THE BLOG
08/28/2014 05:31 pm ET Updated Oct 28, 2014

A Chance to Fulfill JFK's Vision of Community Behavioral Health Care in America: Connect 4 Mental Health

Not long ago, I met with a number of criminal justice and public health researchers from the RAND Corporation. They were doing me a favor, actually. I was visiting Santa Monica, California and wanted to share some lessons from Broward's Mental Health Court and how they related to the challenges of prison reentry. The RAND Corporation conducted the first economic impact study on mental health courts (Allegheny, Pennsylvania) and was now tasked in a public health needs assessment to aid the state of California with its federal court mandate to realign its state prison population. It was a vibrant discussion. One that greatly enhanced my global understanding of disparities and criminalization.

Over time, I expanded an inter-disciplinary course I was teaching for Nova Southeastern University, Criminal Justice Institute, which included disciplines in law, psychology and criminal justice. I greatly appreciate the time spent, particularly with renowned RAND (Reentry) lead researcher Lois M. Davis, who generously shared her expertise and taught me a great deal about the essential relationship between access to integrated public health, health literacy and successful community reentry from prison. One may fairly ask: But you're a mental health court judge, and why should you care about prisoner reentry?

The answer comes with understanding basic root causes of crime and punishment. There is no doubt that serious crime deserves punishment. Yet, in my community (Fort Lauderdale, Florida) we were fighting a different battle. Every day, persons with serious mental illnesses, co-occurring substance abuse, and other related medical problems were pouring into our local jail. The year was 1997, and a task force had been assembled to seek solutions to a scathing grand jury report outlining the major gaps and deficiencies in our community-based system of care. Our jail was overcrowded and a federal class action was implemented to reduce the jail census and respond to the deficiencies in mental health treatment. We were a jurisdiction in crisis. The truth was, Broward County was no different than any other jail system in America.

In 1997, a local mental health/criminal justice task force reached a decision on how to best respond to the criminalization of persons with mental illness and our public defender, Howard Finkelstein, led the effort to establish a specialized mental health court. The core values of the court are best described in three objectives: public safety, therapeutic procedural justice (dignity) and jail diversion with linkage to scarce community based care. We could have easily have referred to our new problem solving strategy as "a community court" where our success was completely intertwined with the shared dedication of our community treatment providers and criminal justice partners.

In her opening of the Connect 4 Mental Health community Initiative, led by The National Alliance on Mental Illness (NAMI) and the National Council on Behavioral Health, (National Council), Linda Rosenberg, the CEO and president of National Council, invoked the vision of the final piece of legislation signed by President John F. Kennedy on Oct. 31, 1963. The Community Mental Health Act was, as President Kennedy intended, "a bold approach." Looking back, the vision to create community mental health centers to provide a comprehensive array of mental health treatment and services is just as relevant and perhaps more compelling than ever. Quoting President John F. Kennedy, Ms. Rosenberg, reiterated JFK's vision, "Calling for the cold mercy of custodial care to be replaced by the open warmth of community." At the time, this new bold mission was aimed to end the atrocities and neglect being perpetuated all across the U.S. in state-run psychiatric hospitals that were known as "Snake Pits." This new initiative was intended to usher in a new era of social justice to build a federally funded targeted community based delivery of mental health services. Where new medications, treatment regimens that would ultimately spur an invigorated and empowered consumer civil rights movement, grounded in recovery and self-determination, should have sealed President Kennedy's vision.

Yet here we are 51 years later with countless Americans still shut away behind institutional walls and criminalized, often due to a lack of access to community based mental health treatment and services. Armed with the evidence and data that treatment works for a majority of individuals, the national mission to fix our national mental health care delivery system stalled. The vision that individuals can live work, engage and participate in community and enjoy the same legal rights, protections and entitlements as every American, remains unfulfilled. The barrier, largely due to social stigma and discrimination so deep and wide, that salient prejudices not only interrupted Kennedy's bold vision, but would set the stage for a governmental policy failure so profound that our nation's jails and prisons would devolve into contemporary snake pits.

Which leads me back to RAND Corp. In its 2011 report, entitled Understanding the Public Health Implications of Prisoner Reentry in California, State of the State Report, Lois M. Davis and her team outline a community based public health (policy) framework (which has relevance, whether or not one is in California). This set of community policy recommendations are actionable, and through a modern lens may be viewed as a renewed effort to realize the vision of John F. Kennedy. You too can support this vision. Conenct4mentalhealth is aimed at this. To inspire us to open our hearts to appreciate the historic urgency to usher in community based behavioral health delivery systems once and for all. It's time to end the institutionalization and criminalization of persons with serious mental illness. Join the collaborative partners of Connect4mentalhealth to rededicate ourselves to prioritize the vision of accessible and integrated behavioral health and recovery -- within the warmth of community.