Mental health: two words no one wants to put together. These words are often considered an embarrassment or stigma. Illnesses range from depression, anxiety and panic attacks to schizophrenia and kleptomania. There are over 200 mental disorders.

In a 2005 study by the U.S. Department of Justice, one in 10 Americans had some form of mental health disorder. Now, in 2021, that number has risen to 19% of Americans – just over 44 million people. Further, these numbers are irrespective of wealth or poverty.

In life, most people deal with peer pressure. It starts in childhood and lasts until we die of old age. In prison environments, it’s more of the same.

What’s said or what’s done is often public knowledge to the institution within minutes. The Mental Health Department is seen as a negative entity, at times. This may be because it is associated with the stigma of having a mental illness, that you’re less of a person according to your peers or what you may say can and will be used against you at a later date.

In response to a lawsuit won, in an article dated February 5, 2019 by Prison Legal News, it was reported that “Florida has over 18,000 state prisoners diagnosed with a mental health illness that requires treatment. The FDC operates 10 inpatient mental health units in prisons that treat about 1,200 prisoners whose mental illness significantly impairs their ability to function in a general prison environment.”

The complaint alleged that only “cookie-cutter” service plans were offered, rarely changed and treatment typically lacked any meaningful content. There was a lack of clinical staff and guards in the inpatient health units. It also alleged the FDC had “no system to identify and correct systematic deficiencies in the quality of care in the inpatient mental health units.”

“This settlement agreement represents significant changes in the way inmates with serious mental illnesses receive care and treatment while serving sentences in Florida prisons,” Maryellen McDonald, then Executive Director of Disability Rights Florida, said. “With the dramatic rise of individuals with serious mental illness entering our criminal justice system, it is no surprise that our state prisons sadly become the last stop for those most at risk of severe psychiatric crises.”

Prisons shouldn’t be an unfortunate last stop, let alone a first stop for those with mental illnesses. In interviews with multiple residents at ECI, I was able to see if anything stemming from this lawsuit may have affected today’s treatment with those under psychiatric care.

The names of those interviewed have been redacted and replaced with a number because these are medical conditions and to protect their anonymity.

For two of the three interviewed, both said they were dealing with mental illnesses while still in the county jail. When they entered the FDC, they were interviewed. Arriving at their permanent institution, they were told they would need to be seen every 30 days. For years, they’ve been seen monthly.

These two individuals said they voluntarily stopped taking the medication they were prescribed. Resident One said he stopped because he didn’t like the way the medicine made him feel. Resident Two said he believed he no longer needed the medication.

Resident Three said after a death in his family, he needed to speak with someone. After doing so the counselor still met with him once per month. However, “since around 2001, they [mental health] have not called me one time to see how I am. To me, it shows how much they care now about me or others.” Resident Three did say that if he was asked to go back and talk he would.

Resident Two said that while here at Everglades, he has been fortunate to have the same counselor as opposed to his previous institution where it seemed like the counselors were changed on a weekly basis. This has helped him immensely. Having a consistent counselor with whom he can build a trust base has helped. “They always have an open door policy that when, or if, I need to, I can talk to someone,” he said.

Resident One said, “I am a war veteran. You don’t see those every day. With the nature of the things I have in my head, there is a very, very limited amount of people who I can actually talk to. Outside of that, it’s either with myself, mental health, or the ones I trust I talk to.”

“In dealing with mental health, I understand their resources are limited. I understand they do their best, especially my counselor. But in the end, it’s like trying to explain physics to an elementary student. If they’ve never seen or been through what we have, I can’t expect them to relate and give the help I actually need. It’s not their fault the after effects of war. Who can you talk to to understand you? So sooner or later you have to ask: what’s the point? I think if they weren’t inhibited by the policies of the Department of Corrections, they could do better.”

I then spoke with resident Jerry Mofield, who runs a support group for residents who have mental health issues. The majority of people he interacts with have severe issues like head trauma, PTSD, major depression, or debilitative depression.

I asked him how he’s able to do this with staff and administration knowing about it. “No, I’m not licensed,” he said. “I don’t prescribe medication or diagnose problems. It’s just a group that comes together to discuss issues. With the experience among the group, that’s what helps solve the issues.”

I created an obstacle response intervention outreach network system. The obstacle is the issue – e.g. anger, depression, or anything that gets in the way of you being successful in life. The response intervention is the support group. The networking is using the various people through the group. We are now trying to find a way that the Mental Health Department is also a part of this process, too,” Mofield said.

Is there a difference between going to this group or mental health? “Ninety-nine percent of the time, it’s an impersonal visit. They aren’t invested. With this group, we are invested. Mental health, you’re seen once a month. This group meets a couple of times a month. If you have an immediate problem, there are hoops or a process you have to go through to be seen by mental health. The support group, there’s always someone available you can talk to,” he said.

“Some guys are really scared to talk to mental health about the thoughts going through their heads. In the group, they feel safer knowing it’s not going in their psychiatric folder or being used against them at a later time,” Mofield said.

He continued: “One of the biggest issues people have had is that they give you medication to deal with the issues but the one major thing they don’t do is give you any help to cope with the medication you are put on. Some of the medication they give you changes your entire outlook on life, and there’s no help for that. A lot of the time, people make fun of you because of the way you act from the medication’s side effects.”

Subsequently, it shows that the fight to normalize mental illness is not the only fight needed. It seems as if another obstacle has to be hurdled: the side effects of the medication itself. Should there be more awareness for those who may not have a mental illness? To better help or cope with others who may have one, so that there are no more instances of peer pressure or teasing?

Pursuant to Florida Statute 916.107(4)(a), Rights of Forensic Clients as related to the findings on mental health issues (Disorder/Insanity) to continue to trial, “each forensic client shall receive treatment or training to the client’s needs, which shall be administered skillfully, safely and humanely with full respect for the clients’ dignity and personal integrity. Each client shall receive medical, vocational, social, educational and rehabilitative services as the client’s condition requires to bring about a return to court for disposition of charges or a return to the community. In order to achieve this goal, the department and the agency shall coordinate their services with each other, the Department of Corrections, and other state agencies.”

The question should now be: why is this not a statute for post-conviction instead of just pre-trial?