CHAPTER 13

A Crying Shame

Derrick Brown and his father, Tyrone, stood before the bench at a status hearing to review Derrick’s community placement. At twenty-two years old, Derrick was intellectually disabled and had been diagnosed with attention deficit hyperactivity disorder (ADHD). He’d just been released from the Miami-Dade County jail, where he had been held after a series of elopements—running away—from residential treatment centers to which he had been ordered. I didn’t understand why the judge decided to release Derrick to his father’s care. Tyrone Brown had just been released from prison after serving twelve years for robbery and hadn’t seen his son for well over a decade. Perhaps the judge didn’t realize that Derrick would need specialized care for his condition, or perhaps he didn’t realize that Derrick’s father would be incapable of providing that level of care, given his limited resources and experience as a parent.

The last time Tyrone Brown had seen his son, Derrick was a ten-year-old boy who loved to play basketball and video games and do all the other sorts of things one would expect a young boy to do. To Derrick, his father was a stranger, a reminder of lost childhood memories, of holidays and birthdays. Perhaps Tyrone appreciated this—or perhaps not. Derrick, however, stood close to his father as if he were a lifeboat and the court, an endless ocean. For Derrick, his father was one of two adults he trusted, a trust that had formed through the father-son bond, as tenuous as that was.

“It is nice to meet you, Mr. Brown,” I said. “It was good of you to be here today.”

Tyrone Brown lowered his head and stood remorsefully before the court. Although he was not the subject of the hearing, one would have thought, seeing his body language and other nonverbal communication, that he was the one facing a tribunal for punishment.

“Judge,” Mr. Brown said, “I have failed my son, my family, and, most of all, myself. I have come to ask for the court’s forgiveness and help. The last time I saw my son . . . he was very different. I have been away in prison for so long. I feel like I am living on another planet. I don’t know how to operate a smartphone. I have no idea how to transact for basic services, and I do not have a steady job. How could I possibly take of my disabled son when I can barely take care of myself?”

“I understand, Mr. Brown,” I said. “I do not believe that the judge who released Derrick to your care had been properly informed about Derrick’s special needs.”

Derrick had been referred to the mental health court three years before on a charge of trespassing and possession of cannabis. Since that time, the court had made numerous attempts to secure an appropriate community placement for Derrick. So far, every placement had failed, and Derrick had often run away.

For the past six months, Janis had been monitoring Derrick at a group home in Miami-Dade. We had been told that everything was going well when, in truth, Derrick had been cycling in and out of jail in various locations in Florida. It took a great deal of effort, but we had finally gotten Derrick back to Broward County.

At this point, the court was at a loss. Derrick’s impulsive behaviors had proved too much for even the most experienced program administrators in Broward County, including Dr. Samuel Kelly of Dynamic Health Care. In the past, every time the court requested help to divert Derrick out of jail, Dr. Kelly had always stepped up to the plate. This time, however, he asked the court to allow him to step out. Ansom Phillips, the criminal justice liaison for Florida’s Agency for Persons with Disabilities, was also present at the hearing.

Dr. Kelly opened by saying, “Judge, I asked for this hearing because I am greatly concerned about the health and welfare of Derrick who has been placed in one of our therapeutic group homes.”

“Can you be more specific, Dr. Kelly?” I asked.

“Yes, Your Honor. We care about Derrick very much. At this point, I believe our program has exhausted every reasonable behavioral approach and strategy available to us. To sustain Derrick in our program, the state provided him a mental health technician to support him on a one-to-one basis. This means that this staff person’s sole responsibility is to support and assist Derrick. Yet this strategy has not been effective. Derrick has walked away from the program each day. As you know, this is not a locked facility. Staff cannot legally force him to stay or restrain him. Our case management team believes that he is more interested in walking around the neighborhood in search of drugs than he is on working on his rehabilitative goals.”

“Judge,” Ansom Phillips interjected, “in anticipation of this hearing, I have contacted the director of the Agency for Persons with Disabilities for assistance in identifying a group home which is equipped to manage Derrick’s intellectual and behavioral challenges anywhere in the state of Florida.”

As Derrick listened to the discussion surrounding his fate, he became increasingly agitated.

“Miss Ginger, I want to stay with Dr. Kelly,” he said. “I’ll be good—please, Judge Ginger.”

As Derrick’s pleas become louder and more intense, I covered my face with my hands, as if that would shield me from the emotional intensity of the hearing. It was difficult to witness Derrick on the verge of tears, pleading for the only life he’d known. I wondered when—or if—a solution could be found. I told myself over again in a silent mantra, Every problem—no matter how vexing—has a solution.

I directed my attention to Mr. Phillips. “What do you propose?” I asked.

“In my view, the search for an appropriate residential placement for Derrick must be widened,” he said. “In the meantime, Derrick is at risk. His elopements have led to at least half a dozen arrests in two different counties. I cannot ask Dr. Kelly to continue to try to maintain Derrick in his program. We must consider the other clients who reside there, who are vulnerable. I also believe, based on Derrick’s behavioral pattern of elopement and substance use, that he is at significant risk of victimization by adults with criminogenic behavior. I believe he should be remanded to the jail for his safety and the agency should expand its search for community placement.”

“I am very concerned about this proposal, Mr. Phillips,” I replied. “This court is dedicated to decriminalization—putting Derrick in jail is not consistent with the values of the court. There must be some other alternative than jail.”

“If I may,” Janis said. “We need to be objective about how we respond to this dynamic. Derrick will not meet criteria for hospitalization. I know this is a terrible situation—but someone could get hurt or worse.” Janis paused and crossed her arms over her chest before releasing a deep sigh. “I don’t think I need to remind you about the recent shooting in North Miami, which involved a case manager of a young man with autism who walked away from his group home. When his case manager ran after him, the police received a call about a man with a gun. It was tragic! There was no gun—it was a toy truck. The case manager knew that his client loved trucks, and he carried one to help stop him from running. Somehow, the police mistook the toy truck for a gun and shot the case manager. Fortunately, he survived. But the young man with autism was traumatized and ended up institutionalized.¹ This incident was devastating for everyone. We don’t want something like this to happen to Derrick or his caretakers.”

“That’s very true, Janis,” I said quietly. “We do not want to invite tragedy.”

As I contemplated the possible solutions I could offer Derrick, my mind wandered to the recent Miami-Dade County shooting of twenty-five-year-old Levar Hall. According to news media reports, Mr. Hall’s mother had called the police because Levar (who had been previously diagnosed with schizophrenia) had been behaving erratically. She told the 911 dispatcher that her son had just been released from a psychiatric unit and was not stable. When the police arrived, they found Levar Hall armed with a broomstick. He was shot and killed when he failed to comply with police commands.² As difficult as it was, I knew I had no choice but to concede that tragedies surrounding police encounters can occur. Until an appropriate home for Derrick could be found, he would be safest in jail.

“Judge,” Ansom Phillips said, “I will do everything I can to locate a more appropriate placement for Derrick as quickly as possible.”

I glanced at my court deputy as he instructed Derrick to take a seat next to the jury box. Derrick understood what was happening to him and began to shout, “Judge, I’ll be good—I’ll listen!”

I did my best to reassure him that he would not be staying in jail for very long and that we were going to find him a place to live where he would be happy and safe.

“No, Judge, I want to live with my father!” Derrick cried. His voice, desperate, was weighted heavily with loss.

I scanned the courtroom for Tyrone Brown, but during the hearing Derrick’s father must have quietly slipped out. He had not said goodbye to his son or tried to comfort him. Unable to emotionally absorb what had become of his son and not able to help, I suppose Tyrone Brown thought it best to leave.

I could not imagine what Derrick was thinking when he, too, noticed that his father had left him there in the courtroom to fend for himself against people he hardly knew—and against an uncertain future. Children of incarcerated parents have difficulty trusting others, including their parents, once they emerge from behind bars. For Derrick, it must have been heartbreaking to have invested trust in a father he’d hardly known and to have been rejected so cruelly, so suddenly, and so publicly. The courtroom’s silence reflected my wordless shock back to me. The truth is that for Derrick and other young minority men referred to the court, the social determinants of where one was born and raised, what kind of adversities were experienced in childhood, including poverty and parental neglect—all of these intersect in the criminal justice system.

To date, statistics across the country reveal that the majority of incarcerated teenagers and adults are from minority populations in the lower income bracket. It’s no surprise, therefore, that the complex relationship between racial and class bias and disparities in health, in a highly fragmented and underfunded mental health system of care, often frustrates the court’s goals to extend services to those who need them most. Instead, system limitations coupled with negative cultural attitudes place obstacles in the way of breaking the cycle of arrest, leaving substandard housing, poor education, adverse childhood experiences, neglect, exposure to violence, and incarcerated parents to give rise to behavioral problems that a community-based approach could, in time, ameliorate.³

Currently, more than 2.3 million people are incarcerated in our nation’s jails and prisons.⁴ Approximately 50 percent of all inmates in US jails and prisons are black, although they make up less than 13 percent of the population.⁵ More startlingly, one in six inmates has a diagnosable mental illness.⁶ The development of an accessible and culturally competent system of mental-health-care delivery is essential. Research reveals, however, that the development of health policy is often the responsibility of those with little representation of the black population or health professionals who are knowledgeable of the culture of African American communities, committed to their well-being. ⁷

In 2001, the US surgeon general, David Satcher, published Mental Health: Culture, Race, and Ethnicity, a supplemental report to the landmark 1999 report Mental Health: A Report of the Surgeon General. The supplemental report responded to the fact that although the United States is a diverse nation, rich in “incalculable energy and optimism,” it is essential to emphasize the point “that all people do not share equally in the hope of recovery.”⁸ As the surgeon general stated in the 1999 report, “Even more than other areas of health and medicine, the mental health field is plagued by disparities in the availability of and access to its services. These disparities are viewed readily through the lenses of racial and cultural diversity, age, and gender.”⁹

The supplemental report also documented the existence of disparities that impact the mental health care of racial and ethnic minorities compared to nonwhite populations. Findings include a lack of access to and availability of mental health care and services. Further, even if mental health care is secured, the care is often of poor quality. According to Satcher, minorities are overrepresented among the nation’s most vulnerable populations, minorities have higher rates of mental health disorders, and the “burden for minorities is growing.”¹⁰

What happens when rehabilitative programs, services, and supports are not available? For many people—depending on their level of care needs, culture, and other psychosocial factors—sometimes what is being offered in mental health courts holds little relevance for lives that have drifted off course. This, paired with family dysfunction or economic struggle, makes not only locating care but truly engaging in care extremely difficult. Ken Marks, the young baseball player, had the support of his parents to assist his journey toward recovery. Derrick—like many other young people without caregivers—was forced to face his journey alone, leading to a life trajectory filled with trauma and adversity.

Watching Derrick stand before the bench after his father had abandoned him illustrated what the research has clearly shown: without necessary family and community supports, recovery from mental health and behavioral health problems is a nearly impossible struggle.

Kelvin Wesley grew up in Fort Lauderdale. He had been a stellar athlete, excelling especially in the 400- and 800-meter races in track and field. He had been arrested for the offense of criminal mischief. According to his arrest affidavit, Kelvin allegedly threw a rock through a store window. Kelvin had been referred to mental health court by his public defender.

Kelvin appeared in court accompanied by his mother. Janis spoke to his mother prior to the hearing. Mrs. Wesley explained that Kelvin came from a large family that was deeply involved in their church. His mother had raised three other children and worked two jobs. “I do the best I can,” she said in her meeting with Janis. She worked as a home health aide for two separate organizations, which meant she often had to work nights.

“Kelvin was always a sweet boy and a hard-working athlete. But by Kelvin’s junior year in high school, his attendance started slipping,” Mrs. Wesley explained. “It was heartbreaking. He was being considered for a full scholarship to a major university. Scouts had watched him run and wanted him on their team.” She explained that he had gotten into the wrong crowd and experimented with drugs. After that, he was not himself.

Mrs. Wesley paused and shook her head. Her eyes seemed to focus on the wall behind me. “He never understood why he didn’t have a father,” she said quietly. “His father left me before Kelvin was born. He wanted nothing to do with his child.” The words hung in the courtroom air, before she continued her account. Mrs. Wesley had attempted several interventions with the help of their pastor, but they could not convince Kelvin to get help.

Pretty soon Kelvin had been arrested for grand theft. He dropped out of school before graduation. He lost any hope of getting a college scholarship and began to engage in activities that led him into the criminal justice system.

Now, as the deputy escorted him into the courtroom, Kelvin grinned at me and nodded his head in greeting. I nodded in return.

“Judge,” his public defender, Mitchka Bavandi, said, “I met with Mr. Wesley in the jail, and he is highly motivated to participate in the court.” I listened to Mitchka advocate on her client’s behalf. “Mr. Wesley stated that he had never had the benefit of any kind of mental health or drug treatment.”

I introduced myself and explained the court to Kelvin. I noticed that he seemed unusually engaged in the court process. “Could you and your mother join Janis and me at the bench?” I asked. “I will need your assistance in helping the court understand your background.” Kelvin and his mother approached the bench.

“Mrs. Wesley,” I asked, “has your son ever been evaluated by a mental health professional?”

“Yes, Judge,” she said. “Kelvin was Baker Acted several years ago, when he became unmanageable and was behaving strangely. The doctors kept him in the hospital for several days and then referred him to the Henderson Behavioral Health Center. He was diagnosed with schizo-affective disorder, but Kelvin never followed through with his appointments.”¹¹

I had a gut feeling that Mrs. Wesley was holding something back. I understand it can be difficult to talk about sensitive family matters, but if Kelvin was going to participate in the court, I needed to understand his issues and areas of risk.

“Do you ever have any concerns about your safety or the safety of the other children in the house?” I asked.

Mrs. Wesley looked uncomfortable. Later, I would learn that she had not told Janis in their meeting that at times Kelvin acted out in anger.

“Judge, I generally have no problem with Kelvin. He is a good son,” she said, choosing her words carefully. “But when he does drugs, he gets angry and I lock myself in the bedroom. I would say that he can, at times, have an anger problem.”

Perhaps because of the look on my face, or her wanting to soften the blow of the news that her son could be violent enough that he scared her, but she added in a quiet voice, “He never had a father.”

I calmly asked Janis to come to the side of the bench. I felt a need to talk to her discreetly. I wanted to work with him in the court, but his criminal history was serious and his anger issues raised concerns about risk. After a brief discussion, Janis suggested that we give him a chance. However, she was also concerned about his anger and the potential risk to his mother and other family members in the home. She recommended a residential program that offered treatment for mental health and substance use disorders. “If he is willing,” Janis added.

As I discussed Janis’s recommendations with Kelvin, he balked. He wanted to resolve his case and return home. I explained to him that the court was voluntary and this was the treatment plan that the court clinician believed that he needed. I explained to him that it was his choice. He did not have to participate in the court. If that was his choice, I would transfer his case back to the assigned division.

After much discussion with his public defender, Kelvin was still vacillating.

“Mr. Wesley,” I said, “the choice is yours. I would only suggest that if you need mental health and drug treatment, you should get it. The research is well settled that untreated mental illness leads to several negative consequences, including addiction and incarceration. You are already being impacted by untreated mental health problems. Perhaps it’s time you take a therapeutic approach and change your life. You deserve a healthy life. I heard you are a great athlete.”

I never expected Kelvin to agree with me. He seemed confident in his position that he did not need help. To my surprise, however he said, “You know, Judge, no one has ever said that to me before. I want to try.”

“That is a great choice,” I said. “May I call you Kelvin? It’s going to take a few days or so to secure a bed for you. Are you OK with that?”

“I am, Your Honor,” he replied. “I want to go back to school and start running track again.”

Mrs. Wesley, overcome with relief that perhaps there was hope, began to sob.

Within a few days, a bed became available. Kelvin appeared at the status hearing and we reviewed the order for his conditional release. He had agreed to successfully participate in the residential treatment program and abstain from any alcohol, intoxicants, or drugs. He would follow his mental health treatment plan. I explained to him that if any problems arose, to please tell the staff, who would request an immediate court hearing to review, and possibly change, the plan. I instructed Kelvin that he could not leave the program without court permission. Kelvin stated that he understood and agreed. The court staff was proud of his choice, particularly Mitchka, his public defender, who believed in him and patiently listened as he processed his decision whether to engage in care.

Less than twenty-four hours later, I received a text from JoAnne, my judicial assistant.

The clinical director of the program reported that at 9:00 p.m., Kelvin had jumped over the fence and absconded from the program.

I couldn’t believe it.

In shock, I realized that he had not stayed at the facility for one day. I issued a writ for his arrest for violation of the conditional release order. Someone had to call his mother. Janis volunteered, since she had spent the most time with her and had the counseling skills to soften the blow.

At the next court hearing, there was no word of Kelvin and his whereabouts.

There was, however, positive news about Derrick. Janis reported that Ansom Phillips had phoned her to tell her that the Agency for Persons with Disabilities had identified a behavioral program for Derrick. It was in a rural part of Florida, where there was green space for Derrick to get out and enjoy recreation. Mr. Phillips and Dr. Kelly had reviewed the program and agreed that it was appropriate to meet Derrick’s behavioral needs. Also, they felt that Derrick would be less likely to run away in a rural area.

A court hearing was convened, and we shared the news with Derrick. Like all of us, he was pleased that he would be leaving the jail system, but he wondered why his father had not visited him or come to court. Dr. Kelly explained to him that his father was doing the best he could to get settled and adjust to his new life outside prison, and that Derrick needed to do the same.

As the court continued follow Derrick’s progress in the new program, we were delighted that, so far, he had not run away and seemed to be engaged in care. The reports included that he had developed a passion for basketball and had made progress in other functional areas. The court staff expressed relief that he was safe, had remained at the program, and had not been re-arrested. We considered this new program a significant and transformative shift in Derrick’s life.

After I left the courthouse that afternoon, I drove toward downtown Fort Lauderdale to run a personal errand. As I stopped at a light at a busy intersection, I happened to glance to the left, and I spotted Kelvin. He was standing on a corner waiting to cross the street. He appeared clean and was dressed in fresh clothes, which made me think that perhaps he had returned home to his family. I didn’t know what to do. Part of me wanted to lower my window and ask him why he left the program. I wanted to know why he was intent on ruining his life.

Instead, I immediately turned my head away to avoid eye contact with him. I wasn’t sure that he would have recognized me, but I didn’t want to take a chance. I couldn’t predict what he would do if he did recognize me. I remembered how his mother had explained that he was “sometimes angry”—so much so that she locked herself in her bedroom in her own home. Kelvin had always appeared so calm and put together in court. Yet there was another side to him that I was sure I didn’t want to see.

I thought about the people who had participated in the court whom we have helped, so many people. And yet, we cannot help everyone. Sometimes life experiences, trauma, and neglect become such large barriers that there aren’t programs available to treat the years of broken thoughts and hearts. Kelvin, though, was young. He had so many strengths that he could have activated had he given the program a chance.

Four months later, Len Swadlow, the prosecutor in mental health court, informed me that Kelvin Wesley had been arrested, this time on felony charges for the sale and distribution of narcotics. I thought about his mother, how relieved she had been when she thought that help had finally arrived. In that moment she believed that her son, the track star, was going to be OK.