Center aims to treat arrestees with mental illness
This could be the year MiamiDade County makes history, opening a center for treating and helping — instead of incarcerating — people with mental illness. It is thought to be the first of its kind in the nation.
But delay upon delay upon delay — so much bureaucracy it’s hard to blame any one thing — mean that the planned Miami Center for Mental Health and Recovery is slated to open some 20 years after it first was promised.
Many of those who will be helped are chronically homeless. Most have been diagnosed with schizophrenia, or bipolar disorder. Many abuse drugs or alcohol. All of them find themselves in and out of jail, at great cost to taxpayers, after being accused of committing non-violent crimes. They’re largely invisible to society, except when they cause problems.
An alternative to jail, the center will be a place judges can send non-violent defendants accused of misdemeanors or low-level felonies instead of locking them up. Police could take potential arrestees there instead of booking them in to the jail.
Offering the gamut of services a person might need to turn their life around, the center represents a starkly more humane approach than the neglectful, abusive treatment federal authorities documented in Miami-Dade jails as recently as 2011.
If it opens this year, the center will be the crowning achievement of Judge Steven Leifman’s career. The 65-year-old Miami-Dade associate administrative judge retires from the county bench next January. Leifman has worked since his earliest days as a judge to reverse what he saw as an illogical, inhumane approach to handling arrestees with mental illness.
It’s a predicament no jurisdiction has solved, and mistakes can be deadly. On any given day in America, jails are filled with suspects with mental illness. Because of their chronic condition, they may not be safely mixed with the general jail population.
And simply cycling them in and out of jail is a waste of public money — and of human lives, Leifman said.
“No one’s getting better. They don’t get better in jail,” Leifman said. “You have a chance to break that horrible cycle. … You have a chance to help people recover.”
Decades of plodding
Some 20 years ago, Miami-Dade voters approved a $2.9 billion “Building Better Communities” bond program for, among many other things, the center that still hasn’t opened. It’s at 2200 NW Seventh Ave. in Miami, a renovation of the building formerly housing a state lockup for restoring mental competency to accused felons awaiting trial.
A county list of projects said the center would free up jail space and provide a more effective way to “house the mentally ill as they await a trial date.”
While progress stalled on the center, the underlying practices championed by Judge Leifman have taken root since then: non-violent suspects with mental illness or substance use disorders can be diverted from jails and connected with support services in the community. A national expert in decriminalizing mental illness, Leifman travels the country sharing “the Miami model.”
But the new, 208-bed center will offer everything under one roof. Clients will get help accessing benefits they qualify for, receive optical, dental, medical and psychiatric care, appear in the facility’s courtroom when necessary, detox from substances, quit smoking, have unfortunate tattoos removed, work with dogs in an on-site kennel, learn culinary job skills and receive help getting permanently stabilized. All in a seven-story, renovated state building near west Wynwood that will serve an estimated 9,000 clients a year.
A 2020 documentary entitled The Definition of Insanity about Leifman and the mental health project, narrated by director/
actor Rob Reiner, premiered at the Miami Film Festival and was aired nationally on PBS.
“It’s a humane, science-based concept,” said retired Circuit Judge Jeri Beth Cohen, president of the board for the Miami Foundation for Mental Health.
A shameful past
Though Miami-Dade is now seen as progressive in diverting some mentally arrestees with mental illness away from jail cells, the county’s past is dark.
A 1984 headline in the Miami Herald blared “Study: Dade fails with insane criminals.”
The story, by legendary cops beat writer Edna Buchanan, led with a mentally sick robber and killer who had “18 arrests, 918 days in jail, 112 court appearances, 20 psychiatric evaluations and 1,033 days of treatment in state hospitals.”
He was, according to the report, “a perfect example of the failure of Dade County’s justice system to deal with incompetent and insane criminals.”
A citizen-led investigation, by activist Renee Turolla, had exposed the failures in a 400-page report that was followed by heavy news coverage.
A Dade grand jury picked up on it, peering into what it described as “the trail of the mentally ill from the street, to the jail, to court, to state hospitals, back to court and then back onto the street, only to retrace these steps again.”
The grand jury in 1985 concluded that with proper care, these arrestees “would have a real chance for success,” and the costs would be lower than repeatedly jailing or hospitalizing them.
Among the recommendations was a residential treatment facility.
Twenty-three years later, in 2008, conditions in Miami-Dade County jails were still so dismal for people with mental illness, the federal Department of Justice launched a three-year investigation.
Jail guards routinely physically abused inmates, the report said. Suicidal inmates were treated with such disregard that they did indeed die in their cells. Detainees were “routinely subject to discipline” for behavior that was symptomatic of their illness.
“[Miami-Dade Corrections and Rehabilitation’s] deliberate indifference to protecting the Jail’s prisoners from harm is a systemic failure,” the report said.
In 2013, the county agreed to a slew of corrective actions, under a federal DOJ consent decree, including a renewed promise to build the mental health facility.
Judge Leifman, who’d been pressing for the facility for years by then, was quoted: “It’s time that we change the way we’ve been dealing with this problem. This is an excellent step in the right direction.”
Last fall, the DOJ announced that Miami-Dade’s jail system is mostly in compliance with the consent decree, and can be removed from federal oversight next year if the reforms are maintained.
Neighboring Broward County, whose jail system also has been subject to consent decree monitoring, is facing similar issues, struggling with how to properly care for inmates with mental illness. On Jan. 29, the president of the national NAACP asked for a federal investigation into a reported 21 deaths in Broward jails since 2021, many of them committing suicide.
‘It’s going to cost’
Initially, there will be no savings, Leifman and Miami-Dade County Mayor Daniella Levine Cava conceded.
To the contrary, there will be startup costs — amounts Leifman, Levine Cava and others said were still in discussion and can’t be revealed.
“We might not be saving money just yet, but we’re saving lives,” the mayor said.
She said the Miami-Dade County Commission will vote in February or March on a budget to operate the center, and on contracts with Jackson Health System and the Advocate Program, which is now slated to operate the facility.
Plans for Thriving Mind South Florida to operate the center collapsed when Thriving Mind withdrew, citing the lack of plans or a budget, CEO Dr. John W. Newcomer said in a written response to the Miami Herald.
Thriving Mind did agree to complete the building’s $51.1 million renovation — paid for by Miami-Dade County and Jackson Health System. A temporary certificate of occupancy was granted Dec. 22, Newcomer said. The building was turned over to the county on Jan. 26.
But when?
Whether the Miami Center for Mental Health and Recovery will open its doors in 2024 is an unsettled question.
A published report in July 2019 quoted Leifman predicting an opening in 18 months. A county report in July 2020 put the project completion at June 2023. In a grant application in 2021, the county said it would be “opening in early 2022.” News coverage last year had it opening in six months.
Levine Cava now predicts an opening “within the year.” Leifman said it would likely be November. CEO Isabel Perez-Moriña of the Advocate Program said it would likely open by year’s end.
One thing is agreed upon, though.
Each client, upon admission to the center, will have his or her feet washed, said Leifman, who borrowed the idea from a program for the homeless in Boston.
The gesture, an act of humanity and, for the foot-washer, humility, will set the tone, Leifman said.
“We want people to know they’re welcome here,” Leifman said. “Many of them have learned helplessness. They’ve given up because the system is so bad. Half of them don’t care if they breathe, anyway. That’s why the feet washing is so important.”
At the labyrinthine mid-rise a bit north of Jackson Memorial Hospital, Leifman led his umpteenth tour on a recent Monday, asking criminal justice and social work faculty from Florida Atlantic University how they might collaborate.
“You have to be persistent,” he said to the group. “Everyone talks about change, but no one wants to do it. It’s hard. It takes time. But trust me, this is well worth it.”