Summit on mental illness points public officials to better methods

State, county and private officials whose organizations deal with people afflicted with mental illness should work collaboratively on new approaches that could save money, cut down on police involvement and get proper treatment for those who need it.

That was the message from the “Hawaii Summit on Improving the Governmental Response to Community Mental Illness” held Wednesday.

“None of us created these problems alone and none of us will be able to solve these problems alone. We all must be part of the solution,” Judge Steve Leifman of Miami-Dade County told about 90 legislators, police officers, health officials, Honolulu’s prosecutor, deputy public defenders and others from across the state who filled a meeting room in the Hawaii Supreme Court building.

The event opened with comments by Gov. David Ige and Hawaii Supreme Court Chief Justice Mark Recktenwald.

A “significant portion” of Hawaii’s homeless population suffers from mental illness, which “represents a significant burden on health care, law enforcement, social services and community systems,” Ige said.

Left untreated, many of those with mental illness “end up on the street or in the court system,” Ige said.

Recktenwald ticked off a growing list of programs involving partnerships between various organizations to deal with mental illness across the islands, but said there is “a lot of room for innovation.”

In June, Ige signed HB 1013 that created a task force to look at involuntary hospitalizations for people at risk of harming themselves or others. Lt. Gov. Josh Green continues to preside over the monthly task force meetings at the state Capitol.

Working together, Recktenwald said the people gathered Wednesday at Ali‘iolani Hale “can actually improve public safety. And that’s a critical feature.”

The summit included presentations by officials from Los Angeles, Arizona and Nebraska. It was similar to a two-day summit held in Florida in June 2000 that led to significant changes in the way parts of Florida now view mental illness, said Judge Leifman, who was the keynote speaker at Wednesday’s summit.

“No one was looking at the entire system, when in fact this population was utilizing the resources of everyone in that room and then some,” Leifman said. “There is no other population of individuals who utilize so many different expensive resources.”

In Florida, the overall inmate population jumped 56% between 1996 and 2012. At the same time, the number of inmates with moderate to severe mental illnesses skyrocketed by 170%.

“It is growing so fast,” Leifman said, “that the number of prison inmates is expected to almost double over the next 10 years — from 17,000 to more than 30,000 — requiring Florida to build 10 new prisons. The cost to build and operate 10 new prisons just for people with mental illnesses over a 10-year period is almost $2.2 billion. … There is something terribly wrong with a society that is willing to spend more on imprisoning people with mental illnesses than to treat them.”

Florida’s mental health summit led to changes in how different institutions deal with the mentally ill — and with one another.

It began with training for 7,300 law enforcement officers representing 36 different agencies.

The number of arrests of mentally ill suspects suddenly began to plummet, Leifman said, from 118,000 arrests annually to 53,000 this year. As a result, one major jail closed, saving taxpayers $12 million annually, he said.

Diverting mentally ill defendants from the court system and into treatment also led to decreases in the number of repeat offenses, which meant the “recidivism” rate fell from 75% to 20%, Leifman said.

Total jail bookings dropped by 59%. And total days spent in jail fell 57%.

After their cases are adjudicated, Leifman said the former defendants receive more help and treatment, including mentoring from people with mental illnesses who went through the program before them.

He called the mentorships a critical part in getting the participants to stay engaged in the program.

“Diversion is great, but if the services are inadequate it will fail,” Leifman said.

So Florida officials are now building a $42.1 million “one-stop shop” for the most acutely mentally ill.

It is expected to include primary health and mental health services, dental care, eye treatment and tattoo removal, Leifman said, along with a culinary program, housing and trauma services and activities run by people with mental illnesses to teach self-sufficiency.

It’s also intended to be a research hub and center to develop best new practices in mental health care medicine, psychiatry, nursing and social work.

The center broke ground in May and is expected to open in March 2021.

If he had to do it over again, Leifman said he would have included an additional approach that would have involved specialists in pediatrics and education because so many adults with mental illness can trace their issues to childhood trauma.

“Mental illness is not a criminal justice issue,” Judge Leifman told those gathered at Hawaii’s Supreme Court building. “It only became one because we applied the wrong model.”