America’s 1st Mental Health Court Turns 20: Time to End Criminalization

The woman sitting handcuffed in the jury box in the courtroom could not have been more than 30 years old - but she looked 20 years older. Beaten down by homelessness, trauma, drug addiction and under-treated bipolar disorder, she appeared haggard and despondent. Yet, when I introduced myself to her (I will call her Sheila) and enthusiastically welcomed her to the court, Sheila sat up and looked at me with eyes wide open. “You are here to help me?” “Yes, (I replied) the entire court team is here to help you secure the treatment and services you need and get you out of jail, if you are interested.” In that moment, Sheila lifted her shackled legs up and plunked them on top of the jury box and cried, “Judge I’m sick – how can they arrest someone for being sick?” This is America” – she wailed in a manner which struck my heart.

After listening to her remarks, which in a traditional courtroom may have been grounds for contempt sanctions, the courtroom was silent. When she was done, Sheila thanked me for listening, then lifted her shackled legs up and gently placed them on the floor. What could I say? I told her she was right. I said, “This is America and people who need access to mental health and drug treatment should be able to get the care they need – before life derails and tragedy strikes.”

Welcome to Broward’s Mental Health Court, which began in June, 1997, as our community’s “leap of faith.” With no money, no governmental grants – and simply the will of a community “to do something” to take a stand against the inappropriate criminalization of people with mental illness and other cognitive disorders. It was the high-profile case of Aaron Wynn and a scathing grand jury report, which led Broward County Public Defender, Howard Finkelstein to his awakening that Broward County needed to do something to end the suffering and perils of incarceration. The Court is a local effort. The decision to create a problem-solving court of dignity was a shared-vision by a community with a thirst for justice. No one, could have anticipated that our stance against criminalization would ultimately collide head-on with Fox Butterfield’s article “Asylum Behind Bars: A Special Report” (published eight months after the launch of Broward’s Court). In that article, Fox Butterfield’s investigation confirmed what individuals and families affected by mental illness already knew. That community treatment and services were not available, (or as in Broward County) virtually impossible to obtain. A national crisis which still sustains, notwithstanding new approaches in person-centered psychiatric rehabilitation and recovery which is leading many people back to school, work, and community to pursue their dreams and personal goals.

In twenty years – I can attest, no one is immune. The criminalization of people with mental illness is an equal opportunity problem. It strikes professionals, and hard-working family members who have fallen on hard times, many never realizing that they perhaps they suffered from depression or some type of mental health condition. There have been many lessons learned over the course of twenty years. The stories of loss, trauma, family erosion, drug addiction and poverty have offered many insights into the resilience of the human spirit and strengthened my belief in recovery. Recovery is real – and the notion that an individual should have to get arrested to gain access to healthcare is not consistent with democratic ideals. The criminalization of people with mental illness can end if America’s policy makers choose to correct the policy failings of the past and reject the discrimination which has left our nation with a costly legacy of shame and immeasurable suffering.

It’s true, Broward’s Mental Health Court, (a human rights strategy) has diverted more than 20,000 people from its jail, launched a new system of justice, was a model for federal legislation in 2000 which seeded new mental health courts and related collaborative problem-solving strategies. Yet, these efforts are not a fix. Americans deserve excellence in community-based mental health care. It is time to change the narrative. We must shift to a public health model of care and invest in integrated community based systems of care which are affordable, accessible, innovative and evidence-based.

It’s the Court’s 20th birthday – the greatest gift of social justice would be to end the criminalization of people with mental health and cognitive disorders in America.

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