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Mom: The ill need help, not jail

Her son spent time in juvenile facilities before being diagnosed as bipolar. A mental health court could help, say local judges who want an alternative to jail.


© St. Petersburg Times,
published July 1, 2001

INVERNESS -- Leslie McAvoy believes jail was her son's salvation, but only after a long period of sheer nightmare.

McAvoy's son, Adam, has bipolar disorder, but he wasn't diagnosed until after he had already spent most of his teenage years in juvenile detention facilities.

He was arrested several times for hitting other children at his school. While most people thought he was just a wild kid, Adam really had no control over his rage, McAvoy said.

Three years ago, a doctor at the jail recognized Adam's problems and recommended he be placed in a program for mentally ill patients.

Today, Adam takes three different medications and visits three therapists. His disorder is almost completely under control, McAvoy said. But she'd like to spare other parents the years of confusion and uncertainty that she endured.

"We just got lucky," she said. "It scares me to think that other people might not get lucky."

McAvoy, a local representative for the National Alliance for the Mentally Ill, supports the creation of a mental health court in Citrus County, an idea that is being explored by two local judges and Mindy Phelps, director of the Marion-Citrus Mental Health Center.

Phelps said a mental health court would be very similar to the county's drug court. Non-violent offenders who are identified as mentally ill would be referred to the program as an alternative to jail. They would be linked with a case manager, who would ensure the defendant was receiving the proper treatment and medication.

If the rules are broken, the defendant could end up in jail, Phelps said.

"It's sort of a conditional release," she said.

But the county is still a long way from implementing such a program. Funding would be a major issue: Phelps estimates it would take at least $50,000 a year to run a mental health court.

"There's a lot of things that will need to be worked out before a court like this is going to be started here," she said.

The effectiveness of mental health courts is a topic that is hotly debated within the mental health community. Advocates say it's an effective way to get treatment to those who need it. But critics charge that the courts encourage the arrest of the mentally ill rather than seeking out less-traumatic forms of intervention.

One of the first mental health courts in the country was started in 1996 in Broward County. Judge Ginger Lerner-Wren, who presides over the court, said it was started in response to a growing number of incidents involving mentally ill inmates in the county jail.

Under the system, case managers pull together everything necessary to help the defendant, including therapy, job training and housing, Lerner-Wren said.

"We've created a very safe haven for them, where they feel validated," she said. "We understand that people aren't their symptoms."

There is no set program and the amount of time a defendant spends in Broward County mental health court varies from person to person.

The court still struggles for funding every year, but Lerner-Wren said she believes it has been overwhelmingly successful.

"Most of these people would end up languishing in jail," she said. "And if they did go out, they would likely commit another crime and end up right where they started. . . . At least it's some kind of response. It's not intended to provide all the solutions for our country's public health crisis."

But Tammy Seltzer, a staff attorney for the Bazelon Center for Mental Health Law, said too many communities are using these courts as a crutch when more effective options are available.

First, in order for a patient to receive treatment, he or she must be arrested. "That's a pretty perverse way to provide help," Seltzer said.

And after patients have the arrest on their records, it can make it more difficult for them to receive some of the care and housing that otherwise would be available.

The availability of a mental health court, especially when coupled with a lack of other alternatives, might actually encourage police to arrest mentally ill people in a misguided attempt to get them help, Seltzer added.

"An active arrest can be extremely traumatic and very dangerous for a person with mental illness," she said.

The money and resources needed for a mental health court would be better spent on training police officers to link people to treatment rather than arresting them, Seltzer said.

Joan Murphy, who along with McAvoy helped found Citrus County's chapter of NAMI, said she just wants to see something done. Her grandson, Michael B. Murphy, was incarcerated after he held his classmates at Lecanto High School hostage with a knife and claimed to possess a bomb.

Michael was diagnosed with bipolar disorder and is currently receiving treatment.

Murphy said a mental health court might spare some people the abuse she says her grandson received as an inmate. If nothing else, it will bring attention to the needs of the mentally ill in Citrus County, she said.

"We somehow have got to stop this pattern: prison, prison, prison," she said.

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