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Changing the law under which mentally ill people are involuntarily hospitalized to allow court-ordered treatment could have a dramatic impact.
© St. Petersburg Times
published November 26, 2002
When the needs of the mentally ill go unmet, the person dealing with the consequences too often is a police officer. Florida law enforcement officials handle more Baker Act commitments each day (100) than burglary arrests (71). And with many officers lacking sufficient training in crisis intervention, the results can lead to injury or death.
Such a tragedy in 1998 turned Seminole County Sheriff Donald F. Eslinger into an advocate for change. A Seminole deputy, Gene Gregory, was shot to death by Alan Singletary, a schizophrenic man who had a history of troubled behavior but whose family had been unable to get him the help he needed. Singletary himself was killed after a 13-hour standoff.
Eslinger took the issue to the Florida Sheriffs Association, which has come up with a reform of the Baker Act, the law under which mentally ill people are involuntarily hospitalized. It will be presented to the Legislature at its next session.
The proposed law would allow a judge to order certain subjects of a Baker Act hearing to seek treatment and to take medicine prescribed for their illness. Because the person would remain free and violation of the order would carry no consequences under criminal law, the change might not seem significant. But mental health professionals say it would have a dramatic impact on the most difficult cases.
Under the Baker Act's current provisions, a mentally ill person cannot be held for more than three days. Usually, that means the person is back on the street before medication can improve his condition. One of the symptoms of both schizophrenia and manic-depressive disease is that patients fail to understand the need for continued medication. Some of those people end up in court repeatedly as they descend into a self-destructive cycle that is difficult to break.
The proposed law would give them a chance at recovery. Those eligible for court-ordered threatment would have had two or more "acute episodes of mental illness" within 36 months, or one episode that resulted in violence. In other words, they would be individuals who have refused to seek treatment in the past and whose behavior could put them and the public at risk.
That would be about 7,500 mentally ill people a year, a number that is deceptively small. They account for one-third of adult Baker Act cases each year, and are the most troublesome for police. Anyone under such a court order could still refuse treatment, and a judge would have little recourse other than to repeat the Baker Act process. Yet similar laws have been effective in 41 states. "Research shows that most will stay on a treatment plan when a judge says you must," said Larry W. Bacon, Eslinger's spokesman on the issue.
The sheriffs are not asking for any additional money to be appropriated with the new law. That's a tactical decision. Last year, a version of the bill was prematurely filed and failed to gain support from the state Department of Children and Families because of its cost. Bacon said the measure could actually save money in the courts and free up law enforcement personnel, but it will not be used in counties that lack mental health services.
Still, it makes sense to reform the law now. It would give judges one more option in dealing with repeat Baker Act cases, and if the process works, there will be even more motivation for lawmakers to expand mental health services.
A recent study in a state with such a law found that people with a history of mental illness and a police record have a 74-percent reduced risk of arrest when they stick to a long-term care plan. That means fewer chances for harm, and it is reason enough for the Legislature to act.