For more than 15 years, the number of children who are referred for involuntary psychiatric evaluations under the Baker Act has increased at a faster pace than any other age group. The law was not designed to be used on children and many child advocates are pushing for change. They say there should be provisions to ensure children are treated differently than adults. In the fifth and final part of this series on the Baker Act, we examine the challenges faced by advocates who want to improve the law.
Florida’s law regarding the involuntary commitment of children for psychiatric treatment under the Baker Act is applied inconsistently.
The law says three factors have to be present to initiate an involuntary mental health exam on anyone in the state. First, an individual has to refuse a voluntary exam, or be unable to determine for themselves if one is necessary. Second, there has to be a reason to believe someone is mentally ill. And finally, the person must be deemed likely to harm themselves or others.
But when it comes to children, there’s a problem: Minors cannot legally consent to a medical intervention or determine if an exam is necessary.
“All three must be met. Not one, not two," says Diane Stein, head of the Citizens Commission on Human Rights. "Yet this is consistently violated by mental health professionals, law enforcement and others who are given the power to take a person into custody.”
The commission, commonly called CCHR, is affiliated with the Church of Scientology, which has long held an anti-psychiatry position.
It’s also the organization Beth Carr reached out to when her 15-year-old son was sent for an involuntary psychiatric examination in 2016.
“I’m not a Scientologist," Carr said. "I’m a Christian. But CCHR was there. I found them online. And they told me who I needed to call and what I needed to do."
Carr credits the group with helping her get her son back.
Stein says the commission operates independently of the church. The organization has been working for years to advocate for parents and help them through what are often traumatic experiences with the Baker Act.
I see a lot of unaddressed needs. I see a lot of missed opportunities. Rhonda Blackwell-FlanaganThe group has also been pushing to get more clarity and consistency in how the law is applied.
For example, Florida law states parents have to be notified before a Baker Act is initiated, but that doesn’t always happen. The law says family members and friends should be allowed to intervene in some instances, but Stein said that’s often overlooked or ignored as well.
"Unfortunately, whether it’s due to the law being used as a disciplinary tool, or a misguided attempt to create a sense of safety — specifically in our schools — this law is being abused and parents are being left out of the process," Stein said.
When Beth Carr’s teenage son was committed under the Baker Act, she got the call as he was being taken from school.
Martina Faulk, whose 6-year-old daughter was Baker Acted in February, was also informed as her child was being transported. Faulk's attorney, Reganel Reeves, said Faulk should have been afforded the opportunity to get her daughter.
“They should have given the mother the opportunity to come and intervene," Reeves said. "And if they said hey, your child is suspended, or she may need some type of evaluation, or we need to have a meeting … but let’s try to remedy the problem.”
And though Beth Carr has acknowledged the Baker Act serves a purpose, she said there should be a way to mitigate the harm.
The Baker Act is specific to Florida, yet a form of it exists in most other states. Not every state is as restrictive when it comes to parental rights.
At least one state is doing it well, said Michael Shapiro, head of the North Central Florida Branch of the American Academy of Child & Adolescent Psychiatry. Shapiro has studied Pennsylvania's law, which allows children over a certain age or their parents to consent to mental health evaluations.
“If you are 14 or above, either the parent or the kid can say you have to go to the hospital," Shapiro said. "And the doctor can go with either one. And the idea is basically, let’s err on the side of helping kids.”
Under Pennsylvania's law, if neither the parent nor child consents, then all of the Baker Act requirements would have to be met in order to initiate an involuntary psychiatric exam. Shapiro believes if Florida made its law similar to Pennsylvania’s, it could cut down on unnecessary referrals.
A 2017 task force report on the involuntary referrals of children under Florida's Baker Act found that one-third were unnecessary.
For years, Florida legislators — Democrats and Republicans — have filed bills to improve the law. And there have been some changes.
The state has put more money into mobile response teams. Those teams use psychologists and psychiatrists to determine involuntary examinations. They’re meant to take the pressure off law enforcement. But those teams have up to an hour to respond. School administrators say their school resource officers, who are already on campus, can address the situation far faster.
"I think it's still a matter of growing into the mobile response system," said David Daniels, Operations Manager for Big Bend Community Based Care. The agency manages mental health and social services for 12 North Florida counties. There are several entities throughout the state, and they work to make sure uninsured Floridians and those who have Medicaid receive services.
"I get the immediacy of the need," Daniels said, "MRT's [mobile response teams] are trained to try to defuse the situation."
And once they de-escalate a situation, mobile response teams are required to provide follow-up services to a child, he said.
"If you can wait an hour, take the hour," Daniels said. "That way you're [preventing] that trauma to a kid of being put in a police car and taken to the Apalachee Center to sit in a waiting room for hours."
More mobile response teams are needed, he said. So is continued growth in telehealth programs, which can reach students in schools, and more school psychologists, he said.
But one big sticking point remains: parental rights in the process.
Tim Enos is head of the Florida School Resource Officer Association. He says sometimes it’s the parents who are the source of the problem.
“We want to do everything possible to eliminate that trauma act of taking that child to a crisis center," Enos said. "But we have to understand that just because mom and dad want to come pick you up, doesn’t mean it’s going to be any better.”
And Daniels agreed. Most parents are great parents, he said, but some can get overwhelmed or frustrated. Other parents give up on their child, Daniels said.
The Big Bend Community of Care also does child welfare.
"I've seen a number of cases where — we call them 'lockout situations' — where a child goes to a mental health or (Department of Juvenile Justice) commitment or whatever, and when it's time for them to come out, there's not going to be anyone to come pick them up," Daniels said. "And they end up in the child welfare system."
With more money for prevention, perhaps these children wouldn't end up in the system, he said.
Enos said he also believes changes can be made. The state could create a sliding scale that would factor in the severity of the issue when making a decision about whether to Baker Act a child, he said.
More than 130 law enforcement agencies in the state have policies requiring them to attempt to contact family and friends to intercede before resorting to the Baker Act. But those policies aren’t the same as law.
Rhonda Blackwell-Flanagan is the principal of Hartsfield Elementary School in Tallahassee, which is using a trauma-informed approach to manage child behavior. In Florida, about 38,000 kids a year are committed under the Baker Act. That's more than 100 kids a day, and Blackwell-Flanagan says the numbers tell a story.
“I see a lot of unaddressed needs. I see a lot of missed opportunities," she said. "I see a lack of priorities at the state and district level for funding of programs that can make a difference, like the one we’re doing.”
Florida lawmakers will reconvene in March for their annual lawmaking session. The coronavirus pandemic has ravaged the state’s finances. Florida’s education budget has seen increases in recent years, with millions put toward school safety, mental health and teacher raises. But education also makes up the bulk of state general revenue spending and lawmakers will be looking for places to cut.
This article was conceived and produced as a project between WFSU News and Health News Florida for the Fund for Journalism on Child Well-Being, a program of the USC Annenberg Center for Health Journalism’s 2020 National Fellowship.
