Judge Steven Leifman
Appearances
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
We might as well do it the right way, get people what they need. Recovery is real. Many mental illnesses have better recovery rates than heart disease and diabetes. It's really just about making sure there's access, competent and quality care for this population.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And that's one of the things that we're doing with the Conference of Chief Justices. So they started off by having four or five regional summits around the United States where all the chiefs came. And then it worked so well, most of them are having statewide regional conferences. And then it's breaking down specific areas in their states.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Last year, I probably put 150,000 miles on in the air helping states do it because I want to focus my time to help them set up similar programs in their own states. And it's exciting and it's a lot of work, but we know that it's doable.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I just feel very honored and blessed to have the opportunity to do it. My court has been incredibly supportive of me doing this work. My previous chief justice in Florida helped me start this by assigning me to chair a committee for the Supreme Court on this issue. And actually for three years, pulling me off the bench and assigning me to the Supreme Court to work on this full time.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
This is the height of institutionalization, and it's the height of the abuses that went on at state hospitals. So I guess being the low guy in the totem pole, I got asked to go to the state hospital to investigate. The editor of the Miami Herald, who wrote the letter to the legislator, raised concerns that there was abuse going on at this facility and that this young man was being abused as well.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And it really gave me an opportunity to learn these issues and figure out a way that we could do it better. But I have to tell you, it's not rocket science. A few weeks ago, a month ago, I got back from Italy and I was part of a delegation that was there to study the Trieste mental health system.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I was sponsored by the Hilton Foundation and they wanted to see if it was a program that could be replicated or scaled in the U.S. And the reason they picked Trieste is because the World Health Organization has determined that Trieste has the best mental health system in the world. And after visiting it for a week, I can unequivocally tell you it does. They basically had no homeless.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
They had few, if any, people in jail with mental illnesses, few, if any, people in their state psychiatric system, and few, if any, in their forensic system. It was really remarkable. And they did it not through anything that should shock anybody. They intervened early. If there was a break, the doctor went to the house. They wrap around services. They get you housing.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
They have a really great day activity program. They don't define you by your illness. They put you on a long-term injectable medication. And they make sure that you're incredibly well case managed. And you're working during the day. So you have a life and you have goals and hopes. Nothing that we all don't know works.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
We're so quick to try to incarcerate before we treat that it's absurd and it's expensive. The United States spent almost a trillion, with a T, dollars last year on costs related to incarceration. Could you imagine what we could do with that kind of money for mental health and autism?
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It's a couple of things. The message is very important, but I'm finding equally important is who delivers the message. And I think one of the great things that's going on in the U.S. right now is the level of judges that have gotten involved. Reality is that we're seen as Switzerland. We don't have an axe to grind. We don't have an interest or a financial interest.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
By having judges become involved in this issue has really opened a lot of doors. It gets the right people to the table. I tell people the best part of my job is that when I invite people to a meeting, they come. And so we need to use that moral authority, get people to the table, and explain to them what we're doing and why it works.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And look, as cynical as I could be on days, I do believe when you get a chance to meet people one-on-one and you really get to talk about these issues rationally instead of In the world we live on where everything is argued, most people get this. They don't want to see people with mental illnesses in jail. They have loved ones. They know people.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
They want to make sure that this population is cared for, treated, housed. And they know that if you do that, we're going to get better outcomes. And they're pining for it. They really want a system that works as opposed to trying to navigate one that doesn't.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Yeah, that was pretty amazing. Talk about humbling and not bad for a Jewish guy. It came as quite a shock, quite a surprise. It was one of the most humbling recognitions I've ever received. The archbishop, unbeknownst to me, was very familiar with my work, and he nominated me, and the pope selected me, and I received this beautiful medal. It was pretty stunning.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I think what I most appreciated about it was the level of attention it has brought to this cause. And I'm sure that's why they do it, because this isn't one of those sexy issues with cute little kids. People have a lot of stigma about this population. They're afraid of this population. They think they're dangerous. They're not.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
So I walked through the front doors of a state psychiatric hospital 48 years ago. And it was a scene out of One Flew Over the Cuckoo's Nest. Funny in a way, I'm a 21-year-old son. I would never allow him to go. I can't believe they sent a 17-year-old kid. Anyway, I found Jonathan, the young man I was looking for. He was in all four-point restraints.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
For him to do it meant a lot, but it also meant a lot for the cause and for the issue. And for that, I am eternally grateful. And I've ended up developing a wonderful friendship with our local archbishop here in Florida. He actually had me give one of the keynotes
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
speeches recently to all the new priests in Florida which was great so we could talk to them about mental health and what they can be doing when people approach them because I used to be on the board of the American Psychiatric Association Foundation and one of the things that we learned is that by a wide far margin more people go to their clergy for mental health than they do a psychiatrist and you want to make sure that the clergy are well informed and they are well educated and
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
and that they don't try to convince people it's the devil or something like that. The Catholic Church is pretty sophisticated, but they really appreciated learning about these issues. So it's been a wonderful experience.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I'm actually optimistic. I think many of us have been working and toiling in this field for a good 20 years, and a lot of groundwork and infrastructure has been laid. And I think the country, if we don't kill ourselves politically, I think the country is, this may be the last issue everyone seems to agree on, is poised to tackle this issue.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I think people, whether you're coming from the right because you think it's ridiculous how much we're wasting in taxes, or you come from the left and you think it's horrible how we're treating this population, everybody agrees it's not working and it needs and can be fixed.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Through this initiative with the chief justices, through this other initiative, I co-chair judges and psychiatrists, through the National Center of State Courts and the Council of State Government and the American Psychiatric Association Foundation. We've all partnered up and we're really working to make the structural changes in each community that are necessary to fix it. It's challenging.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
because every community is different. There's not a switch that you can flip in Minneapolis or San Francisco or Mobile, Alabama, right? They're all different. You almost have to go community by community to fix it.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And our approach and what I'm going to be doing over the next three to five years with this initiative is to go into the states first, get them to buy in, show them how that they can save a lot of money and save a lot of lives. and then work towards making this structural change. But it's going on. There's examples all over the country right now that didn't exist just five, 10 years ago.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I remember when I first started on the lecture circuit for the course, I'd spend the first 45 minutes of my talk trying to convince people there was a problem. Now, all they want to know is how do they fix it? And so we've done a really good job and the media has done a decent job of educating people about the problem.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Now we have to show people that it's really fixable and that these are the tools you need and this is what your system should look like. And while each community is different, we all have the same essential elements that are necessary to be able to get the desired outcomes everybody wants. It's just a matter of figuring out where you are on that.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
and what changes you need to get you to the next level.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Yeah, and thank you for that. One I would say is people with mental illnesses are absolutely no more dangerous than the general population. And on medication, they're much less dangerous than the general population. They are much, much more likely by a wide margin to be victims of violent crimes than perpetrators.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And that recovery rates for this population, for many of these illnesses, are actually much better than heart disease and diabetes. That it's not a lost cause, that people can recover, they can get their lives back. What we need to do is create structures in the community that provide them access, provide them quality of care, provide them an opportunity to recover. We just don't do that.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
He was being injected with probably Thorazine, which was the only antipsychotic at the time. He was screaming and moaning and crying. And it was a scene out of a horror movie. So I started to look at his records. This is well before HIPAA. I started to talk to the staff, although I will candidly tell you I had no idea what I was looking at. I was 17 and knew nothing.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
In really bad American fashion, We punish them when it's not their fault. And we need to set up a better system of care so that people don't end up in the criminal justice system that was never designed for people with these illnesses.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
If you do that, you get much better outcomes, you improve your public safety, you save tremendous tax dollars, and you give people an opportunity to have a life of hope and recovery. And I think that should be the ultimate goal for every one of us in our society. Why else do what we do? I would tell you it's been the honor of my life to be a judge for almost 30 years.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It afforded me an opportunity to make change that I probably never could have done as a legislator or someone in the executive branch. And it's because in many ways we're first responders like law enforcement. We're on the front line seeing this population come in every day. And we don't have to stand for something that's not working. Our job is to do our best to administer justice.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And that doesn't mean just punishing people. It means figuring out why they're in the system and what can we do to keep them from ever coming back. One of the things that most people don't know is that trauma plays a significant role in triggering serious mental illness. We know today that we didn't know just 20 years ago
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
said about 92% of the women who are in jail and prisons in the United States with serious mental illnesses have horrific histories of trauma, mostly sexual abuse. And that sexual abuse occurs when they're quite young, five, six, seven years old. And about 75% of men who are in jail and prison with serious mental illnesses also have horrific histories with trauma.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Sometimes it's sexual abuse, more likely they've been victims of long-term domestic violence, or they've been witnesses to violent crimes like a soldier might see in combat. We know today that trauma is not an emotional response but physiological. Without getting people treated after they've gone through this kind of trauma, the chances are by a huge percentage
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
that they're going to end up with a substance use disorder and or a mental health disorder. And we need to get ahead of that. We need to be using tools to assess kids in elementary school to see if they have histories of trauma. And if they do, make sure we're getting them treated quickly. Because if we had done that here, even in Miami, we weren't aware of trauma when we started.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
we would have kept two, three generations from ever coming into the criminal justice system at all. And we got to get smarter about it. We have to do what Trieste is doing and get ahead of this and get people treated just like we want to do with any other illness. We don't want to wait for your skin cancer to metastasize and get you so sick that you have to go to an intensive cancer facility.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
We want to get it at the beginning because it's going to be easier, cheaper, and we're going to get much better outcomes. Mental illness is no different. I would leave your listeners with that. We need to get ahead of this. And if we do, we'll get much better outcomes. We'll save a lot of money and we will improve our public safety.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And people won't have to live a life cycling in and out of acute systems like homelessness, jail, prison, and hospitalization.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Well, I appreciate you having me. You have such a nice voice for your podcast. It's great. And your tone and your questions are just perfect. I'm honored to be here today and thank you for inviting me. The pleasure is all mine. Thanks again.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
But what I did find that shocked me, and when I spoke to the staff, it turns out that he was not psychotic at all. He was autistic.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Here they were injecting him with antipsychotic medications.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
While I was there, there was a group of advocates touring the facility, and they found out that there was a representative from a legislator's office, albeit a 17-year-old who had no knowledge and no power. But they insisted I take a tour of the facility. They brought me downstairs to what looked like a dungeon. It was like a jail cell. And I found these seven men.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
lying in their own feces while a guard, they were naked, and a guard stood there with a hose and washed them down like they were animals in a zoo. It was pretty traumatizing and pretty horrific. And while I did not have much authority to help them, I was able, with the help of the senator, to get the young man out of the hospital.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And we got him placed in a really wonderful, amazing adult living facility for other young men with autism. And he was very well cared for after that.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It left a pretty indelible mark on me. About 17 years later, I got appointed to the bench. And ironically, that hospital that I had been at 17 years earlier was closed. The jail across the street from me started to become the psychiatric facility for our community. So those same folks or type of folks that had been in the state hospital, they got released to the streets without services.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And many of them ended up in the criminal justice system. In 1955, there were about, maybe we estimate 5,000 people with serious mental illnesses in state hospitals. There were about, excuse me, in jail, there were about 550,000 at that time in state hospitals. Today, there's less than 30,000 civil psychiatric beds in this country.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And last year, we had about 1.5 million people with serious mental illnesses arrested and about 2 million incidents. And so we never deinstitutionalized. What we really did is we transferred responsibility from these really terrible, crappy, horrible state hospitals to these really terrible, crappy jails.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And the problem is in some ways it's worse because now you end up with a criminal record and it's harder to get housing and it's harder to get employment.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
When I got assigned to the criminal division, I ended up having a case. This is the second part of my story. I was getting ready to go on the bench one morning, and the assistant public defender and the assistant state attorney came to see me. And they said that there was a case that was really mind-boggling on my docket.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
If I wouldn't mind, would I please speak to the defendant's parents who were in court? At the time, I was handling what we call a jail misdemeanor division. These are people on very low-level charges who are still in custody. There's kind of three types of folks in that division. There are those with attached felonies who are not allowed out of custody.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
There are those that are too poor and they can't afford to bond out of custody. But mostly, it's really people with serious mental illnesses that don't know how to get out of custody.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
The parents came in and they started telling me this story about how their son was brilliant, how he had gone to Harvard, how he had a late onset of schizophrenia, and he became homeless and started cycling through the criminal justice system. And as I started to go back into the courtroom, they were pretty distraught.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
The mom was crying and the dad was shaking and they literally were begging me to get their son help. Of course, being a new judge, you think you have a lot more wisdom and a lot more power than you do. I made a rookie mistake and I promised them that I would get their son help because I assumed there was a system in place to treat him. Sadly, there was not.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
As I was going back into the courtroom, the mom stopped me and said, judges, one more thing I need to tell you about my son. She said, not only is he brilliant, but he probably knows more about the mental health system than you do. And I was surprised, and I looked at her, and I think she thought the lawyers had told me the whole story. They had not. And I said, excuse me?
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And she said, my son is the former head of psychiatry at Jackson Memorial Hospital. That is our largest public hospital in Florida. And she said he didn't show up to work one day, and he was having religious ideations. So he cashed in his life insurance policy. He flew to Israel to be closer to God.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And within a few weeks, he was deported back because he was running around naked in the Orthodox sections of Jerusalem and they were afraid for his safety. So they sent him back to Miami where he became homeless and started cycling through our system.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I called this case. We had a great conversation. He ended up having a full-blown psychotic episode in court, screaming at the top of his lungs that his real parents had died in the Holocaust and this couple sitting in the back were from the CIA and they'd come to kill him.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And after ordering a battery of evaluations and adjudicating him incompetent to proceed, it turned out in Florida that because it was only a misdemeanor, I literally had no authority to get him help and I had to release him back to the street. Well, that was the beginning of my journey. And between those two incidents, I think I became the Forrest Gump of mental health.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I just started going through and trying to fix things the best I could, given the wonderful moral authority I had. To my great, pleasant surprise, it has far exceeded all of our expectations. We've been able to do some miracles because I have an amazing staff and an amazing community that has allowed me to make these structural changes that were so necessary.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I'm already working on that. It's not a crisis unit, but I appreciate you asking about it because it's fascinating. It is the first of its kind in the United States, possibly in the world. It is a one-stop shop for the most acutely ill that continuously cycle between the most acute systems of care, such as homelessness, jail, and hospitalization, both primary and psychiatric.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It's the old competency restoration facility. It's 181,000 square feet. And it's going to be a mental health diversion facility for that population. Just back up a little bit so your listeners understand the problem. When community mental health was designed in the United States, the most acutely ill were still in psychiatric hospitals.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Community mental health was designed for people with moderate mental illnesses, not acute. And so when we shut down the hospitals and we went to the war on crime and the war on drugs and we went to sentencing guidelines, and we massively cut housing back in the 80s, this population got thrown into communities, into community mental health systems that were never designed for them.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And so, of course, it didn't work. And they didn't behave the way that we wanted them to behave. But instead of looking at how do we build a better system for them, we instead started to incarcerate them. And that's what happened. So we are building this facility, in fact it's done, to account for that population that never got what they needed.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And understand that there's a smaller subset of this population that are so sick, but they're using up all the resources. We did one study with one of our universities in Florida that looked at who the highest users of criminal justice and mental health services were.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
We sent them the names of 3,300 people who had come through our system, and they had access to all the arrests in Florida and all of the civil commitments in Florida, all the Medicaid and Medicare records.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It narrowed it down to basically 97 people, primarily men, primarily diagnosed with a severe psychotic disorder, primarily homeless, primarily co-occurring, who over a five-year period, these 97 people were arrested 2,200 times. They spent 27,000 days in the Dade County Jail, 13,000 days at a psychiatric facility, cost taxpayers tens of millions of dollars, and we got nothing for it.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And so this building is really for that subpopulation. In fact, we've had this diversion program going on for 24 years, and I'll describe it a little bit more in a minute, but we get a list every day from my county of who is eligible to be diverted into the community. And because of the lack of capacity, we can't get to them all.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Over the last five years, we just looked at the data because we're trying to figure out who's going to go into this building first. We identified 16,000 people who over five years, they were arrested 32,000 times. They spent 1.2 million days in the Dade County Jail. That's 3,400 years. $414 million in taxpayer dollars wasted, and we got nothing for it.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
So it's that type of population that this new facility is for. And so the building will have a receiving facility, a crisis stabilization unit, a short-term residential facility, a deactivity program that'll teach individuals self-sufficiency, how to manage their illness, a culinary supportive employment, vocational supportive employment programs like computer labs.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It will have a primary health clinic, a dental clinic, an eye clinic, and a podiatry clinic. They'll have tattoo removal because people do silly things when they're psychotic and stunned. It has a courtroom in the facility so we can manage both criminal and civil cases.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
It has something called the living room model so that for people who are high users, heavy users of these services, but they're not meeting civil commitment, They can stay there voluntarily and we can engage them into services. And it has 208 beds of housing. They're not going to be there permanently. So we'll probably be able to see quite a few thousand a year.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And there's a limited number of these people. They're just costing us the most because they go through this deep end the most often. If we can get our arms around them, we can significantly change their trajectory and we can break the cycle of incarceration, homelessness, and hospitalization.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Correct. And that's the whole idea, is to make sure that we're using the criminal system for people that need to be in jail. 70% of people in jail today in the United States either have a serious mental illness, a substance use disorder, or both.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
I always joke that we need specialty courts for the 30% that don't so that we can make sure we have a therapeutic jurisprudence system for the 70% that do so we can make sure they get treatment and stop cycling in and out of the system.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Yeah, and that's a wonderful question. And I'm actually quite optimistic because it's changing. And part of the reason it's changing is I've been working very closely over the last several years with something called the Conference of Chief Justices and the Conference of State Court Administrators.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
All the chief justices of all the state Supreme Courts in the United States and all their court administrators. And they have made mental illness their primary issue for the last four or five years. They are having summits now. We have tours to Miami quite regularly. They come here. They learn about how to restructure their community.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
Yeah, I have two stories. And the first one starts when I was 17 years old. I was an intern for a state legislator here in Miami, and he had received a letter from the then editor of the Miami Herald newspaper. about a young man who was in our local state psychiatric hospital. This is 48 years ago.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
They're going back and starting to put together plans on how to do what we've done because we've been able to reduce the arrests in Miami as a result of our project from 118,000 a year to 53,000. Our jail audit went from 7,400 to 4,400. We closed one of our three main jails at an actual savings, not cost shift, of about $168 million so far.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And one of the things that we hadn't anticipated, our police shootings have almost stopped here. And while it's possible that race certainly can play a role in a police shooting, it turns out that the reality may be that many of the police shootings have as much to do with PTSD among law enforcement as anything. They overreact because they get scared.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
The woman that runs my training program for law enforcement, we call it CIT, Crisis Intervention Team Policing, she gets between 150 and 250 calls a month from police officers for their own personal mental health issues. It's tragic, but last year, more officers died from suicide than in the line of duty. We set up a program to help get them treated when they're having issues.
Tony Mantor: Why Not Me the World
Judge Liefman: Breaking the Cycle of Autism and Mental Illness in Criminal Justice
And it has helped amazing, and they've become incredibly empathetic. And then as for the prosecutors, our own prosecutor has become a huge advocate because she's learned that if you want to really improve public safety, we have two choices. We can release this population without treatment or we can release them with treatment. You know what happens when we release them without.