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Where holding, helping meet

Unlike jail, at Florida State Hospital, mentally ill inmates get training.

By ALISA ULFERTS
Published January 31, 2007


CHATTAHOOCHEE - Donald grips his pencil so tightly it threatens to snap. He bends over his worksheet, frowns and erases his name. He blows the dust away and prints his name again.

"Is 'court' a place to play basketball or a place where a trial is held?"

At the sound of teacher Anne Thrush's voice, Donald puts down his pencil. He's ready to listen.

Like many school classrooms, Thrush's room has plants, pictures and bulletin boards with scalloped paper edging. There's a globe and a printed list of rules, including "no unnecessary noise" and "don't help other students unless Teacher asks you to."

But unlike most classrooms, Thrush's room at Florida State Hospital isn't filled with young scholars.

The students are jail inmates who are too mentally ill to stand trial on the charges they face.

Her classroom is ground zero in the fight between the Department of Children and Families, which runs the hospital, and judges who say it must make room for dozens of severely mentally ill inmates jailed longer than the 15 days allowed by state law.

DCF Secretary Bob Butterworth, whose predecessor Lucy Hadi was fined $80,000 for not moving inmates quickly enough, is scheduled to testify on the issue today before a Pinellas County circuit judge.

Florida State Hospital, along with the two other state forensic facilities, is at full capacity, according to administrator Diane James. It rarely has a vacancy for more than a few days; almost as soon as one defendant is released back into the criminal justice system, another county jail van pulls up to the intake center with his or her replacement.

Prodded by retired Pinellas County Judge Crockett Farnell, who threatened to jail Hadi for ignoring his orders to find beds for the ill inmates, the Florida Legislature this month budgeted $16.6-million to pay for 373 more beds at facilities across the state to ease the backlog of inmates, which at times has approached 300.

But those beds won't appear overnight. This is rehabilitation, not warehousing, and finding an additional "bed" involves much more than placing another mat in an already crowded pod, as often happens in the jail system.

In many of the state's county jails, mentally ill inmates languish for weeks or months without treatment.

At Florida State Hospital, by contrast, inmates receive intensive therapy and required medications. Staffers teach everything from what a plea bargain is to how to cook eggs once the defendant's time in the criminal justice system is done. There are classes in art and music therapy, physical fitness and independent living. There's unstructured time to socialize, go to the library or watch television. Basic job skills are taught, including how to behave on the job and during the job interview, not to mention how to behave in court.

"We try to look at the whole person," James said.

And that often takes time. While the average stay for inmates who have been declared incompetent to stand trial is three months, others might take years before they are considered well enough to be returned to jail and court. Some may never leave the hospital; the state has the option of dropping the charges if an inmate still isn't competent after five years of treatment.

The cost per person per year can exceed $100,000.

Teaching life skills

There's nothing overtly psychiatric about Florida State Hospital's appearance. There's no fence around the 620 acres of old colonial style buildings and live oak trees draped in Spanish moss, save for the small patch of double razor wire surrounding the Admission and Evaluation Service. That's where new arrivals from the jails come until their threat to themselves and others can be determined.

Many patients have the freedom to move around; until you look closely for employee identification, often it's not immediately obvious which of the people walking across the campus is a patient or staff.

On one recent day, Thrush leads four students, one of whom is deaf and has a sign language interpreter, through the answers to a quiz about the judicial system. When she's done, the patients will use the answers - "oath," "plea," and "bench trial," among others - to fill in a crossword puzzle.

"What does it mean if you decide to plead guilty?" Thrush asks.

Alfreda, who has been at Florida State Hospital three years after her trespassing and battery arrests, raises her hand. Her answer: "You did it."

Thrush tries again: "What options do you have if you plead guilty, working with your lawyer?" She's met with silence. Thrush prods one more time: "What can you, your lawyer and the prosecutor work at?"

This time Alfreda suggests probation.

"Probation, yes. But plea bargain, that's what I'm looking for," Thrush says.

It's not unusual to go over the same material several times before all the students understand, said Thrush, who was a fourth-grade teacher in Gadsden County schools before she was hired at the hospital. "You have to slow it down and put it on their level," she says after class.

With 838 forensic beds, Florida State Hospital has more than half the state's 1,449 beds. Most of the inmates in Pinellas County who are ordered into treatment go to this hospital, which is about 45 minutes northwest of Tallahassee. The other two main state facilities are South Florida Evaluation and Treatment Center in Miami and North Florida Evaluation and Treatment Center in Gainesville.

Beyond teaching enough about courts to give patients a chance at a fair trial, much of what is taught at the hospital involves helping them recognize the opportunities they have once their illness is stabilized - opportunities that go beyond the crimes that landed them in jail, said Wayne Anderson, senior psychologist in the hospital's secure forensic unit.

If they don't teach these life skills, then the odds that patients will return, either as a criminal incompetency case or as a civil commitment case under the state's Baker Act, go up. Staffers at Florida State Hospital say they want to get it right the first time.

"Part of the challenge is to help people understand that they can develop other skills," Anderson said.