by Ginger
I explained to him why I thought his case had been referred to the mental health court: most likely the magistrate judge read the booking sheet and thought he needed assistance with services, particularly because the arrest involved a hospital.
Then, I counseled him about the use of the word “crazy.” It was a minor thing, and perhaps I should have simply let his remark go and moved on. But I couldn’t. It is my professional responsibility as a judge to create an atmosphere in my courtroom that is free of derogatory speech that is demeaning and in this situation could be viewed as stigmatizing. “Crazy” is such a word. The need to promote dignity necessitated me to say something about his use of the word “crazy.”
“You know, Mr. Collins,” I said, “I think you may understand that this division is a specialized mental health court and that there is a great deal of stigma and shame surrounding mental illness. And we do not want to use language that could cause people to feel badly about seeking mental health care.
“I’m sure you meant no harm, but for people affected by mental health conditions, that language could be hurtful,” I said. “You know, a mental illness is no different than any physical illness, such as asthma.”
“I’m sorry, Judge. I was upset,” Mr. Collins replied. He cast his eyes to the floor and seemed genuinely remorseful.
By the conclusion of the hearing, Janis had coordinated a bed for him at Broward Outreach Center in Pompano Beach. This homeless center, run by the Miami Rescue Mission, has its own on-site medical clinic, where Mr. Collins would be able to get medical assistance for his asthma and access other services. I entered an order to have the Broward County Sheriff’s Office transport Mr. Collins to the Broward Outreach Center.
Mr. Collins entered a plea of no contest to the charges against him, and I took judicial notice of his time in jail. As he walked out of the courtroom, he turned his head to look back at me and raised his shackled arms as high as he could in a gesture of appreciation.
Within a week, Joelle Dylan was back on the docket to discuss her residential program, answer any questions, and talk about her hopes for a successful and positive experience in what would mark the beginning of her journey to recovery and a new life.
“Judge,” Janis said, “I need to talk to you to the side. We have a problem. Joelle was rejected from the program,”
“What do you mean?” I asked. “Everything was confirmed.”
Janis informed me that she had just received an e-mail from the managing entity division, which oversees community bed allocation, stating that Joelle had been denied access to the community-based program she had been referred to.
“Why?” I asked. “For what reason would she be denied?”
Janis explained that DCF standardized procedures required that Joelle’s assigned community case manager go to the jail personally and speak to Joelle face-to-face to obtain her verbal assent that she wanted to attend the program.
“But Joelle clearly stated in court that she wanted to go to a program. Isn’t there anything you can do to get her into that program?” I asked.
“Joelle’s bed was given to the next person on the waiting list.” Janis sighed and paused before she said, “She lost it—the bed is gone.”
Joelle’s case had become a test of how the shift to privatization would impact the court’s processes and how beds would be allocated to our consumers. As a result of privatization, residential treatment beds were controlled by the Broward Behavioral Health Coalition, and as a result, the court’s diversionary process had been disrupted. A system called Level of Care Utilization System was creating new barriers in bed allocation that were preventing consumers like Joelle from getting the care they needed.
I took a brief recess and drafted an urgent e-mail to John Bryant, DCF assistant secretary for substance abuse and mental health. Bryant is a well-respected advocate for mental health and substance services and is supportive of the mental health court. I requested his immediate assistance to exclude the mental health court from this cumbersome and redundant process, which obviously was having an unintended negative impact on the court’s diversionary process.
Within twenty-four hours, I received a response from Valerie Allen, the DCF mental health supervisor. Valerie and I go back more years than I care to remember, when we sparred during my time working for the Advocacy Center for Persons with Disabilities. Valerie called a meeting for within the week to discuss issues affecting the court and ways to streamline DCF procedures. These meetings are often intense for me, primarily because I am highly protective of the integrity of the court process. Sylvia Quintana, executive director of the Broward Behavioral Health Coalition, was present, along with several coalition staff members, who were young and eager to learn about the high-profile case of Aaron Wynn, Howard’s letter to the grand jury, and how the court had been created.
At the meeting, after much banter, Valerie—who is always a strong mediator—offered suggestions that would provide the flexibility and autonomy the court needed to meet its diversionary goals. Janis would be given community case manager status, so that she could more easily make community placement referrals. This suggestion streamlined the process in terms of diversion from jail. No longer would it be necessary for community case managers to meet with individuals to verify what had already been determined through the court process. This simple change eliminated a critical barrier to jail diversion—and for this I was genuinely grateful. In the end, the ability to problem-solve is always about relationship and having the will to be flexible in the promotion of human rights, disability rights, and social integration.
Within weeks, Joelle returned to court with her case manager, Cynthia. Cynthia was extremely positive and had identified several of Joelle’s strengths, such as her politeness, her altruism (she enjoys helping the other residents), and her love of music. Joelle is making steady progress and is slowly adjusting to the therapy groups and being around other consumers. Apparently, Joelle had been isolated at home and was becoming more detached from her family and friends.
It was an excellent report. I particularly appreciated that the program was flexible and that it allowed Joelle to be social when she felt the need to be around other people. The fact that she was adjusting to her medication and participating in activities was great progress. All of the staff were very proud of her.
“Joelle,” I said, “I am so proud of you. In fact, we are all proud of you.”
Janis said to me, “I know we experienced a few hiccups getting Joelle into the program. But I wanted to let you know that the managing entity worked very hard to contact treatment providers and identified a bed not only for Joelle but for the other individual who was more or less ‘competing’ for the same slot.” Janis paused, before adding, “In this court we always talk about making lemonade from lemons. I believe this experience also helped me become more integrated within the DCF–managing entity sphere. Don’t forget I was employed with DCF for more than twenty years. So, it is a win-win for all of us.”
“I want to thank you,” said Joelle. “And my mother asked me to tell you hello.”
“Please tell your mother that I send my best,” I said. Then, remembering the frustration and the hopelessness written on the face of a parent who believed her child would never get any better, I knew I needed to say one more thing. Despite the lack of services, Joelle’s mother had held on to the hope the court had told her to have. And now, Joelle was getting better. I smiled and looked at Joelle, who stood before the bench with a positive future in front of her. “And please tell her that I am proud of her.”
CHAPTER 11
In Honor of Our Elders
One morning, Andrew Lanius, the prosecutor for the city of Hollywood, Florida, came into the courtroom to share an unusual case with me. “I have a case in another division that might be more suitable for your court,” he said. The case involved an elderly woman named Mary McCullough, who was living in an RV with no running water or electricity. She was charged with two se
parate misdemeanor counts of cruelty to animals for dogs, her pets, which were suffering from dehydration and malnourishment due, in part, to Mary’s living conditions. As I read through the details of the case, I wondered if I could also supply a referral to Broward County Elderly Services to assess the habitability and risk of harm for Mary. After all, the court has a long-standing relationship with Elderly Services, whose case managers do incredible work on behalf of vulnerable older adults.
“I was wondering if I could bring Ms. McCullough over to the court now, since she is in the building and has no transportation?” he said.
Even though I questioned the appropriateness of the case to my court since there was apparently no mental health finding, there was no harm in hearing what the defendant, Mary, had to say.
At the very least, perhaps the court could refer her to a service that would prove useful. “Sure,” I replied. “You can have her come over along with her attorney.”
Within minutes, the city prosecutor, the special public defender, and the defendant arrived. The prosecutor handed me a four-page arrest affidavit, two competency evaluations, and an order from the judge, which found the defendant, Mary McCullough, mentally incompetent to proceed. Ms. McCullough had been charged with two separate misdemeanors counts of cruelty to animals.
The allegations were disturbing. Animal control investigators alleged that Ms. McCullough lived in an RV camper without electricity and running water. The dogs had been observed by animal control officers to be severely malnourished and dehydrated and living without proper ventilation. Since that time, the dogs had been removed from Ms. McCullough’s residence and taken to emergency care.
“So, what is the problem?” I asked. “What is the city looking for this court to do? Shall I refer her to Broward County Elderly Services?”
“This case is a bit unusual,” said Andrew. “Ms. McCullough lives in an RV in the parking lot of a retail drug store. She is seventy years old, and the city does not wish to arrest her. We just want to her to find a decent place to live. But she refuses to leave her camper, which we believe is unsafe. We were hoping you could order her into treatment or something to resolve this situation. Additionally, we are concerned that she will bring more dogs into the RV.”
Since this wasn’t an obvious issue of mental health, I was unsure as to how the court could intervene in this matter and asked Mary McCullough and her attorney to approach the bench.
As they took their place at the podium, I introduced myself and explained to them the nature of the court. I emphasized that this is a court of social service.
“Can you tell me a little about yourself?” I asked Ms. McCullough.
I noticed that she was well groomed and stylish. Her blond hair was coiled into a neat bun. She was wearing a geometrically patterned retro-style dress that looked like what someone would have worn in the 1960s. She appeared to be a bright and gregarious character. She explained that she had been one of the first airline stewardesses in the United States to fly transatlantic flights for Pan American. She told the court that her life “was in the air.” She had never married and enjoyed living in her RV because, she said, she felt more secure in smaller spaces.
“What an exciting life you have led, Ms. McCullough! You are quite a pioneer for women in your field,” I said.
I asked Janis if she would take Ms. McCullough and her attorney outside in the hallway to speak to her about her needs and find out how she was truly faring.
When they returned, the hearing resumed. Janis took the lead.
“I have spoken with Ms. McCullough, who does not believe she requires any mental health services or social services of any kind. She explained to me that she is very comfortable in her RV. There is a bed area for her to sleep, and she purchases food and water from the drug store and does not wish to move.” Janis paused before adding, “Essentially, Your Honor, Ms. McCullough is an urban camper. If anything, her conduct may be viewed as eccentric. She has made a lifestyle choice—kind of like a hippie. She is a free spirit.”
I turned to Andrew Lanius, who had listened to Janis’s option. “Well, it appears that Mary is free-spirited,” I said. “What would you like this court to do?”
“Why can’t you order her to see a therapist or take medication?” he asked.
“That would not be legally appropriate. Even if there were a mental health condition, Ms. McCullough has the right to make her own healthcare decisions. Moreover, I do not believe you can medicalize every problem,” I replied.
“The city attorney is very concerned that she will acquire more animals once this case is closed. She refuses to agree not to bring more animals into the RV—otherwise the city would dismiss the case.”
Ms. McCullough’s special public defender, who worked for the city, stood to address the court. “I believe this case must be dismissed, Your Honor. The city cannot prosecute this case, and my client is not a danger to herself or others and not subject to involuntary treatment under Florida law.”
“Mr. Lanius,” I said, “defense counsel is correct. What can this court do?”
“All we are asking is that you work with her to ensure that she understands that she is not permitted to house animals in the RV and to help the city negotiate a more suitable place to live.”
This request seemed reasonable. I turned to the defendant, who still appeared as bright and gregarious as she had been when she first entered the court. “Ms. McCullough, are you listening to what the city prosecutor is saying?” I asked.
“Yes, Judge, but I love my dogs. I took good care of them, and I do not agree with the city.”
I understood the city’s concern. This situation was vexing and it was apparent that some sort of intervention was necessary. I just wasn’t sure what that intervention would be. It was clear that, without Ms. McCullough’s agreement to move out of her RV, the consequences of forced action by the city to evict her would leave Ms. McCullough homeless, and the experience would be extremely traumatic for her. Whatever was going to happen, it would be preferable to have Ms. McCullough join the decision-making process and take part in her own solution.
“Mr. Lanius,” I said, “doesn’t the city have housing resources and case managers you can contact to explore what supportive housing options may be available?”
“I’m not a social worker. I really don’t know the answer to that.”
“Counsel,” I said, “we are all social workers. It is part of the job.”
I agreed to keep the case and continue to work with Ms. McCullough to explore what housing options would be available. I asked Janis to check with Adult Protective Services to determine whether they had assessed this case and then set the next court hearing.
“Judge,” Mr. Lanius said quickly, “I am sorry, but I have already placed several calls for housing resources. No one in the city was able to assist me.”
The court was silent for a moment, and I considered the next course of action. I called a quick ten-minute recess to consider the available options.
When the court reconvened, Janis immediately said, “I was able to find out some information regarding Ms. McCullough.” Janis had found out that Ms. McCullough had a closed case with both Adult Protective Services and Broward County Elderly Services. Apparently, when the APS investigator and Elderly Services case manager went to check up on Ms. McCullough in her RV, she refused to let them in. Slamming the thin little door with the tiny square window and miniature blinds, she said firmly that she did not want their help.
“You know, Judge,” Janis added, “these agencies cannot provide services if someone refuses assistance.”
I placed my head in my hands. I wanted Ms. McCullough to know that we needed her cooperation to help resolve this situation before it turned into a crisis. I did not want her to end up living on the streets, like many other elderly adults without resources.
According to the National Coalition for the Homeless, the number of elderly adults at risk of homelessness has increased throug
hout the country.1 In 2016, the New York Times reported that according to the most recent data from the Department of Housing and Urban Development, homelessness among our nation’s elderly has increased by 20 percent.2 Per the report, from 2007 to 2014, there were 306,000 people over fifty living on the streets.3 In South Florida, the combination of a lack of affordable housing and deterioration of health and finances has led to a critical housing shortage. The Palm Beach Post reported in June 2014, “There are nine seniors waiting for every occupied affordable housing unit.”4 In Broward County, the need for affordable housing is equally dire. As of February 2017, the Broward County Housing Authority stopped accepting applications for Section 8 housing, noting that three thousand names are already on the waiting list.5
I lifted my eyes to look at Mary McCullough and sighed.
“Ms. McCullough, I am sorry, but you can’t stay in the RV,” I said. I hoped the empathy I felt somehow flowed into my voice so that I could communicate how much I understood and how difficult this was for her. “I know you think it is safe, but it isn’t.” I watched her face for signs to show me whether she agreed with me or not. I saw nothing to guide me, so I continued. “As a former flight attendant, you know better than any of us in this courtroom that safety always comes first. I know, with all of us working together—along with the social workers at Broward County Elderly services—we will find you a place to live that is not too large, with water and electricity so you can be comfortable and live with dignity.”
I waited for a response—a protest, maybe. Or a nod. Anything. When none came, I continued, “You deserve that, Ms. McCullough. And I am sure the city will dismiss the charges if you would agree to move out of the RV, move to safer housing, and do not possess dogs.”
Ms. McCullough took in a sharp breath and stood still for several seconds. I watched her facial expressions as emotions and thoughts flickered across her face. Concern, fear, hope: They resided in her eyes and on her cheeks for seconds before they flashed away with another thought or feeling. As I watched, the emotions settled, and she seemed to settle along with them. She might well have realized: This problem is not going away. And things can get considerably worse if the city intervenes and I do not agree to accept services. The life that she wanted would surely be taken away.