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The Orlando Sentinel
January 19, 2003
Copyright 2003 Orlando Sentinel. Reprinted with permission. All rights reserved.
Society struggles mightily with the issue
of mental illness. The idea of forcing medical treatment on anyone seems contrary to
America's commitment to individual freedoms. Yet few object when police instead throw the
mentally ill into jail for acting in bizarre or disruptive ways.
Florida law reflects this reluctance to address the problem realistically. The Baker Act
requires that the mentally ill be a danger to themselves or others before a judge can
order even an evaluation. Early intervention isn't possible without the person's
cooperation, but nearly half the severely mentally ill don't grasp their need for medical
care. Simply put, their illness tells them they're not ill. Reform is needed. People are
landing in jail, over and over again, because they will not voluntarily take their
medication. They act out in ways that involve police, yet don't meet the Baker Act's
strict standards. Some end up dead in violent episodes that could have been prevented with
earlier intervention.
When the Baker Act does apply, it increasingly is law-enforcement officers -- not
mental-health professionals -- presenting cases to the court. That's unacceptable.
The Florida Sheriff's Association proposes a modest reform aimed at the population that
costs the criminal-justice system the most -- those with serious mental illness who have
been repeatedly arrested or subject to the Baker Act. The measure deserves approval in the
upcoming legislative session.
The target group is small -- made up of fewer than 10,000 people statewide. But its size
is deceptive. This troublesome minority is all too familiar to police and accounts for
one-third of adult Baker Act cases each year. Some of them are homeless.
The proposal would allow early intervention for this group. A judge could order a severely
disturbed person to be evaluated or to follow a course of outpatient treatment if the
person has one documented episode of violent behavior or two episodes of dangerous
behavior within the previous 36 months. Similar measures have worked well in 41 other
states.
The sheriffs show political savvy in not seeking additional funding to implement the law
in this financially austere year. They argue, convincingly, that the measure could end up
saving money in the criminal justice system. In addition, the measure doesn't require that
additional services be provided. Judges would not be able to order treatment if services
in an area were inadequate or unavailable.
The lack of sufficient mental-health services in Florida shouldn't hold up this
legislation. But the state would need to ensure that patients are not ordered into less
effective treatment simply because it is cheaper or all that's available. It does little
or no good to give them inappropriate treatment.
The sheriffs' measure is not a cure-all for Florida's mentally ill, but it is a humane and
cost-effective first step.
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