Needs Assessment of the Mentally Ill Involved in the Broward County Criminal Justice System
The NSU research group identified and interviewed key personnel in the judicial and mental health systems in Broward County in order to: (a) identify best practices in providing services for the mentally ill in the criminal justice system, (b) ascertain the needs of individuals with a mental illness involved in the judicial system; (c) identify the needs of the organization and of the mental health and judicial systems towards meeting these best practices; (d) provide recommendations regarding changes to the social services and judicial systems in Broward County; and (e) develop a model for the relationship between the various organizations serving this population in the County. The resultant data was analyzed using an appropriate qualitative methodology in order to identify themes and patterns. In addition, a review of the best practices research literature in this area was conducted and incorporated into a report along with the interview findings and will be provided to the funding agency.
It was apparent that this area was in critical need of study as indicated by a recent Department of Justice report illustrating that over 50% of people in jails and prisons across the nation have been treated for a mental illness and/or substance abuse problem prior to being detained. This represents an increase from approximately 20% of inmates with a mental illness, estimated several years earlier. The incarceration of people with serious mental health needs in Broward County, Florida is not very different from those around the country; although, some studies suggest that Florida’s statistics may even be higher than the national average.
A recent study conducted by the Broward Sheriff’s Office indicates that 18% of the 5,500 inmates currently held in their five facilities are known to have a serious mental illness. They estimate that they serve over 900 mentally ill inmates per day, usually with psychotropic medication, many of whom are discharged and rearrested due to inadequate treatment. Since 2000, when then President William Clinton signed into law the first Federal legislation to establish 100 mental health courts, there has been a spotlight on the plight of the mentally ill in jails, as well as in prisons. Broward County established the first Mental Health Court in the US in 1997 and has become a model for subsequent programs. In 2004, Broward County established one of the first mental health courts for non-violent felons, resulting in over 1,500 people going through this court in the past three and one-half years. Many of these people have been treated in the community with judicial oversight. A mental health task force consisting of members from both the community and the judicial system has been meeting on regular basis for over 14 years.
Despite national efforts to develop strategies for better responding to the needs of the mentally ill, many communities have not been able to stem the flow of the mentally ill into jails that are largely not equipped to deal with their needs. Broward County is no exception. It is imperative in this community to overcome barriers to treating multi-ethnic populations who often have difficulty accessing existing services, due to language barriers and differences in cultural perceptions and norms.
The number of people under the supervision of BSO, at any time, is estimated at 13,500 with approximately 5,500 housed in its jails and 8,000 placed under community control. If 50% of this population were eligible for mental health treatment, this would mean that programs will have to serve 4,000 to 7,000 people. To complicate matters, national studies indicate that approximately 70% of the mentally ill in jails across the country have a co-occurring substance abuse disorder (National GAINS Center, 2002). It is estimated that the population of the mentally ill will continue to increase as the community grows and the mental health services are unable to keep up with their needs. Population projections suggest that there will be an 18% increase in growth (over 350,000 people) in Broward County over the next decade.
BSO reports that they have seen significant growth in the number of psychiatric evaluations, from 464 evaluations per month in 2001 to 614 per month in 2005, representing a 32% increase. Further, the average number of inmates housed in the Mental Health Unit has risen from 194 inmates per month in 2001 to 395 inmates per month in 2005, representing a 104% increase. To meet these needs, it is anticipated that Broward County will have to build another jail. Although there is a debate about the incarceration of people with mental illnesses, the fact remains that for several reasons mentally ill people frequently call jail their home.
The NSU research group has identified various stakeholders who are responsible for providing services to the individuals with mental illness, who are also involved with the judicial system. Furthermore, NSU, an educational institution that receives government funding, works closely with these governmental groups. Obviously, the coordination of all of these institutions and agencies together with the non-governmental organizations is essential to the success of any project undertaken by any one, or a combination of these groups.