A Court of Refuge

by Ginger

  At the end of the hearing, I caught Jack’s eye and smiled. I thought back to the horrible living conditions on the Seminole Unit at the state hospital where I first met Janis and Jack, where many of the patients, like Seth, had lived at the hospital for decades.

  Seeing Seth after so many years, I wonder how Aaron Wynn’s life would have changed had he received any reasonable level of mental health care and services after his tragic motorcycle accident. Aaron Wynn is now living in a private hospital for people with traumatic brain injury in central Florida. The jury’s award of $18 million for violation of Aaron’s civil rights, based upon negligent care and maltreatment at a Florida forensic hospital, was sufficient to provide for his rehabilitation and care.25 Having a safe and decent place to live in the community that we call home seems like such a simple dream—one that many of us take for granted.

  CHAPTER 6

  I Once Was Lost

  The Broward County Mental Health Court never called into question the life experience or history of a person who “claimed to be homeless.” That was the case until we heard Beatrice St. Fleur’s story that brought this issue to light. For the first time, the court heard the story of a person who was truly—and in every way—“lost.” The mystery surrounding Ms. St. Fleur’s identity and where she was from taught us always to inquire about life experiences. Ms. St. Fleur was from the Bahamas, but no one knew how she had gotten to Florida or why she was in Broward County.

  I am shocked at how many of the people referred to mental health court who are classified as homeless are actually missing. This means that for some unknown reason they walked, ran, or wandered away from their lives, which might have included a job, a family, a home, and they had chosen an anonymous and unattached life instead.

  The difference between being chronically homeless and being missing is significant for many reasons. For one thing, the whereabouts of the chronically homeless are not necessarily unknown, whereas a missing person literally “disappears” from their previous life. And while homelessness is, at times, congruent with “missing,” it is important to remember that not all who suffer from homelessness are missing, and those who are missing are not necessarily homeless. The difference lies in the connection one maintains with one’s family, friends, and community. When someone suddenly disappears, those ties are severed, as if the person had suddenly been erased.

  This is why, in the case of a missing person, it is impossible to describe the emotional impact of reuniting a family. As I dial the number of a client’s father or mother and wait for the phone to be answered, the courtroom invariably goes quiet. We all wait in suspense as I do my best to remain matter of fact, in the event the call does not go through. More than likely, however, a family member answers.

  “Hello,” I say, “my name is Judge Ginger Lerner-Wren.” I explain to the party on the other line where I am calling from and ask them if they know the subject of the call. It is both heartbreaking and exhilarating to hear cries of relief when they realize that the call is authentic and their loved one who had inexplicably disappeared is alive and safe.

  When Beatrice St. Fleur, a middle-aged Bahamian woman, was escorted into the mental health court, her distressed state and a language barrier meant that I was initially unable to tell what exactly had, weeks before, brought her to Florida from the Bahamas. According to her paperwork, she had been arrested for allegedly failing to pay a $22 cab fare, but aside from that, I could glean little to nothing about her life other than something had gone terribly wrong.

  Beatrice became, in my mind, another one of those individuals who had gone missing from their own lives. Sometimes this is understandable, since in a traditional courtroom setting defendants aren’t permitted to tell the stories of their own lives. In a traditional court, it is the attorney who addresses the court, not the defendant or the subject of the hearing. The only time a litigant may be permitted to talk about his or her personal histories may be at various legal phases of the court process, such as a sentencing hearing or when a court must make rulings concerning matters of mental competency to stand trial and mental capacity. Otherwise, defendants are mute observers to the court proceedings resulting from their actions and lives.

  In a problem-solving mental health court, this is not at all the case—especially not in the Broward County Mental Health Court, which applies a therapeutic justice approach that encourages clients to tell their personal stories. When they talk about their life experiences, court participants are given a voice and the court process is humanized.

  Beatrice St. Fleur sat with her head down, handcuffed to a chair in the jury box. Her light blue jail jumpsuit acted like camouflage, blending into the scene of the courtroom. Aisha McDonald, the criminal justice liaison for Chrysalis Behavioral Health Center, a local Behavioral Health Center that is committed to serving persons in the criminal justice system, began speaking with her. Aisha’s family is Jamaican. She not only provides cultural context for the court but also has the unique ability to bridge cultural differences when explaining the court’s mission. South Florida is very culturally diverse, with large Caribbean and Haitian populations. According to 2011 data, Broward County was the third most ethnically and racially diverse county in Florida.1 In 2015, its population was 40.4 percent white, 26.9 percent African American, and 27 percent Hispanic, and it had the largest concentration of Caribbean immigrants in the United States.2 So it has been wonderful to have Aisha’s help.

  “Judge,” Aisha said with alarm, “I think you should speak to Ms. St. Fleur. She keeps repeating that she needs to get back to her children, but she does not know where they are.”

  Beatrice responded, but I was unable to understand her. The conversation ran in circles. After several rounds of trying to gather basic information, such as where she was from and who was taking care of her children, Beatrice said that she was a Bahamian lawyer and had to return home immediately to find her children. Unfortunately, she couldn’t tell us where “home” was.

  I stopped asking Beatrice questions, for both Janis and Aisha pointed out that she was becoming agitated. I asked Digna, the court clerk, for an emergency transportation order to get Beatrice to Henderson Behavioral Health Center’s Crisis Stabilization Unit. In the meantime, I thought about other court participants, like Kathryn and Lilly, who had been traumatized by forced separation from their children.

  Trauma had contributed to Kathryn’s decision to abandon the home she had worked so hard to acquire and to turn to the streets. Lilly’s trauma, on the other hand, kept her returning to her home despite a judge’s order awarding custody of the children to her ex-husband and a restraining order to keep her from returning to her former residence. If we could learn a little bit more about Beatrice St. Fleur, I was confident that we could help her find a family member or someone who knew her well enough to help us get her back home.

  The question of who is truly homeless and who is missing is more than a nuance. We have learned from experience that people go missing for various reasons and in various circumstances, including untreated mental illness. Sometimes families file a missing person’s report, but more often than not, no report is filed. It must be a strange thing to discover that someone who is an integral part of your life has simply vanished: there one moment, gone the next. In dysfunctional families it is quite possible that no one will file a missing person alert.

  When I speak to family members, they often express frustration relating to their loved one’s inability to follow their prescribed treatment plan. In many cases, substance abuse is involved, as individuals turn to self-medication, which aggravates existing tensions and anxieties about their deteriorating health and the possibility of incarceration. According to recent data from the National Institute of Mental Health, “20.2 million adults in the US had a substance use disorder and 7.9 million had both a substance use disorder and another mental illness. More than half of the people with both a substance use disorder and another mental illness were men (4.1 million).”3 As th
ey sink further into oblivion due to whatever substance they have chosen—alcohol or drugs—the person they once were also slips away. The ties that keep families together are stretched as a loved one falls into addiction, while the family struggles to support their loved one in the hopes of promoting recovery and preventing further justice involvement and the revolving door of incarceration.4

  Many family members report feelings of fatigue due to unending stress and the pressures of attempting to care for other family members and to maintain their jobs while trying to manage their son or daughter’s mental health problems. In many cases, it is simply too much.

  Each situation is unique and entails a high level of coordination, particularly if the family lives out of state. One reason for the complexity is my requirement that individuals who are subject to reunification with their families must be escorted back home. This is for safety purposes and to ensure integrity of the reunification plan. For individuals who live outside Florida, this means relatives or a designated surrogate must come to the courtroom or jail to pick the person up and accompany them home where they can begin the process of rebuilding and rehabilitation. According to Mental Health America, access to mental health care varies from state to state, and one out of five (20.1 percent) adults with a mental illness report they are unable to get treatment at all.5 Mental health court staff provide families with the names of local mental health centers and resources to assist in coordination of care upon their return home and to gain the support of family members and the community to build resilience and promote recovery.6

  Over the past two decades, I have witnessed how the internet has advanced the court’s ability to reunite people with their families. Now, through online research, we can take the fragments of information we receive from people whose mental capacity is diminished because of illness and separate fact from delusion. People who go missing can be more easily found—online traces of their lives facilitate their return to their existence in the real world.

  Years ago, a young man in his twenties was diagnosed with schizophrenia and was referred to the mental health court for erratic behavior in a public place. He identified himself as a graduate student in a school of business in Connecticut. Prior to the existence of the internet, this shred of information would have taken several months to track down and verify, but an online search verified his testimony within seconds. Further review of the school’s website confirmed the name of the master’s program. When I called his father in Connecticut to tell him that I had his son in the courtroom, he confirmed that his son was a graduate student and that he did not know his son had been arrested.

  His father stated that he was aware of his son’s erratic behavior but did not recognize it as mental illness. He assumed that his son had been out of contact with him due to the demands of the graduate program. He had no idea that his son was in Florida or that he would have any reason to be involved with a court of any variety.

  The mystery surrounding Beatrice St. Fleur deepened. Her public defender reported that she had contacted the jail to determine whether her client had any identification or passport in her possession when she was arrested. There was none. The property that was inventoried upon Ms. St. Fleur’s arrest included a purse, wallet, and three one-dollar bills. There was no way to confirm where she lived in the Bahamas or whether her assertion to the court about being an attorney was true.

  I remembered that I knew an attorney who had recently appeared in my regular criminal division who was a professor in Caribbean law and practiced immigration law. I called his office and asked if he could stop by the courtroom. Within the next few days, he came by and I explained the vexing problem we were having with Beatrice. Did he know of a way to check if she was an attorney in the Bahamas and whether there was a family law case pending? The attorney generously agreed to assist and went to the hospital to visit her.

  It did not take long before we learned that Beatrice was a victim of domestic violence. She told the attorney, “My husband threatened to kill me if I did not give him custody of our three children.” She took the threat seriously and felt she had no choice but to leave the household, and the island.

  The attorney decided to go through the Bahamian consulate and review Beatrice’s status. He confirmed that she was a Bahamian citizen and an attorney. The consulate agreed to replace her passport, and the attorney worked to intervene on her behalf in the family courts.

  When I heard this, I was taken aback. I thanked him, but explained that it was not my intention that he should represent Beatrice on a pro bono basis. I had no idea that she was a victim of domestic violence. Apparently, she was so distraught that she fled with nothing but the clothes on her back. He indicated that he was pleased to help and wanted to assist her with reuniting with her children and to represent her on the petit theft case (petit theft is a misdemeanor charge in which a person has stolen property that is valued at under $300 without the intent of returning it).

  I was overcome with gratitude.

  After several weeks in the hospital, Beatrice returned to court for a follow-up hearing upon her release from the hospital. She was feeling much better and explained that when her husband threatened to kill her, she was already on the brink of an emotional breakdown.

  As an attorney, she said she had filed a petition for divorce and custody of the children. From a cultural perspective, she stated that her estranged husband was angry and humiliated that she was planning to disclose the history of domestic violence to the court. She would disgrace his name if she did that, and that was the moment when the threats began.

  “That was when he commenced an intensive campaign of psychological and emotional abuse,” she said. He warned her that no one would believe her claims of domestic violence and her family would disown her. As the emotional abuse intensified, Beatrice’s mental health declined.

  Soon, the anxiety was unmanageable. “I could not take anymore,” she said. She felt unsafe and alone.

  She had no memory about her decision to leave her home, her family, and everything she knew and cared about. As victims of abuse and trauma commonly report, her mind stopped recording accessible memory and she turned to a flight-or-fight response. “I was in a panic when I purchased a one-way ticket, and I don’t know why I chose Fort Lauderdale,” she said.

  “Do you feel safe enough to return?” I asked.

  “While I was at the hospital I made plans to live with family on the other side of the island, and the children are already with them. It seems that the threats about seeking custody of the children were not authentic but intended to instill fear and intimidation. When I called my family, they did not know what had happened to me. They feared the worse.”

  I heard the unspoken words: “I had gone missing. I had been erased and no one was sure that I would ever return.”

  As I watched the petite woman prepare to return to her home and family, I imagine that Beatrice’s mental health might have deteriorated in jail if the Broward County Mental Health Court hadn’t intervened. She might have ended up on the streets or trapped in the criminal justice system as issues of mental competency would more than likely need to be determined by the judge. All over a $22 cab fare. Thankfully, she was diverted from the jail and received psychiatric treatment in a setting where she could feel safe.

  Not all cases end so well. I soon learned that the young business school student from Connecticut had another criminal case pending in Palm Beach County from the assistant state attorney. No matter what we in the mental health court did, we could not reunite him with his family because of his other criminal case.

  I called his father from the phone on my bench at his next status hearing and canceled any plan for reunification. I informed him that the criminal case pending in Palm Beach County was a felony and that the judge had revoked his bond, based upon his new arrest. I told him that the only thing I could do was to release him on the Broward case, which would free him to return to Palm Beach County to face the more serious charge
. His public defender would do her best to advocate for him through the Palm Beach Public Defender’s Office. It was an incredibly painful conversation.

  His father was distraught. He interrupted my words of consolation to protest that his son was just fine and not suffering from a mental illness. “Judge, we are a Jamaican family, and we really don’t discuss mental health, and I am not familiar with these things.” He nearly began to cry.

  “Judge, there is a great deal of shame surrounding mental illness in the Jamaican culture,” his defense attorney said.7

  There was nothing I could do but state the facts as they were. He thanked me for my help and for taking the time to call him.

  “At least, Judge, we know where our son is. He is not missing,” he said.

  CHAPTER 7

  Therapeutic Justice Goes Mainstream

  In 2005, eight years after the Broward County Mental Health Court’s founding, the principles and goals of therapeutic jurisprudence had become more than a judicial philosophy applied in the court. Over time, this restorative and problem-solving approach had become a core element of my judicial role in my regular criminal division, which is adversarial and process driven. It was clear, when I encountered Michael Evans sitting in the courtroom between dockets, that therapeutic jurisprudence is a universal practice in the law and not limited to problem-solving courts such as the mental health court.