1963 Report of Subcommittee on Mental Health, Florida Legislative Council File contributed for use in USGenWeb Archives by Betty Mae James Smith, BettyMaeS@aol.com USGENWEB NOTICE: In keeping with our policy of providing free information on the Internet, data may be used by non-commercial entities, as long as this message remains on all copied material. These electronic pages cannot be reproduced in any format for profit or other presentation. This file may not be removed from this server or altered in any way for placement on another server without the consent of the State and USGenWeb Project coordinators and the contributor. *********************************************************************** FLORIDA LEGISLATIVE COUNCIL COMMITTEE On STATE INSTITUTIONS FINAL REPORT of the SUBCOMMITTEE ON MENTAL HEALTH (Copy Reproduced by FLORIDA STATE ARCHIVES DEPARTMENT OF STATE R. A. GRAY BUIDING Tallahassee FL 32399-0250 Series 19 Carton 219) ------------------------------------------------------------------------ In the final report of the Committee on State Institutions to the Legislative Council in January 1961) the Committee recommended that state institutions be more selective in the hiring of personnel so that eventually the quality and standards of professional services would be upgraded; that the Committee be authorized in the 1961-63 biennium to study the feasibility of establishing a psychiatric hospital at Raiford State Prison; and that the Subcommittee on Mental Health be extended additional time to complete its investigation of press allegations relative to conditions at Florida State Hospital. On the final day of the 1961 Legislative Session, the Subcommittee completed its assignment, and the Committee on State Institutions released a 14 page report with findings and recommendations. Concurrently with the activity of the Legislative Council, the Legislature indicated its desire to have a more comprehensive picture of the State's Mental Health Program by creating the Governor's Advisory Committee on Mental Health with an appropriation of $35,000 to make a comprehensive survey of Florida's Mental Health Program to insure that it is being effectively, effeciently and economically operated. The Committee on State Institutions for the 1961-63 biennium held its organizational meeting in Gainesville in the fall of 1961, and at this meeting, it reconstituted the membership of its Subcommittee on Mental Health and instructed the Subcommittee to continue the study begun by the previous Subcommittee and to report back to the Committee with its recommendations. The Subcommittee held six workshop meetings throughout the State: two in Tallahassee, two in Orlando, and one each in Sarasota and Miami Beach. The Subcommittee studied the report of the previous Subcommittee, and after meeting with the heads of the Division of Mental Health, Child Training and Sunland Training Centers, it found that many of the recommendations contained in the report were being carried out. Specifically, the following were either completed or in the process of being put into effect: 1. the appointment of personnel directors, 2. 40-hour work week, 3. improved orientation and training course for psychiatric aides, 4. a minimum of two psychiatric aides on each ward of the State Hospital at all times, and 5. a personnel position classification and pay plan for employees. (The classification and pay plan are included in the budget requests to the 1963 Legislature.) After examining the 1961 law which provided that the Sunland Training Centers be separated from the Division of Child Training Centers, the Subcommittee found this law was not carried out as intended by the Legislature. The Subcommittee was advised that this provision was not put into effect because no funds were appropriated to employ an additional director and staff for the operation of a central office of the Division of Sunland Training Page -2- Centers, and the present Director of the Division of Child Training Centers has had to act in the dual capacity as Director of the Divisions of Sunland and Child Training Centers. To correct this, the Subcommittee recommends that section 965.03, Florida Statutes, relative to the establishment of two separate divisions of sunland and child training schools be implemented and that an advisory council be appointed by the Governor to work with the Division of Sunland Training Centers, and that section 965.03, Florida Statutes, be further amended to provide that no division director shall be concurrent head of more than one division. The Subcommittee also found that the 1959 law providing for the establishment of a 48 bed children's psychiatric hospital in Broward County still has not been implemented because the appropriation request of one million dollars for construction has not been granted by the 1959 and 1961 Legislatures. It should be emphasized that a facility for the treatment of psychotic children has been recommended by legislative committees since 1955, and due to the continually increasing number of children in need of psychiatric treatment, it is now imperative that appropriations be provided for this purpose. The Subcommittee, therefore, recommends that two units for psychiatric children be constructed, one at Gainesville on a first priority basis, and the other at the South Florida Hospital on a second priority basis, with a prospective patient's ability to pay not being considered as a criteria for admission. The child psychiatric in-patient unit at the University of Florida would be a research center and part of the training program for psychiatrists, neurologists, surgeons, interns, etc., and it would serve two purposes: 1. provide facilities for continuing research Page -3- into the problems of the psychotic child, and the State of Florida would have its own source from which to draw competent persons trained in the field of child psychiatry and related fields, ( at present, there is a shortage of such personnel ),and 2. the facility would serve as a pilot program for the future establishment of larger institutions for the care and treatment of psychotic children. The unit at the South Florida Hospital would be used for diagnostic and clinical purposes. In accordance with the instructions of the Committee on State Institutions there has been a careful study of the possible removal of child molesters and sexual psychopaths from the Florida State Hospital to some undetermined location somehwere within the proximity of the proposed treatment center at Lake Butler, the medical school at the University of Florida, and the hospital for the mentally ill at Macclenny. At the present time, there are approximately 450 charge patients confined in state mental hospitals. The presence of many of these presents an extremely difficult situation in existing facilities insofar as proper treatment is concerned. The most difficult patients are the non-psychotic child molesters and the criminal sexual psychopaths. In the recent study of mental health services in Florida conducted by the American Psychiatric Association, it has been recommended that this type should not be the responsibility of the state mental hospital, but should receive proper treatment within the Division of Corrections. The Subcommittee finds that there are still many questions which must be answered before it can make an informed decision recommending the location and an appropriation to make possible the transfer of such patients from Florida State Hospital. It is estimated that the cost Page -4- for such a facility may range from $2,500 to $3,000 per bed and possibly higher depending on location, whether new facilities are provided and other factors. The Subcommittee is still in the process of studying legal problems in connection with the transfer of these patients, and because of the inconclusiveness of its findings at this time would like to recommend that the Committee on State Institutions request that the Legislative Council give the Subcommittee additional time to complete its study of this problem. The 1959 Legislature authorized the combining of the mental health facilities at Dorr and Carlstrom Fields into one facility at Carlstrom. At present, one of these facilities is being used by the hospital and the other is practically going to waste. It is the general concensus of the authorities concerned with their operation that the needs of the State could best be served by transferring all patients from Dorr Field to Carlstrom Field, and that Dorr Field be converted into a minimum security prison. The distance between the Dorr and Carlstrom Field branches of the G. Pierce Wood Memorial Hospital in Arcadia is approximately sixteen miles. There is a direct cost of $295,000 per biennium that is due to travel between the facilities and duplication of services. By housing hospital patients at Carlstrom Field, not only will standards of care and service be greatly improved and large savings effected, but a badly needed minimum security prison can be provided by converting the vacated Dorr Field branch at a minimal cost. The Divisions of Mental Health and Corrections are in agreement that this should be done. The Subcommittee gives its full endorsement to the above suggestions, and in addition recommends that new laundries be provided at Dorr and Carlstrom Fields. Page -5- In the area of child training) there is a serious need for an "After-Care" Program which would be responsible for examining the backgrounds of children while in the training center) and upon release from the center, would provide proper supervision for children while readjusting to life in the community and also other assistance such as help in finding employment and advice in handling problems confronting them. Presently, these children are being returned from the industrial schools to the same environment which may have been responsible for their delinquency, and because of their inability to adjust to these conditions, they eventually become candidate for admission to Raiford State Prison. The Subcommittee feels that if an "After-Care" Program for juvenile delinquents was initiated in Florida many of the States juvenile delinquency problems would be resolved, a large number of these children would be given an opportunity to develop as useful citizens, and in the long run, the Program would net the State a tremendous savings in costs, both in the Child Training Centers and in the State Penitentiary. The Subcommittee, therefore, recommends that an "After-Care" Program for juvenile delinquents be instituted by the 1963 Legislature. In recent years, Florida has received national recognition because of its fine program for the mentally retarded. Presently, there is no known cure for a person who has become mentally retarded; at best, the most that can be expected is maximum development through training and rehabilitation within the limits of the individual. However, the real opportunity for achievement lies with the ultimate prevention of mental retardation through research. Florida is fortunate in having a physician on the staff of the Orlando Training Page -6- Center who is recognized nationally for the outstanding research he has done on mental retardation; who is dedicated to the welfare of mentally retarded children; and who, because of his reputation, has been responsible for attracting nation-wide grants and donations from private foundations and governmental agencies in the form of money, medical equipment and medical supplies representing a total market value of approximately $400,000. There is some speculation that the fine research being conducted by the small staff at the Orlando Center has resulted in a breakthrough which could lead to the eventual removal of mental retardation. It is the consensus of the members of the Subcommittee that continued research on mental retardation should be given the greatest possible encouragement, and that there is real need for the establishment of a research center for the mentally retarded which could be accomplished at a very nominal cost. The creation of such a center would be helpful in attracting physicians and research personnel to the state, and Florida would be eligible to receive much larger grants from foundations and governmental agencies. The Subcommittee, therefore, recommends that there be established in this state the Florida Medical Research Center for the Mentally Retarded to be located at the Sunland Training Center at Orlando. The Governor's Advisory Committee on Mental Health contracted with the American Psychiatric Association (APA) to make a complete study of Florida's Mental Health needs. The APA completed its preliminary survey report late in February, 1963,but as of March 21, 1963, the final detailed report has not been completed. Consequently, this Subcommittee will not be afforded the opportunity to study the report in time to make any recommendations on it for Page -7- the 1963 Legislative Session. RECOMMENDATIONS: 1. ESTABLISH A CHILD PSYCHOTIC IN-PATIENT UNIT AT THE UNIVERSITY OF FLORIDA ON A FIRST PRIORITY BASIS, AND APPROPRIATE ON A SECOND PRIORITY BASIS, THE FUNDS FOR THE CONSTRUCTION OF THE 48-BED PSYCHIATRIC HOSPITAL IN BROWARD COUNTY WHICH WAS APPROVED BY THE 1959 LEGISLATURE. 2. ENLARGE THE CARLSTROM FIELD BRANCH OF THE G. PIERCE WOOD MEMORIAL HOSPITAL IN ARCADIA TO RECEIVE ALL MENTAL PATIENTS PRESENTLY HOUSED AT THE DORR FIELD BRANCH AND CONVERT THE DORR FIELD FACILITY TO A MINIMUM SECURITY PRISON. 3. INSIST THAT SECTION 955.03, FLORIDA STATUTES, PROVIDING FOR THE ESTABLISHMENT OF SEPARATE DIVISIONS OF SUNLAND TRAINING CENTERS AND CHILD TRAINING SCHOOLS, BE IMPLEMENTED; THAT AN ADVISORY COUNCIL BE APPOINTED BY THE GOVERNOR TO WORI~ WITH THE DIVISION OF SUNLAND TRAINING CENTERS; AND THAT SECTION 965.03, FLORIDA STATUTES, BE FURTHER AMENDED TO PROVIDE THAT :INO DIVISION DIRECTOR SHALL BE THE CONCURRENT HEAD OF MORE THAN ONE DIVISION. 4. ESTABLISH AN "AFTER-CARE" PROGRAM FOR JUVENILES TO BE RELEASED FROM CHILD TRAINING SHCOOLS. 5. PROVIDE FOR THE ESTABLISHMENT OF THE FLORIDA MEDICAL RESEARCH CENTER ON MENTAL RETARDATION TO BE LOCATED AT THE SUNLAND TRAINING CENTER AT ORLANDO. Page -8-