Mental health: Involuntary help, Florida Times Union, February 24, 2003

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Florida Times Union

February 24, 2003

EDITORIAL
Mental health: Involuntary help

Florida sheriffs say the police are now the de facto agency for administering the provisions of the Baker Act, Florida's law on mental health patient care.

Years ago, mental health professionals convinced politicians that housing people in mental institutions was like keeping them in jail, and that most should be released. Many were -- and now many of them are in real jails.

The original idea of "de-institutionalizing" was that community-based care would take up the slack. Instead, bureaucrats dragged their feet and people were reluctant to have facilities in their neighborhoods. Thus, thousands of mentally ill people are wandering the streets.

There are facilities but the law does not allow anyone to be provided with care unless he is dangerous, and many pro- fessionals do not want to make that determination, or cannot.

As a result, it is estimated that there are five times as many mental patients on the streets in Florida -- or in jail -- than in mental institutions. In 31 Florida counties, not one mental patient was referred by mental health professionals last year. All got into the system through the criminal justice system.

It often takes an act of violence against someone else for mentally ill people to be swept up by the police and put into treatment. In too many cases, either the police or patient is killed.

This is not how it was meant to be. Revisions of the act are proposed in this year's session of the Florida Legislature.

One proposal is to get judges involved earlier, before violence occurs, so the mental patient can be assigned to treatment in community-based care.

In 41 other states, the law allows judges to consider a petition and order examination and treatment. They also can order the patient to submit to the treatment, which is important. Schizophrenic mass murderer Ted Kaczynski, the Unabomber, would not take medication or admit mental problems.

For the good of the mentally ill and the protection of their potential victims, a way is needed to shift the onus away from the police to those who are trained in mental health care.

However, concerning claims that it will not increase costs, or could even decrease them, skepticism is warranted. Also, there are few teeth in the bill. Civil rights issues, which we don't think are signi- ficant, will be raised. Because it is a difficult issue with unknown costs and the state is in fiscal straits, caution is urged.