In early September, National Public Radio’s The Daily podcast’s episode: “What Happened to Daniel Prude?” investigated the distressing relationship between the criminal justice system and individuals living with serious mental illness (SMI). In late March, police apprehended Prude naked in the snow, amid a psychotic episode. His brother, Joe Prude, had called the Rochester Police Department earlier, concerned for his brother’s well-being. Upon encountering Daniel, police used a restraint technique that limited Daniel’s ability to breathe, causing him to asphyxiate. Hours later, Joe Prude rushed to the hospital to find his brother completely brain dead. One week later, Joe removed Daniel from life support.
Daniel Prude’s death exemplifies the lethal dangers the criminal justice system and law enforcement pose for individuals experiencing unstable mental conditions, particularly individuals of color such as Prude. Under current policy, individuals experiencing mental illness are 16 times more likely to die in encounters with law enforcement and 13 times more likely to find a bed in jail than a state civil hospital (Gabriel & Sadoff, 2020). In 2015, research from the Treatment Advocacy Center stated at least 1 in 4 of all fatal police shootings involved individuals with SMI. While Black Americans, such as Prude, experience mental illness at similar rates to non-Black groups, they are less likely to receive guideline consistent mental health care (APA, 2017). Work by individuals experienced in public policy, concerned by the frequent persecution of individuals living with SMI, attempts to address these issues by restructuring the criminal justice and law enforcement system.
In Miami-Dade County, Florida; Cindy A. Schwarz works as the Project Director of the Eleventh Judicial Circuit of Florida’s Criminal Mental Health Project (CMHP). This program focuses on retraining law enforcement to interact prudently with the mentally ill and connects criminal offenders living with SMI with existing services to aid their treatment and community reintegration. Shwarz’s contributions to CMHP combats the cyclical nature of the relationship between those living with SMI and the criminal justice system. First, police arrest individuals suffering SMI for small misdemeanors such as trespassing, panhandling, and public urination. Before the establishment of CMHP, the courts immediately lost jurisdiction over offenders incompetent to stand trial. These individuals then languish in jail before their release onto the streets. Offenders with SMI finally reenter society without a diagnosis, treatment plan, housing, or a support system and eventually re-offend and cycle back through the criminal justice system a month later.
In early 2000, Judge Steve Leifman established The Criminal Mental Health Project in an attempt to aid the 175,000 adults living with SMI in Miami-Dade County caught in the criminal justice system. The CMHP encompasses stakeholders in healthcare, the criminal justice community, jails, and law enforcement to ensure that criminal offenders with SMI receive treatment and rehabilitation instead of punishment and abandonment. Hired in 2003, Schwarz acts as the Substance Abuse Mental Health Administrator, connecting criminal offenders suffering from SMI with community mental health programs. At first, she admits, “We didn’t understand criminal justice. We didn’t understand the language … how the system worked.” The general difficulty navigating the criminal justice system is compounded for individuals that not only suffer from SMI, but often cannot maintain an exact mental state to understand the court proceedings.
Luckily, upon arriving at CMPH, Schwarz hit the ground running. “Seventeen years later we have made fantastic efforts and really moved the needle on what our project does and how we integrate into the community,” she tells me. Since the program started, participants are 55 percent less likely to re-offend. With a substantial decrease in inmates since the implementation of CMHP, Miami-Dade County even closed one jail facility, estimated to have saved taxpayers $12 million per year.
The care comprising CMHP’s pre-booking and post-booking components unquestionably contributes to its impressive success. The pre-booking jail diversion program consists of Crisis Intervention Team training, a nationally recognized program used to educate law enforcement officers to interact with the mentally ill. CIT training encompasses 40 hours of specialized training covering areas such as psychiatric diagnosis, suicide prevention, behavioral de-escalation techniques, mental health and substance abuse laws, and treatment programs available in the community. Since its implementation in Miami-Dade, the program has trained 7,600 police officers, educating more mental health care officers than anywhere else in the nation. Since the program’s implementation, the influx of CIT trained police officers corresponds with a decrease in arrests from 118,000 to 56,000. Since the implementation of CIT, police shootings have decreased from two per month to six in the last eight years.
Despite CIT’s unquestionable importance, most of CMHP exists within its post-booking programs. Defendants undergo mental illness screening and those who show distinct signs of mental illness move to the community-based crisis stabilization unit which provides medication and psychosis stabilization. CMHP participants then work with the court system to create a collaborative treatment rehabilitation plan. Specific to each individual, treatment plans include medicine, housing, a plan to find work or education, and mentorship. In court, a public defender, state attorney, and judge work together to modify or dismiss CMHP participants’ criminal charges as the individual progresses through the program.
In addition to connecting mentally- ill offenders to pre-existing community treatment programs, Schwarz played a crucial role in introducing the SOAR Entitlement Unit Program in 2007. SOAR connects individuals experiencing SMI with public entitlement benefits such as Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), and Medicaid which provide resources to access housing, treatment, and support services to the community. Upon integrating SOAR into CMPH, Schwarz realized, “This is going to be the best thing that ever happened to us! Bring me someone, bring me anyone, and I’ll do the first application.”
CMPH workers brought Schwarz a young man named Justin Volpe.
At the time, Volpe had spent 46 days in Miami-Dade County’s Pre-Trial Detention Center Psychiatric Unit until being identified as a contender to participate in the CMPH program. After agreeing to cooperate in the post-booking diversion program, Volpe settled into an assisted living facility paid for by the social security money secured through the SOAR program. Soon after his release from jail, Volpe relapsed using crystal meth until he finally decided he had had enough. Relapse isn’t uncommon, Schwarz informs me. In Miami-Dade county, 20 to 25 percent of program participants are rearrested and need treatment and services.
Upon Volpe’s return to the program, Schwarz realized what Volpe’s treatment plan was missing: meaningful work. “When we had a position available, I said to the staff ‘Let’s have Justin do it.’” This marked the beginning of Volpe’s work as a Peer Specialist, a mentor diagnosed with mental illness who works with program participants to facilitate engagement in CMPH and community reintegration. Judge Leifman admits,“The secret sauce of our success is our peer support system.” Now a consultant for mental health facilities and substance abuse programs, Volpe has played a role in helping over 1,000 people avoid jail on top of training over 3,000 local police officers to approach the mentally ill. Twelve years after enrolling in CMHP, he lives with his wife and eight-year-old son in Miami and continues to spend time working for CMPH as a Peer Health Specialist.
Schwarz’s work in the Mental Health Court presents faith and forgiveness in a world that so often averts its gaze from the suffering of the marginalized. The Criminal Mental Health Project provides someone with the tools to succeed, watches them fail, and still say, “Let’s try again. I believe in you.” While grief cannot resurrect Daniel Prude and the countless others killed on account of their mental illness, current efforts to reform the criminal justice system offer some hope for the future. In an op-ed piece published in the Washington Post, Volpe remarks, “working with the 11th Judicial Circuit Criminal Mental Health Project in Miami-Dade … saved my life.” To mend what is broken to save human lives, faith and forgiveness must triumph over punishment.