Friday, July 28, 2023

By Josh McGhee

Happy Friday, MindSiters!

I spent the weekend with family and friends in Green Lake, Wisconsin. Did you know my kid was interested in paddleboarding, swimming in ponds, and deer hunting? Me neither. Anyway, I’m happy to be out of tick country.

In this month’s Diagnosis: Injustice, we’ll preview our new series looking into how the Baker Act has left many Florida residents with long-term trauma after being handcuffed by police and taken in for an involuntary mental health exam. Also, the Tulsa Sheriff says he will no longer let the county jail take part in a state program to treat severely mentally ill prisoners in jail while they await trial. And we’ll look at the case of 46-year-old Melissa Perez, who was fatally shot by San Antonio police officers last month while in the throes of a mental health crisis.

Let’s get into it…

Investigating the Baker Act

I spent the first week of July on a reporting trip in Florida. It was hot. It was humid. I took in a lot of sun. I saw the beach in Fort Myers. And the beach in Palm Beach. And Miami Beach. I learned that Florida has a lot of beaches. But, most importantly, I talked to lots of good-hearted people who had something important to tell me.

Back in May, we received a tip about the scarring experience a woman went through  when she sought help during a mental health crisis earlier this year. Though the woman agreed to receive a psychological examination at a local hospital, she was not prepared for the trauma that would begin just minutes later when a police officer arrived to transport her there – as an involuntary patient. 

That was the genesis of a months-long reporting dive into the Baker Act, a Florida law enabling emergency mental health services and temporary detention for people impaired because of mental illness. Although the 1972 law appeared set up to allow families to force mentally ill loved ones into treatment and ensure that people were not detained without just cause, it has become a dragnet for school-age children and now occurs so frequently in Florida it has become a verb: Baker Acted. Between July 2020 and June 2021, there were 194,680 involuntary mental health examinations, which often require a 72-hour hold in a health care facility. Research shows that Florida is an outlier in how often it uses involuntary exams and retention – and that the population most likely to be Baker Acted is getting younger and more vulnerable.

While in Florida, I was able to speak with more than half a dozen people who experienced the process first-hand. I also examined research studies and lawsuits, pored over data and interviewed policy experts, researchers and hospital staff. Together, they paint a bleak picture of an out-of-control process that needlessly traumatizes adults and vulnerable children as young as 5 years old.

In the coming days, get ready for the first story in our series looking into how the Baker Act has been used in communities across the Sunshine State.

Tulsa Sheriff says no to treating severely mentally ill people awaiting trial in jail

The sheriff who runs Oklahoma’s second largest county jail system is ending a program to treat people with severe mental illness who have been charged but not yet tried inside a Tulsa jail, saying it can’t handle the needs of people so ill they don’t understand their criminal charges, according to a story from The Frontier.

In the past, people charged with criminal offenses who had serious mental illness were sent to Oklahoma Forensic Center, a 216-bed hospital facility where patients receive medications, regular talk therapy and education on how the court system works in an effort to restore their “competency” and ability to participate in their own defense.

But in recent years, the waitlist for the hospital has grown to more than 200 people, leaving some people in county jails in Oklahoma waiting a year or more to get a bed at the hospital. In Tulsa’s jail, the sickest were locked down 23 hours a day in a segregated unit. 

The new, jail-based competency program provides medication, but other therapeutic services are only available at the hospital. It was launched by the Oklahoma Department of Mental Health and Substance Abuse Services in December 2022 amid investigations into the state’s mental health system. Weeks earlier, a U.S. Department of Justice investigation into Oklahoma’s mental health system was announced. There were also rumors of a federal lawsuit, since filed, accusing the state of allowing mentally ill Oklahomans to languish in jails awaiting hospital beds, the Frontier reported.

Since starting the new program in county jails, the Department of Mental Health has claimed it no longer has a waitlist for treatment at the state hospital because it is offering those services in county jails, said Lora Howard, interim chief public defender for Tulsa County. 

“They started this jail restoration thing solely so they could say ‘we don’t have a waitlist’ because they were getting a lot of heat for having people that were a number 120-something and number 130-something on a waitlist for a bed,” Howard told the Frontier.  “They don’t have adequate beds to do the treatment that’s needed. But the way around that isn’t to just not do the treatment.” 

Howard said the Tulsa Public Defender’s office still has 30 to 45 clients waiting for a hospital bed.

Bonnie Campo, a spokesperson for the Department of Mental Health, defended the jail-based program, which chiefly provides antipsychotic medication. Providing medication immediately at the jail is  “better than no treatment or inadequate treatment,” she said, adding that some defendants have successfully regained competency and were able to stand trial. Antipsychotic medication is the most common way to restore someone’s competency, she said. 

Family & Children’s Services, a Tulsa-based social services agency that has been operating the jail-based program in the Tulsa jail, told The Frontier in an email that it is working with the jail administration to “ensure that inmates who have been receiving competency restoration services are provided the necessary psychiatric medications to maintain continuity of patient care” after the program is halted.   

Another fatal police shooting – this time in San Antonio

The spotlight is once again on police response to mental health crises. This time it’s in San Antonio, where three officers fatally shot 46-year-old Melissa Perez, a woman who had been diagnosed with schizophrenia.

Last month, the San Antonio Police Department responded to Perez’s home after receiving reports that she was cutting fire alarm wires. Her family says she told police the FBI was using the alarm to spy on her.  She was shot and killed inside her locked home by police officers while allegedly throwing a candle holder and moving toward the window with a hammer, although the police were outside the house when they opened fire, according to CNN.

The question is, why wasn’t the city’s Mental Health Unit — which is supposed to be available around the clock and is staffed with specially trained officers — sent to the home? 

According to William McManus, chief of the San Antonio Police Department, it should have been. He said the death was a result of a failure to follow procedure, not a sign of systemic problems, the New York Times reported.

“We don’t have any gaps in our policies, our protocols or our training that would have allowed that to happen,” McManus said. “It was simply a failure on the scene by a sergeant who should have made that call.”

Representatives of one officer told the New York Times his actions were justified. A lawyer for another told the San Antonio Express News, which first reported the story. that charging the officers with murder so quickly was “unprecedented.”

The department’s Mental Health Unit was formed in 2008 with two officers and a sergeant. It has grown to 16 officers, two sergeants, and two detectives, and, in 2022, responded to 5,201 calls. So far this year, it has responded to around 2,000 calls, the department told the Times. The police department received about 55,000 mental health-related calls from January 2019 to April 2021, according to a 2021 report by the Meadows Mental Health Policy Institute.

The unit’s small size provides “frankly just not enough manpower” for a city as big as San Antonio, Doug Beach, executive director of the city’s National Alliance on Mental Illness affiliate, told the Times.

The lawsuit, filed on behalf of Perez’ family, cites other cases where officers were sent to mental health-related calls and the Mental Health Unit wasn’t called or didn’t respond. 

“Ms. Perez was not shot by a single officer who temporarily forgot his training in a split-second decision,” the lawsuit says. “There were multiple officers who acted over a two-hour period of time.”

Read more about the case here.

Stay tuned for our Baker Act reporting next week. And I’ll be back with another Diagnosis: Injustice next month,

Josh McGhee

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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Type of work:

Josh McGhee is an investigative reporter covering the intersection of criminal justice and mental health with an emphasis on public records and data reporting. He has covered Chicago on various beats for...