Miami-Dade County Judge Steve Leifman has just stepped down from the bench after 30 years, effective December 31st. He’s internationally known for developing major reforms of how the criminal justice system deals with people who have mental illnesses; he’s even been honored by Pope Francis.
Leifman says his career has coincided with the de-institutionalization of people with mental illnesses, 48 years ago. At that time, most people with mental illnesses were in institutional care, such as in a psychiatric hospital. Leifman was a 17-year-old legislative intern, sent to look into a constituent’s complaint about the way her son was being treated in institutional care.
“He is in a bed with all four-point restraints. And he’s probably 100, 150 pounds overweight from the Thorazine that they are injecting him with. And he’s screaming and crying and carrying on and moaning. Out of a horror movie," Liefman described.
He says he requested to see the patient's files and received them at time before federal health privacy laws were in place.
"So I’m going through this stuff and trying to figure out what the hell it meant. I had no idea, except something caught my eye. And I talked to the staff, and I said, ‘Excuse me, what’s this? It says that he’s autistic.’ He wasn’t even psychotic -- he was autistic!”
The patient, named Jonathan, ended up getting proper treatment, says Leifman, but when those facilities began releasing people to the community for services, the criminal justice system wasn’t ready for it.
“What we recognized was that we were all so busy doing our job -- judges judging, prosecutors prosecuting, defenders defending, police policing -- nobody was responsible for the system that was allowing these poor people to cycle in and out of every acute care system in our community at great expense and at great harm to these poor individuals.”
The Miami-Dade Criminal Mental Health Project found that on average, people with mental illnesses remain incarcerated four to eight times longer than people without mental illnesses arrested for the exact same charge, at a cost seven times higher.
In 2000, Leifman helped develop a training program that teaches law enforcement officers to recognize the signs and symptoms of mental illnesses. That’s the pre-arrest piece of the Criminal Mental Health Project.
“And so we set up a treatment program where we’ll get them treated outside their department with the permission of all the police chiefs. And we don’t have to report it unless they’re suicidal or homicidal. And so they love it, and it has played a significant role. You can draw a straight line down from the five years before we started CIT [Crisis Intervention Teams] to now where the police shootings have almost stopped. It’s really remarkable, and that was something we had not even anticipated. It was just a wonderful ancillary benefit of doing the right thing for the right reason. And then, it turns out, it saved the City of Miami hundreds of millions of dollars.”
The post-arrest piece of the project diverts people with mental illnesses to treatment centers, rather than locking them up.
“So if you get arrested now, we have a whole new screening system. If you meet criteria for our program and you’re willing to take treatment, we get you out of jail and we get you into a full treatment system. And if you meet criteria for the Baker Act on a misdemeanor, we usually get you out within a few days of your arrest. We try not to order as many psychological evaluations because they’re a waste of time, but instead try to get you treated. And if you successfully complete our program, which most do, we drop the charges anyway and you don’t have a record.”
With this in place, Leifman says, recidivism for Miami-Dade’s misdemeanor population went from 75 percent to 20 percent. And recidivism among its felony population went from 75 percent to six percent. Now, with the administrative responsibilities of a judge behind him, Leifman is free to devote himself to taking his reforms to other states and other nations.
