Journal of Psychiatry, joins a series of studies that suggest the program can be helpful for patients who, while they constitute only a small number of the people with mental illness, are some of the most difficult and expensive to care for.
Of course the case could be made that if the community provided sufficient services the problem wouldn’t require such an intervention. But we’ll take treatment any way we can get it. Said D. J. Jaffe, founder of the Mental Illness Policy Org. in New York, “It doesn’t just commit the patient to accept treatment; it involuntarily commits the mental health system to provide it. The court order applies to both.”
While only a small percentage of those with mental illness end up in the criminal justice system, Mental Health Court provides a humane, cost-effective alternative to incarceration.