By Nicoletta Pappas
After a three and a half hour drive, our shaky, red coach bus pulls into the compound of the North Florida Evaluation and Treatment Center (NFETC). Members of Dr. Krahl’s abnormal behavior in criminology class groggily wake from their slumber, realizing they have finally arrived at their destination. Wiping the sleep from my eyes, I exit the bus. I did not know what to expect entering one of Florida’s secure mental health facilities. Run by the Department of Children and Families, the NFETC is only one of the state-run treatment centers that focuses on helping men who are deemed legally insane or not fit to stand trial regain competency. A tremendous amount of therapy, manpower and counseling goes into returning these men to competency. During our visit, the NFETC staff explained to us that due to continuing budget cuts, mental health center employees have found their jobs to be increasingly difficult. The centers do not have access to up-to-date resources, while other states do. More budgeting should be allocated by Florida legislators to increase staff, update technology and improve employee pay and benefits. Without this, safety of the staff, the patients, and even the community could be at risk.
Individuals with mental disorders require an increased amount of care and therapy. They are occasionally difficult to reason with, something that is made nearly impossible when they do not take their medication. Because of America’s deinstitutionalization in the 1960s, long-term mental health institutions were defunded and the mental health population was thrown out onto the street, causing the homeless population to skyrocket. Long-term facilities were replaced with small state-run treatment centers, but these treatment centers were sparsely available to the majority of people that needed it. Without homes, money, and treatment, these individuals are unable to properly follow laws and, as a result, are getting into trouble. They are locked up after repeated offenses and according to the Department of Justice, represent 15-20% of the jail and prison population.
The problem in Florida is that every year, the legislature continually cuts the budget for these state-run facilities, but increases the requirements of the staff. The NFETC staff informed me that in 2011, the NFETC had a 19% decrease in their budget, causing them to decrease their staff from more than 20%. While these cuts were taking place, the central office was requiring treatment teams to establish competency in individuals in less and less time. This means that each person had to speed up the competency process and decrease the amount of adequate treatment each patient was receiving. In the matter of a few years, the central office for NFETC decreased its time to restore competency by 20 days. It may not seem a lot to us, but to those who are dealing with a major disorder like schizophrenia and bipolar disorder, every day of treatment and required medications makes a world of difference.
Forensic mental health services are like turning tables in a popular restaurant that is short staffed. Because of the budget cuts, staff at mental health facilities are so overwhelmed they can only focus on how to get the patient back into the community as quickly as possible.
Staff members at the NFETC find themselves putting on “four hats” when it comes to doing different jobs. NFETC can house around 200 people, but is only running on about two-thirds of their capacity level because it does not have enough staff to maintain the men. One treatment team made up of counsellors, psychologists, psychiatrists and nurses is responsible for up to 45 men. Doctors are short-staffed and there are not enough nurses for the needs that must be met. This is a disadvantage for the patient and Florida communities because patients are not able to receive all the treatment they need, heightening their risk of reoffending.
Last week the Tampa Bay Times released a three-part exposé on the increase in violence and decaying conditions in Florida mental health facilities. They described how staff is becoming careless in their treatment, leading to increased deaths of patients and loss of important treatment information. They based their research on staff and past patient interviews, along with facility incident reports. What the Times fails to notice are extraneous variables that affect the staff’s ability to work. Members of the NFETC team explained that it is difficult writing and organizing reports. They have no centralized electronic record system and do most of their reports by hand. Written reports become a problem when other clinicians can’t read previous staff’s handwriting, which results in loss of important information. Mental health facilities like NFETC are also at a disadvantage when it comes to recruiting. When a vacancy opens in their staff, they do not have the funds to hire a qualified psychology or public health major because their yearly salary is too low, and students need to pay off loans. This leads to less experienced staff members dealing with mentally ill patients having no hands-on knowledge on how to care for them.
What Florida needs is a change. The state is 49th out of 50 states for quality of mental health treatment, spending a whopping thirty-six dollars per person on mental health treatment, according to the National Association of State Mental Health Program Directors Research Institute. Florida is the only American state that does not have an electronic mental health system along with the American territory of Guam. Members of the Florida legislature need to step up and realize the problem. Allowing state-run mental health facilities like NFETC to hire more qualified staff members and possibly give a grant to pay back student loans would increase the quality of care. More staff members would allow them to focus on actual treatment instead of a constant time constraint. The mental health community would benefit as well as the regular community. If all the other 48 states can do it, why can’t we?