Spokane is turning to Miami for advice in reforming the county’s public health and safety systems and lowering the rate of homelessness.
The new Safe and Healthy Task Force today met with retired Miami Judge Steven Leifman to hear what spurred the south Florida city to make big reforms.
This interview was lightly edited for clarity and brevity.
Steven Leifman: 25 years ago, I had a case in my courtroom where the defendant turned out to be a Harvard educated psychiatrist who had a late onset of schizophrenia. He ended up having a full blown psychotic episode in my courtroom. And I did everything by the book only to have to release him back to the street, floridly psychotic, imminently dangerous to himself or others and homeless. His case really turned out to be a window to everything that was wrong with both our approach in the criminal justice system and in our community mental health system.
As a result of his case, we ended up having a two-day summit in Miami with all the traditional and non-traditional stakeholders. And we totally restructured our entire community response to people with serious mental illnesses and substance use disorders who continuously cycled through every acute system in our community. We far exceeded our expectations.
We were able to reduce by putting together both a pre- and post-arrest diversion system, meaning we retrained our law enforcement. We set up a program called Crisis Intervention Team Policing. We now have the largest trained squad of police officers in the United States trained in this. We have about 8,800 officers trained. Our arrest in Dade County went from about 118,000 to 53,000. Our jail audit went from 7,400 to 4,400.
We closed one of our three main jails and our police shootings almost stopped because it turned out that the level of PTSD among law enforcement is through the roof. And we set up a treatment program outside their departments for help. We also set up a post arrest diversion system where we changed our screening tools in the jail and use validated tools.
And we changed personnel who did those screenings so they were really well done. And instead we focused on getting people treated. The recidivism rate among our misdemeanor population went from 75% to 20%.
Doug Nadvornick: What are some of the things that you think need to be changed here in order to make the system more effective?
SL: There are a few things that we think can be done immediately that would start to help improve the process. One is, you know, they discharge people from jail in the middle of the morning, in the middle of the night without any kind of access to care. That's an easy thing to fix. We need to have new discharge planning put into place so that there's a set time when somebody leaves your jail that they leave with a transition plan and case management, and they're hooked up to services before they leave. The same has to be true for people leaving either a crisis stabilization unit or an emergency room that have these serious illnesses. And those are things that we can do pretty quickly.
Also, some of your crisis stabilization units only operate nine to five, five days a week. These are illnesses. You know, it's not like you have a heart attack nine to five, five days a week. Well, you don't have a mental health crisis, you know, always nine to five, five days a week. So those need to be open 24/7, just like primary health crisis units.
There's very little coordination between the different entities that are teaching this population. So we want to start to coordinate care and make sure people A, get the right assessment. So we figure out what their needs are. B, we hook them up with the right services based on their particular need. And we help case manage them and we make sure that they're housed, medicated and they have something meaningful to do during the day. So they're not hanging around getting bored and getting in trouble.
Those are some of the things that we want to help the community to do. The other thing is we know today that over 90% of the women in jail and prison and over 75% of the men in jail and prison with these serious mental illnesses have horrific histories of trauma.
Your school board superintendent is part of the task force and we're talking to the school board about how do we assess children in elementary school that may have serious histories of trauma and helping them get treated now instead of waiting and allowing them to grow up in our criminal justice system.
