The 4th Judicial Circuit is pioneering mental health initiatives that address the complex intersection between mental health and the criminal justice system.
The Mental Health Offender Program and the Mental Health Court are successfully diverting low-level offenders with mental health diagnoses away from jail and into treatment.
The 4th Circuit should build on these successes by developing additional programs for a wider range of individuals. Attorneys within the circuit should actively advocate for the expansion of mental health services, ensuring that comprehensive support is available to all who need it.
Building on the success
Both MHOP and the Mental Health Court serve essential roles by providing court-supervised mental health services to offenders. Since its launch in 2021, MHOP has diverted many mentally ill individuals from jail to treatment.
Former Chief Judge Mark Mahon praised MHOP as “a cost-effective and humane solution” to reducing the burden on the court system. Duval County Judge Brooke Brady noted that in its first year, MHOP saved Duval County significant costs, reducing expenses from $362,218 to $12,641 by diverting participants from incarceration to treatment.
Similarly, the Mental Health Court provides an alternative to incarceration for defendants who need treatment rather than punishment. By offering a structured, supervised environment, the Mental Health Court helps participants receive psychiatric care, counseling, and rehabilitation services.
Duval County Judge Kelly Eckley-Moulder said in a Jacksonville Bar Association podcast that participants often enter the system addicted and disconnected from their families but graduate with jobs and stronger family connections.
Both programs have notable limitations.
The Mental Health Court only serves those with an active criminal case and a diagnosed mental health condition. Similarly, MHOP requires a pre-existing mental health diagnosis for participation. These eligibility requirements leave many people without access to the services they desperately need.
Expanding mental health offerings
One way to address the broader mental health needs within the circuit’s jails and detention centers is through the development of programs like Grow Before You Go.
This initiative, developed by doctorate in public health candidate Indigo Ferdinand, focuses on using horticultural therapy to improve the mental and physical well-being of those in correctional facilities. It emphasizes providing practical skills through gardening and vocational training, which serve both therapeutic and rehabilitative purposes.
The program targets individuals who may benefit from a combination of mental health support and skill-building to improve their chances of successful reintegration into society.
A similar program could be implemented in Duval County’s correctional facilities, either by revitalizing the “P-farm” at Montgomery Correctional Center or by creating new partnerships that provide vocational and therapeutic support to a wider range of inmates.
Such programs could serve a wider range of individuals, including those with less severe or undiagnosed mental health challenges. This would also benefit the general inmate population, offering opportunities for skill development and mental health improvement through therapeutic activities.
Examining mental health data
While MHOP, Mental Health Court and programs like Grow Before You Go offer critical support with the criminal justice system, they must be complemented by communitywide mental health initiatives.
Duval County continues to experience a shortage of mental health providers, with a provider-to-population ratio of 1,200:1. This shortage is echoed in Clay County, which has an even higher ratio of 1,500:1, and Nassau County, where the ratio is 1,800:1. These numbers highlight the urgent need for improved access to mental health services across the entire 4th Judicial Circuit.
Emergency room visits for mental health issues are also high, particularly in Duval County, where the rate is 35 per 1,000 residents. Clay County and Nassau County report slightly lower but still concerning rates of 30 and 25 visits per 1,000 residents, respectively.
These statistics suggest a significant reliance on emergency services for mental health crises, which could be reduced through preventive care and early intervention.
Additionally, there exists a lack of voluntary inpatient mental health treatment for indigent people without health insurance in 4th Circuit counties and this presents a significant gap in care.
While there are facilities for substance abuse treatment and involuntary commitment under the Baker Act and Jimmy Ryce Act, as well as costly private inpatient options for those who can afford thousands of dollars per day, poor and homeless people have nowhere to go voluntarily to stabilize for 30 days.
This absence forces many to wait until their mental health deteriorates to the point of involuntary intervention, often resulting in cycling through emergency rooms, jails, or worsening conditions without adequate care.
To address this, Duval, Clay and Nassau counties must examine these statistics and expand access to voluntary inpatient mental health treatment for those with and without insurance coverage.
A call to action
As legal advocates, it is our responsibility to push for these expanded mental health services.
While MHOP and Mental Health Court are effective for those already in the system, we must advocate for expanding mental health services targeting a broader inmate population.
We must also advocate for expanded mental health services across all counties in the circuit. Legal advocates can help prevent people from falling into the criminal justice system because of untreated mental health issues.
Creating affordable or publicly funded inpatient options would provide a safe place for the indigent to seek stabilization before a crisis occurs.
The combination of preventive mental health care, along with additional programs and offerings, could reduce the number of people entering the system as a result of unmanaged mental health conditions, ultimately reducing the strain on emergency services, hospitals and the criminal justice system.
Ronnie Graham is pro bono director at the Florida Health Justice Project.