The Client was referred to us by a very respected Psychologist. Her daughter was completely out of control – running away, drinking and smoking crack in the “hood”. She was also suffering from Bipolar disorder and Schizophrenia. My job was to have her Marchman Act or court- ordered into treatment. I was warned that this Client could get belligerent. I went to the mother’s house on a Saturday to conduct the Assessment.
It was clear to me that this Client was in need of psychiatric therapy in addition to substance abuse treatment. I filed the petition in the mental health division of the clerk’s office. When the Court date arrived I presented my assessment which opined that this Respondent was a danger to herself and others and that she could not make a rational decision on her own regarding treatment. Evidence was stated to support this clinical determination.
The Court submitted to my findings and ordered the Respondent to Treatment for a period of 60 days. Because this Client was indigent and did not have health insurance, she was ordered into BARC, the county addiction receiving facility (in Broward County). However, BARC declined to treat this Client, even with a court order, because they do not treat clients with certain mental disorders – specifically Schizophrenia. In addition, this Client had been on the “waiting list” for another county-operated residential facility for three months and was not getting in any time soon.
After being denied treatment at BARC, it became necessary for this Client to be “Baker-Acted” on two occasions- one after an assault on her then-pregnant sister. The second had been filed in Domestic Violence Court as a result of Client breaking a restraining order. By this time, the Client was in the mental health unit of the jail for a period of almost a month. She had refused to take her medication and refused to come to court on one occasion.
This case dragged on for almost 5 months in Marchman Court, with multiple hearings. One treatment facility agreed to admit her for “assessment and stabilization” only to discharge her on the 4th day. Medicaid would not cover anything longer. The Respondent could not go home, because her mother and sister were in fear for their safety. It was a sad realization that the mental health unit of the county jail was the only place where this twenty-four year old female could get treatment.
Finally, the Judge compelled her to come to court and I proposed the best plan I could coordinate under the circumstances. A major issue was the fact that the Client had Medicaid which will not cover any Residential treatment facilities. We were able to find an Assisted Living Facility (ALF) which specializes in mental health clients. We arranged for a Mental Health facility in the community to pick up the client from the ALF a few times a week for out-patient day treatment and case management. It has been a few weeks, her medications have been stabilized, and things seem to be going well. She actually likes the ALF and has made some friends there. I have been coordinating treatment between the facilities as well as attending all court status hearings.
One of the things I learned from this experience is that Florida is in serious and dire need of County/ State-funded residential treatment facilities for Clients with Co-occurring Disorders (formerly known as “Dual Diagnosis”). I realize that the budget is tight, but we need to make the treatment of mental health and addiction clients a priority. In the end, the dollars spent on treatment will pay for themselves.
The Marchman Act has many “loopholes” and must be approached with caution. For example, had I found a treatment facility outside the county willing to admit this client, the court would have been without authority to enforce an order to that facility. Another issue is Due Process. Every Respondent to a Marchman act is entitled to be served in person. What if the respondent is homeless or has no fixed address because they are jumping from one drug motel to another? The problem is that we may be excluding the very segment of the population most in need of these interventions. At ASI, we use a private detective agency to handle the service of all Marchman Act Respondents. They will continue to attempt service multiple times if necessary.
The first step of a Marchman Act Petition is for a “Petition for Assessment” to be filed with the Court. The Respondent must be evaluated by a qualified addictions professional before the Court will order treatment for that individual. At ASI, we are Certified Addictions Professionals capable of performing Assessments of the Respondents. This saves time, which is of the essence. In the alternative, the respondent would have to be sent to a county Marchman receiving facility, where there is usually a waiting periodto receive the assessment. We prefer to go to court with the assessment in hand so that treatment can be ordered ASAP. The standard time period ordered for treatment is 60 days. If longer treatment is necessary, a “Petition for Extension of Treatment” can be filed with the court. An extension period of up to 90 days may be granted by the court.
ASI will handle Marchman Act cases in all counties throughout the State of Florida, although we are based in tri-county area (Dade, Broward and Palm Beach). Many times the process itself serves as a very effective Intervention tool. The threat of jail time has a way of convincing some addicts to accept the help that is being offered to them. The process can be tough on the entire family, not just the addict. Our goal is to facilitate this process for the families and to be there for them throughout the entire process. That is why we stay involved in each case for up to six months. Circumstances often change and we need to be able to think and act quickly sometimes thinking outside “the box”. The coordination of a Treatment Plan is something that should be tailored to the individual needs of each client. For that reason, ASI is affiliated with a large network of excellent treatment providers throughout the region. One of our primary focuses is strong Case Management. There should not be lapses between levels of treatment, but a smooth and gradual transition. We will not recommend a discharge before it is clinically appropriate.
Any questions or comments about the Marchman Act or other Interventions can be referred to ASI at firstname.lastname@example.org.
Myles B. Schlam, J.D.,CAP/CCJAP A
dvocare Solutions, Inc.- Executive Director
*Myles B. Schlam is a nationally recognized expert in Drug Addiction and the Criminal Justice System and an Internationally Certified Alcohol and Drug Counselor. He is one of 100+ Criminal Justice Addiction Professionals (CCJAP) in the State of Florida. Mr. Schlam graduated from the St. Thomas University School of Law in 2002. ASI is licensed by the Florida Department of Children and Families and operates in Palm Beach and Broward Counties.