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California's Public Safety Realignment Act: Will It Serve as a Model for Community Mental Health?

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I recently visited California. There, I was bombarded with ads for Proposition 47 -- The Safe Neighborhoods and Schools Fund. I must admit being from Florida these ads were extremely thought provoking. According to the Los Angeles Times, "this statewide initiative to reduce penalties for illicit drug use and petty theft is part of a multimillion-dollar campaign to revise sentencing laws in California and across the nation." Further, this initiative would build upon the passage of Proposition 36, which in 2012 revised California's existing three-strike law and limits life sentences to serious or violent felony convictions in support of California's Public Safety Realignment Act.

As a florida judge and as a matter of disclosure, ethically I am not permitted to endorse and or support any legislation or political cause -- I am not. I am, however, taking this opportunity to educate those unfamiliar California's Public Safety Realignment Act and to better understand its background and its direct connection to mental health. To aid this blog, I enlisted a colleague, Lois Davis, Rand senior researcher, criminal justice -- prison reentry who provided context to California's Public Safety Realignment Act and the prison overcrowding mandate.

According to Ms. Davis, I was partially correct. She explained the underlying prison conditions which led to the filing of federal class action of Brown v. Plata in 2001. The Plata case, largely known as a prison overcrowding decision, it was fundamentally based upon a long history of abhorrent constitutional violations pertaining to the failure of the California Department of Corrections and Rehabilitation (CDCR) to provide both minimally adequate medical and mental health treatment to those in state prison.

The federal class action, originally filed in 2001, alleged the CDCR, through its failure to provide adequate minimum medical care, was in violation of the Eighth Amendment, the Americans with Disabilities Act, and section 504 of the Rehabilitation Act of 1973. After a failed stipulated attempt to settle the action through a court ordered receiver, the lower court's ruling to reduce prison population was ultimately appealed and heard by the U.S. Supreme Court.

In a 5-4 decision, the U.S. Supreme Court cited the following evidence:

  • High vacancy rates for medical surgical staff (20 percent) and (54.1 percent) psychiatrists.
  • The state had not budgeted for sufficient medical staff and lacked sufficient space to add additional staff.
  • Shortfalls contributed to extended delays for treating mentally ill prisoners housed in administrative segregation and awaiting scarce treatment beds, which led to conditions of unrest and violence and disciplinary actions.
  • Backlogs exist of up to 700 prisoners waiting to see a doctor for physical care. With overcrowding, particularly acute in receptions centers which processes 140,000 new or returning prisoners a year.
  • Numerous experts testified overcrowding is the primary cause of constitutional violations.
  • The court found there was no realistic possibility that California could build itself out of crisis.

As the pioneering judge of The Broward County Mental Health Court, dedicated to the decriminalization of persons with mental illness from a human rights orientation, I swiftly appreciated the multi-level challenges being addressed by the U.S. Supreme Court. While prison overcrowding was deemed a core problem, the overarching constitutional violations, based upon the Eighth Amendment of Cruel and Unusual Punishment, could not be overcome due to prison overcrowding. As noted by Supreme Court Justice Kennedy, "California could not build itself out of this crisis." The constitutional violations were based upon the failure of California's Department of Corrections and Rehabilitation (CDCR) to provide basic medical care and lack of mental health treatment for those inmates with physical medical problems and those with serious mental illness was upheld. The State would have two years in which to downscale.

The criminalization of persons with mental illness is an abhorrent trend which emerged with the failed policies relating to deinstitutionalization policies of the civil rights movement. This trend will play a major role in California's Public Safety Realignment Act. According to local news reports, many mental health advocates are holding out hope that Proposition 47 will provide desperately needed relief and shift funding to the community to enhance access to community based mental health treatment and programs. According to The Sacramento Bee, Stanford Law School reported that the number of mentally ill people in California prisons doubled from 2000 to 2014. Per the data, 45 percent of prisoners have been treated for mental illness within the past year.

Clearly, there is an urgent need for states and local government to prioritize community-based mental health programs. Recently, I participated in a video to support Henderson Behavioral Health Center of Broward County, Florida. Henderson Behavioral Health Center is Broward's largest and oldest nonprofit community behavioral health center and founding collaborative partner to Broward's Mental Health Court. The video session was in support of the National Council's on Behavioral Health's Connect for Mental Health Initiative. A national media and awareness campaign to prioritize serious mental illness and advocate for community based programs. Henderson's innovative program for Early Intervention after First Episode Psychosis is one of four best practice community models selected by the Connect for Mental Health collaborative.

I have written several blogs on the urgent need to end the unjust trend of the criminalization of persons with mental illness in the U.S. I have also advocated for mainstream research policy centers to include and integrate the criminalization of persons with mental illness into its overall research agenda to reduce mass incarceration. The state of California and its mandate to reduce its prison population and enhance access to community based mental health treatment and services has become a bellwether. The nation's eyes are on California, Texas and all of those states and communities eager to achieve social justice and prioritize mental health in this nation. I look forward to the State of Florida joining the ranks of those states and advocates willing to lead.