The locked units at South County Mental Health Center overflow with people in crisis.
Addicts struggle through withdrawal. A schizophrenic woman argues with an empty chair. A bipolar man paces angrily. Would-be suicides, at least a dozen, numbly stare at the floor, the window, the television, their hands.
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HOW WE GOT THE STORY
It’s rare for journalists to be allowed access to a mental health crisis unit, rarer still for them to be allowed to interview people sent there to be stabilized.
Throughout February, reporter Stacey Singer and photographer Gary Coronado spent time at the South County Mental Health Center in Delray Beach, with the permission of CEO Joseph Speicher.
Speicher allowed them in because he hoped to increase understanding of the nonprofit’s role as a community public safety resource and increase understanding of people with mental illnesses in general.
The journalists followed key ground rules, not interviewing or photographing people without their permission, and avoiding interaction with clients considered incompetent to make their own decisions. Some photos are blurred in places in print and online to protect identities.
WHAT IS THE BAKER ACT?
Involuntary commitment for psychiatric examination when a person could be a danger to himself or others. It can be initiated by judges, police officers, physicians, social workers and some other health care professionals.
A person cannot be held more than 72 hours without a petition to a court, criminal charges or patient approval for more treatment, if needed. The law, enacted in 1972, was named after its sponsor, former state Rep. Maxine Baker of Miami.
Served in Florida mental health programs (2010-11)
Adults 198,687; Children 94,369
Estimated number of Floridians with severe and persistent mental illnesses below 200% of poverty line:
Adults 329,774; Children 146,724
FLORIDA'S MENTAL HEALTH SYSTEM: FOCUSED ON CRISIS CARE
The state has limited beds for long-term care. The mission of the system is to treat people in the least-restrictive environment possible, so the crisis units, which hold patients for several days until stabilized, are the meat of the public system.
Here are the basics from most restrictive to least:
Long-term beds (patients sent by court) – 7 state hospitals
1,108 bed capacity
People found not guilty by reason of insanity, defendants ruled incompetent to stand trial.
The cost annually to treat a forensic patient is $125,000 to $130,000.
2,244 bed capacity
People with a major mental illness and at “substantial risk” for being dangerous to themselves or others.
Short-term crisis beds
Usually days-long emergency care for people with acute psychiatric conditions. People can go to a Crisis Stabilization Unit voluntarily or be brought in involuntarily by police on medical or law enforcement orders.
In 2012, 150,466 people received involuntary psychiatric exams under the Baker Act. Of the state-paid inpatients, 1 in 4 had to be readmitted within the year. The state pays $292 per bed per night for patients who qualify.
Public Baker Act receiving facilities in Palm Beach County:
Nonprofits: Jerome Golden Center in West Palm Beach and Belle Glade; South County Mental Health in Delray Beach
Hospitals: Delray Medical Center, JFK Medical Center in Atlantis and St. Mary’s Medical Center and West Palm Hospital (formerly Columbia Hospital) in West Palm Beach.
Community Services - Outpatient
After-care help, self-directed care with support in getting housing, employment, medication and other needs as well as drop-in centers for social, recreational and networking help.