The Definition of Insanity, which was screened publicly for the first time on Monday, March 9 in Miami, Florida, is a film highlighting an alternative way of addressing the knotty and uniquely American problem of the criminal justice system’s management of mental health. The film centers around a resolute leader, Miami-Dade Judge Steven Leifman, who was able to transform a county with an exploding jail population into a jurisdiction that would serve as a national model for reducing jail populations and helping people with mental health needs access proper care. The Jail Diversion Program (JDP) is a cornerstone initiative of the Miami Model, and one of a few programs showcased in the film. Though we at Equitas were glad to learn about the intricacies and details of this model, the documentarians Gabriel London and Charlie Sadoff thankfully spared moviegoers the wonky details. The film instead focused on the human side of the program, presenting the Miami Model as a unified whole and a continuum that has reoriented and redirected thousands of lives in its approximate 20 years of operation.
The film follows three participants in the Jail Diversion Program throughout the process of judicial hearings, working through the requirements of the program, and becoming equipped with life management skills needed to stay on track with medications, appointments, self-care, and adherence to their individual recovery plans. For those whose family ties were strained, who no longer had a safety net or even a feeling of hope, the JDP gave participants a sense of purpose and connection in addition to meaningful recovery opportunities. Other stars of the film were peer specialists Justin Volpe and Walter Thompson. “Peer specialists” (or “peers” for short) are people “in recovery.” These are people who are actively managing their own mental health needs while also providing case management to clients moving through the program. Peers serve an essential role in programs like the Miami Model by establishing credibility and trust between a service provider and the recipient of those services. Additionally, they provide long-term stability and a career opportunity to participants that can become peers themselves after successfully completing the program.
The Miami Model, and programs like it, work because they get at the fundamental needs of people experiencing mental health and substance use concerns. They demonstrate commitment both institutionally and interpersonally to individuals who have often experienced social isolation and stigma related to their mental health and criminal histories. Further, programs like the Miami Model typically cost far less than the alternative: Jailing a person requires paying for the security staffing and technology of a jail, as well as the minimal food, housing, and healthcare, all of which add up to a sizeable daily cost. Alternatively, utilizing health-centered fundamentals such as community housing, therapeutic interventions, and other services can create additional meaning and connection within the lives of people in recovery, drastically reducing overall costs and strain on the crisis system. Stabilizing a person and their underlying health condition reduces the likelihood that the individual will cycle through encounters with law enforcement, experiencing jail time, and unnecessarily being admitted to hospital emergency rooms.
These positive outcomes bore out in Miami, and the long-term shift in resource allocation was dramatic. A constant reminder of what was at stake, the JDP participants highlighted in the film would sometimes remark that the alternative fate—had the JDP not been there to redirect them—would often be years in prison instead. Collaboration among criminal justice stakeholders and community providers, as well as the prioritization of health-based and recovery-oriented alternatives to incarceration, allowed Miami to close one of their three jails at a savings of $12 million per year.
The story told in The Definition of Insanity provides not just a ray of hope for better interventions to America’s mismanagement of mental health, it shows all leaders the path to implementing something similar in their own communities. Judge Leifman continues to lead this work in Miami while training judicial leaders across the country to implement innovative programs like his.
By meeting with his fellow judges, Judge Leifman is also priming some of the nation’s most influential leaders to make impactful changes to state laws later on. In collaboration with the Equitas Project, Leifman is developing new legislative recommendations which will be published at the end of 2020. These legislative recommendations are aimed at mitigating barriers to treatment in every state, barriers which reinforce stigma against people with mental health needs and which do not reflect contemporary understandings of brain functioning and health. Equitas believes that with the nationwide release of this film, the American public will also see the benefit of a change in these laws and will be receptive to trying better-informed interventions that can make real change in the lives of individuals and our communities. Stay tuned for more on this work and our other initiatives in 2020.
We are inspired and spurred to action by the rising tide of interest in the intersection of mental health and criminal justice around the nation. We hope you are, too. Join the nation in screening The Definition of Insanity on April 14 on PBS. Be sure to check your screening time and schedule a reminder to tune in on your local station website. The Definition of Insanity will be preceded the day before, April 13, by a screening of Bedlam, a film giving an overview of the current state and history of the mental health crisis in America. Visit the PBS.org website to find your local PBS station’s showtimes and screening information.