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Florida Today

July 18, 2003

Reprinted with permission of the authors. All rights reserved.

Advocates seek stricter law to deal with the mentally ill
Reform would protect patient, lawmen, save money

By John A. Torres and Alan Snel

Roberta Hodges' son has trouble taking his medication.

He was diagnosed with paranoid schizophrenia more than 40 years ago. He's had to be forcefully hospitalized several times using Florida's Baker Act, which empowers officials, such as police, doctors and judges, to act in cases where patients pose a danger to themselves or others.

The problem, the 80-year-old Hodges said, is the law only applies for 72 hours, and then the person is released. Now she and others are calling for a tougher law, one that would allow the courts to order the mentally ill to accept outpatient treatment. The proposed change would be modeled after New York State's Kendra law.

Kendra Webdale was killed in January 1999 after being pushed into the path of a New York City subway train by a man with severe mental illness. The man, Andrew Goldstein, had a history of noncompliance with treatment.

"People should be helped if they need it, not just if they are carrying a knife or a gun," Hodges said. "People need to get more educated about mental illness. My son has had troubles ever since he was born."

Ultimately, Hodges and others -- including members of the Legislature -- want a tougher Baker Act, one that goes beyond a 72-hour stay in a hospital. They'd like to see a law that forces mentally ill people to accept medication and treatment for their mental illnesses. It's not just safer for those who are sick but for police called to confront them. They say it will save money, too. Some people in Florida have been "Baker Acted" -- the vernacular used by police -- dozens of times.

New legislation is already in place but despite passing easily through the state House, it did not make the Senate floor calendar because of time constraints. There is hope among advocates it will pass next year.

Hodges has started a letter-writing campaign to gain support for a change to the law during next year's legislative session.

In Brevard County, use of the law is on the rise: 2,937 times in 1999 to 3,651 in 2001, the latest figures available. The Sheriff's Office totals have increased from 605 Baker Act reports including 54 suicide attempts in 2000 to 722 Baker Act reports including 129 suicide attempts in 2001 to 883 Baker Act reports including 137 suicide attempts in 2002.

The median age of those subject to the Baker Act was 37 years with 51 percent being male. The racial breakdown was as follows: 72 percent white, 18 percent black, 8 percent Hispanic.

The increases mirror percentage jumps throughout the state. In 1997, 69,235 Floridians were Baker Acted, a number that jumped to 83,989 in 2000 and 95,990 in 2001.

Baker Act cases have become part of daily life at the Brevard County Sheriff's Office, something law officers say is constantly putting them in danger.

In one case two months ago, Sheriff's Deputy Tyrone Harvey responded to a home in Titusville and found a woman with 50 cuts on her forearms and another 30 in a checkerboard pattern on her stomach.

The woman explained Blanche -- a voice she hears -- advised her to get the bad blood out of her system. That's why she had cut herself.

And just last month, Deputy Tim Shealey showed up at the Mims home of man who said he had argued with his father and planned to get a knife to kill himself.

His explanation? He had watched the movie "A Nightmare on Elm Street" and thought it was "neat." He was also depressed and was not taking his medication because he didn't like the side effects.

In these cases, sheriff's deputies filled out a document called Form 52. They had just used the Baker Act to involuntarily commit three north Brevard County residents.

Right after mental health professionals, law enforcement personnel are the second-largest group of workers who process Baker Act cases statewide. In 2000, 51 percent of the Baker Act initiations were completed by mental health workers, while police handled 44 percent of the cases. Judges processed 4 percent.

"There was a bill sponsored by the Florida Sheriffs Association, that would update the Baker Act to make it comparable to 41 other states regarding court-ordered out patient treatment," said Rosanna Esposito, attorney for the Treatment Advocacy Center, based in Virginia.

Kendra's Law, established in November, 1999, has been a huge success according to a recent three-year study analyzing the findings.

In the first three years of the program in New York, 2,433 people received assisted outpatient treatment orders. Of those treated there was a 77 percent reduction in psychiatric hospitalization; 86 percent reduction in homelessness; 83 percent reduction in arrests; 86 percent reduction in incarceration; 45 percent reduction in harm to self and 44 percent reduction in harm to others.

"Right now in Florida there are only two options: inpatient hospitalization or just release them back into the community," Esposito said. "There's a gap there and this would work to fill this gap. Under the proposed bill a person would be mandated to follow a treatment plan. The person could then reach services that way."

Hodges would like to see something put in place that would force her son to take his medication.

"He doesn't do well in taking his drugs," she said.

One time, Hodges' son got into a pickup truck, with no money, and simply drove to Georgia. He wandered into a church where he was speaking incoherently. Church members contacted his mother, who arranged for his safe return home.

That was not the first time he had the law used for him.

"There have been times when he's been Baker Acted and he didn't speak a word of sense in front of the judge," Hodges said.

The Baker Act is not new. It was enacted by the Florida Legislature in 1971, named after Maxine Baker, a representative from Miami. The law was substantially reformed in 1996.

Rep. David Simmons, R-Altamonte Springs, was the prime sponsor of the bill that passed easily through the House this spring.

"There is a significant gap in the coverage that exists here in the state of Florida," he said. "We unfortunately do not have outpatient treatment for those who need to stay on their medications. What we have found is a recycling of the same individuals through the system."

Indeed, during a two-year period, 111,500 people were Baker-acted 151,201 times. One individual accounted for 43 Baker Act examinations, costing the state more than $81,000 in medical and administrative fees, not including courts or police costs.

"Certainly a person like that could be reached and treated more efficiently," said Esposito.

Advocates for the change in legislation say the bill will actually save the state money. They say that the bill would require no new services, only better utilization of services already in place.

"The belief is that there would be a significant reduction in costs," Simmons said.

"When police show up, their first goal is to stabilize the scene and try and coax the person to seek institutional help," Sheriff's Office Cmdr. Jimmy Donn said. "If that does not appear a likelihood, we fall back on the involuntary commitment to an institution."

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