Wayne County studies 'Miami model' for mental health jail diversion

Detroit — Sheriff Benny Napoleon refers to the Wayne County Jail as the state’s largest mental health facility. It’s a dubious distinction, one he feels miscasts the jail into a mentally rehabilitative role it wasn't, and isn't, designed for.  

Napoleon wants to stop the revolving door that brings the mentally ill through the lockup, arguing it would be more humane and less expensive to treat that population rather than jail it repeatedly, and at great cost.

But what to do instead?

That's what officials hope to learn from studying Miami, where over a span of almost two decades, arrests involving the mentally ill, court-ordered mental evaluations, jail stays and even officer-involved shootings have plummeted as the county changed the way it dealt with people whose legal troubles stemmed from untreated mental illness.

Over the next two days, stakeholders in the justice system in Wayne County will huddle with a small team from Miami-Dade County in Florida, as Michigan’s largest county continues to seek out ways to divert mentally ill, non-violent offenders away from the jail system and into treatment.

Jail diversion is not a new effort in Wayne County. For years, police in Detroit have dropped people off at crisis centers in lieu of, or in addition to, arresting them. And for years, Wayne County Jail officials have sought residential treatment options for some mentally ill inmates. 

But police, jailers, prosecutors and judges are frustrated by this revolving door between the jail and the streets.

"Wayne County Jail is not a rehabilitative setting," said Timothy Kenny, chief judge of Wayne County Circuit Court.

A Detroit delegation of about 12 flew south months ago, and now it is their turn to welcome their southern counterparts. 

"We are looking to engage the broader community" with the trip north, said Cindy Schwartz, director of the Miami diversion project since 2003.

During the trip to Miami, officials learned how Miami-Dade slashed annual jail bookings, which reached 118,496 in 2011, to less than half that — 55,356 — in 2018.

The cost savings allowed the county to break ground this summer on a comprehensive mental health diversion facility, which will offer housing, counseling, culinary arts training and even tattoo removal. That facility, expected to open in 2021, will treat "high utilizers nothing else has worked on, those who need the most resources," Leifman said.

'Frequent flyers'

Both trips are funded by the Detroit-based Ethel & James Flinn Foundation, which invests in improving “the quality, scope and delivery” of mental health services in Southeast Michigan. 

Among its efforts, the Flinn Foundation has funded mental health first-aid training for some 650 police officers and 10,000 civilians in Metro Detroit.

Learning the Miami Model is not just about adopting a new approach — the goal was never for a straight adaptation, says Andrea Cole, CEO and executive director of the Flinn Foundation — it's a chance to ask people who've built a diversion program what they did when their vision or capabilities met roadblocks.

In Miami-Dade, an academic study found that just 97 heavy users of the jail system — people in Detroit tend to call them “frequent flyers” — cost taxpayers some $13 million over five years.

Judge Steven Leifman, architect of Miami’s Criminal Mental Health Project, has joked previously that it would’ve been cheaper and more effective to send them to Harvard rather than jail. 

“They would have had a shot at an education," Leifman said. "They would have had housing. They probably would have done a lot better.”

The so-called Miami Model operates at multiple levels: pre-arrest diversions meant to stabilize rather than punish, post-arrest diversions meant to connect people to resources they wouldn’t otherwise have.

Merely pulling people out of jail isn't enough, Kenny said. 

"This is not only about getting people out of the jail as quickly as possible, it's about reconnecting them to the treatment they need to improve their quality of life, and stay out," said Kenny, who has championed a Flinn Foundation-funded jail diversion effort in Wayne County that's been underway for several months.

Since May, 60 clients have been pulled from the Wayne County Jail and connected to treatment and services meant to stabilize not only their mental health, but their lives. 

Leifman will give a talk Wednesday called "making jail the last resort."

Dollars and sense

Since fall 2014, the Wayne County Jail has worked to house some of its mentally ill population outside of a lockup, where appropriate, Napoleon said. It relies on a network of seven residential treatment centers.

“We release them, when we can, to residential treatment centers,” Napoleon said. “That’s a win for the inmate, who is being treated in a proper facility, and it’s a win for the taxpayer, because residential treatment doesn’t cost as much as keeping that person in jail.”

Sheryl Kubiak, dean of Wayne State’s school of social work, sits on both Gov. Gretchen Whitmer’s statewide jail diversion task force and a Wayne County-specific effort, funded by the Hudson-Webber Foundation.

Any amount of time in jail can throw someone's life off course, Kubiak said. The sooner someone can be treated, the better, and if that can be done before an arrest is made or charges are filed, that's ideal.

Kenny explained the ripple effects of even a brief jail stay: “If it takes somebody several days to come up with a $100 bond, maybe they don’t show up for work, and they lose their job. And if you lose your job, maybe you can’t pay your rent and get evicted. There are all kinds of collateral consequences we're looking at.”

“No judge wants to be in a position where they’re pushing the revolving door. You lock somebody up for 30-60 days, they get out, and 10 days later they’re back in again,” Kenny said. “What’s worked in other areas? What are the best practices? What does the research show?”

Crisis intervention

Detroit Police Department arrests about 70 percent of Wayne County Jail inmates. Any effort to steer the mentally ill from the jail system will fall largely on the shoulders of its 2,000-plus officers, who can divert pre-arrest.

Detroit police already conduct diversion efforts for those believed to be mentally ill, said Assistant Chief James White. In 6,464 police runs from March to August, more than 2,000 people were transported to mental health crisis centers at Detroit Receiving Hospital or Sinai-Grace.

The Detroit Police Department requires recruits to take 19 hours of mental health training while in the police academy. Officers are also trained in mental health first aid.

Before there was a Miami Model to work from, many other cities studied Memphis for additional tools on police runs involving the mentally ill.

The Memphis Model is known nationally as Crisis Intervention Team training. It was developed in collaboration with the National Alliance on Mental Illness after a fatal officer-involved shooting in the late 1980s. 

CIT is a 40-hour training curriculum that teaches officers to spot the symptoms of mental illness and respond accordingly.

It was an immediate success in Memphis, where officers sustained some 5,000-plus injuries while taking calls related to mental illness from 1985 to 1987. From 1994 to 1997 there were fewer than 1,000 such injuries. 

In Miami, where police handled some 91,000 CIT-related runs from 2010 to 2018, Leifman said, those resulted in only 152 arrests.

"That's my single proudest accomplishment as a judge," Leifman said.

By now, about 6,500 officers in South Florida have received CIT training. Michigan has about 19,000 sworn officers as of July, per the Michigan Commission on Law Enforcement Standards, or MCOLES.

While four Detroit police staffers have been trained as CIT instructors, a partnership with the Detroit Wayne Mental Health Authority this fall will expand its efforts on that front.

Training started Monday. Two teams of 10 Detroit officers each, along with 14 "regional partners" on each team, will receive 40 hours of CIT training.

CIT training includes topics such as "introduction to psychopharmacology," "verbal de-escalation techniques." Participants also work through a number of crisis scenarios. 

Once trained, street officers will have another tool in dealing with the mentally ill, one that in other parts of the country has resulted in fewer arrests.

"There are some people who just need to be stabilized," White said. "There is the possibility that a trained mental health professional will be out with the officer and be able to provide stabilization services immediately, on the street — say if someone doesn't have access to their medication — so we don't have to incarcerate and we don't have to go to the hospital."

jdickson@detroitnews.com