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In Miami-Dade County, untreated mental illnesses and substance use disorders aggravate our criminal justice system, exhibiting a substantial inadequacy in community mental health services.
Such negligence exposes individuals to danger and violates our obligations as a community. Prioritizing effective mental health solutions is essential for enhancing community safety and well-being.
The United States currently is facing a significant public health crisis related to mental health, which remains largely unaddressed at the national level. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 18 percent of the general population is affected by mental illness. In contrast, 44 percent of jail inmates and 37 percent of prison inmates experience mental health issues.
The Treatment Advocacy Center also estimates that approximately 383,000 individuals with severe mental disorders are incarcerated, a staggering figure compared to the number of state mental health hospitals, which is 10 times smaller. Insufficient investment in mental health leads to the criminalization of individuals with mental illnesses for behaviors such as trespassing, loitering, and disorderly conduct, even in the absence of violent crime.
In Miami-Dade County, the results are massive. The county spends nearly $848,000 each day — over $310 million each year — to detain around 3,200 inmates who require mental health treatment. The Miami-Dade County Jail is considered by many to be the largest mental health facility in the state of Florida. Around 9 percdnt of the county population suffers from serious mental health conditions, yet less than 13 percent of that population is treated in the county’s public mental health system. These statistics represent human suffering, stigma, and incarceration that is truly tragic, avoidable, and costly to the community in multiple ways. This financially and socially damaging circumstance is the wrong way to build community trust.
Miami-Dade also demonstrates what visible progress looks like. The Eleventh Judicial Circuit Criminal Mental Health Project (CMHP), established in 2000, has been nationally recognized for reform. The program moves participants suffering from serious mental health illnesses out of the jail cycle and into treatment and housing. Since the program was initiated, the county’s daily jail population has dropped from almost 7,000 to about 4,000. One jail has been closed entirely, resulting in significant savings of over $120 million for taxpayers.
Participants of the program experience a reduction of over 75 percent in jail bookings and jail days. The recidivism rate for participants who complete the program is just 6 percent.
That is not just compassion in action — it is smart public policy.
The achievements are not limited to the courts. Miami’s Crisis Intervention Team program has trained over 5,000 law enforcement officers on the safe and effective handling of psychiatric crises. These officers responded to over 10,000 crisis calls in the last year, diverting 1,900 people to treatment facilities and making only 24 arrests. This is a remarkable change from the late 1990s, when tragic, fatal confrontations between police and people with mental illness were all too frequent.
Miami-Dade plans to expand its mobile crisis teams and co-responder units, which will be rolled out by 2025. These units will place mental health professionals alongside police or clinicians on their own. These teams routinely provide on-site de-escalation to provide psychiatric assessments and connect people to mental health care, saving many from arrests and unnecessary hospitalizations.
Freedom House Mobile Crisis Team, which has public and private funding of over $2.2 million, now provides support seven days a week. The impact is remarkable. During calls, co-responder teams initiated the Baker Act to impose psychiatric holds only 30 percent of the time, down from 90 percent. Community-based interventions contributed to a 19 percent decrease in unsheltered homelessness in Florida.
For those who doubt the financial soundness of community-based models, data from Miami makes a strong case against them. The Florida Department of Corrections says that it costs taxpayers about $28,861 a year to keep someone in state prison. The cost of keeping someone in Miami-Dade County jail is even higher.
Providing supportive housing with wraparound behavioral health services, on the other hand, costs about $20,000 per person per year (Council of State Governments Justice Center, 2019). This investment pays off in real ways. Miami-Dade’s program cut jail time for participants by 76 percent, saving the county about $12 million a year and showing that community care is both a more humane and cost-effective way to go (Leifman, 2021).
However, the challenges remain significant. Miami’s behavioral health system still has unfilled positions, volatile funding, and siloed, uncoordinated datasets across agencies and systems. Baker Act initiations are very concerning for law enforcement, especially around racial equity issues. Many people circulating through the system dozens of times with no followup care, housing, medications, or a release plan contribute to that. Some self-service crisis options, such as crisis response or phone systems, have experienced budget-driven changes in availability. For the positive changes to last, a commitment to permanent, comprehensive, and integrated funding of these unmet service gaps is essential.
The question is no longer whether Miami can afford to invest in these things. It is whether we can afford not to. We are already spending hundreds of millions of dollars annually on a punitive system that’s failing everybody. The ethical and economic case for care is evident. Every person diverted from jail into treatment is a victory — for them, for their families, and for our community.
Mahbub Bhuyan is a behavioral health professional and social science researcher specializing in mental health policy and criminal justice reform. He writes on issues at the intersection of public health, governance, and community well-being, advocating for evidence-based approaches that prioritize care over incarceration.
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