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Pathways president Kull was in the Orange County Jail in the 1970s and says he never had a problem with the mental health services offered there. He speaks from experience, as he suffers from depression and anxiety, and was diagnosed with schizophrenia in his teens.
Since his jail term, he has been an advocate for mental health, currently serving on the State Mental Health Planning Council and previously on the boards of National Alliance on Mental Illness Greater Orlando, NAMI Florida, the Mental Health Association of Central Florida and others.
He says the problem lies in the number of people in jail who shouldn't be.
"We need to get people out of jail and into mental health facilities," Kull says. "They do not need to be in jail."
Because of the nature of mental illness, not taking one's medication is a frequent problem and can lead to other troubles, Kull says.
"You're not taking your meds anyway," he says. "Some of them aren't. They tend to be people who need their meds – you're sick but you don't think you're sick. You don't realize you're sick. You don't take meds and you become disruptive of people's lives."
According to Ninth Circuit public defender Melissa Vickers, the problem isn't the jail itself – they try their best – but more just that they aren't a mental health facility and don't have the capabilities to treat people in the best way possible.
"The Orange County Jail tries to do the best they can with what they have," Vickers says. "They'll medicate them, but that's all they can do. And the medication is sometimes not the same as what they have on the outside. It's not set up to treat them – there's no therapy, no counseling. Some won't get medication at all, depending on the client and what behavior they've exhibited."
She says the issue is one for the courts and legislators rather than the jail itself – there needs to be an effort to identify and get people out of jail who are suffering from mental illness.
"It's not the jail's fault," she says. "If they're told to hold someone there, they have to do it."
Jenkins says this is true – and she doesn't mince words in saying the jail is not and never was intended to be a mental health facility.
"Everyone who comes in is screened for mental illness," she says. "They're seen by a mental health professional. But we're not a behavioral center here – we have a mental health coordinator, but we don't do counseling with a private office, with couches where you can put your feet up."
Inmates have the option to ask to speak to a mental health counselor, she says – but if they're deemed a danger to themselves, they can be put in isolation. The stress of coming into the jail may amplify their already tense mindsets, though.
"Anybody coming into the jail has a reaction," Jenkins says. "Those who are mentally ill may have an exaggerated reaction."
Crisis intervention training classes in Orange County are taught by Aspire Health Partners, an amalgam of three different local entities: Lakeside Behavioral Healthcare, Seminole Behavioral Healthcare and the Center for Drug-Free Living. The classes are intended to help law enforcement deal with mentally ill individuals in a compassionate and efficient manner. In Orange County, the training is funded by the Valencia Criminal Justice Institute and costs $2,500 per class.
Also known as the Memphis Model, CIT places officers in simulated scenarios so they can learn to problem-solve in a safe setting. According to NAMI, the model was developed through a partnership between NAMI, the University of Memphis CIT Center, CIT International and the International Association of Chiefs of Police. CIT was chronicled as an overall success in a 2012 study by the National Center for Biotechnology Information.
The study says because officers "frequently respond to crisis calls involving individuals with serious mental illness," it's important for them to know how to deal with those people delicately and intelligently.
"Serving as de facto psychiatric specialists, police officers often must assume roles held by nurses, social workers and case managers as the principal referral source to psychiatric emergency services," the study reads. "For these reasons, it is crucial that officers are equipped with knowledge about various mental illnesses, and have the appropriate communication skills to safely intervene and expedite the disposition of the individual who is experiencing a psychiatric crisis."
The CIT model focuses on educating law enforcement on the signs and symptoms of mental illness and techniques to de-escalate situations when dealing with a mentally ill person. Through role-playing and field trips to actual jails and mental institutions, officers learn more about the issue.