First-of-Its-Kind Mental Health Center Debuts in Miami

The new center also is expected to yield significant cost savings and relieve pressure on the criminal justice system in Miami, by helping to keep those with mental illnesses out of county jails. 

The 208-bed facility — owned by the State of Florida and leased to Miami-Dade county — stands seven stories high and spans 180,000 square feet. 

Its design meets standards set by the 1971 Baker Act, also known as the Florida Mental Health Act. The law permits the temporary detention of people for up to 72 hours for mental health assessments, but also mandates certain design specifications such as intake centers, emergency vehicle access and a crisis stabilization unit. 

As well as providing a facility where both legal and clinical assessments can take place quickly, the center provides a cost-effective alternative to the criminal justice system, and helps address some of Miami’s significant homelessness while also providing psychiatric services and aiding both the recovery and re-housing of residents. 

Annually, the new treatment and diversion center is expected to save the county $100,000 per inmate with a mental illness. It currently spends roughly $848,000 per day, or $310 million per year to house 3,200 inmates. 

The property’s gut rehab repositioning cost approximately $52 million and will now cost $30 million per year to run. Funding will come from local, state and federal sources in addition to private philanthropy. 

SBLM’s Cohen has been working on the project since 2010. He was initially engaged because he’s a qualified architect for Miami-Dade County, and one with extensive experience with correctional facilities and homeless shelters. In New York City, Cohen worked on Brooklyn House of Detention as well as facilities on Rikers Island and Wards Island. 

Judge Leifman was already involved with the Miami project when Cohen came on board, and had been from the very beginning. 

“Mentally ill people were being picked up by police, and brought in front of [the judge] in his courtroom,” Cohen said. “There really was no alternative but to put those people in jail, and so [the Corrections and Rehabilitation Department] was dealing with a population that they really weren’t equipped to deal with. It got to the point where there were expos about how the county was treating this population and the horrible conditions that they were living in, and that is what really started this whole project. Miami owned up to it and said, ‘We have to do something.’ ” 

Located close to Jackson Hospital, the new center was once a hospital that the state had owned for 25 years, before leasing it to the county for a low amount. Originally, the Corrections Department was going to take the whole building, with just a couple of floors reserved for mental health care, but eventually the county took the entire building as a treatment and recovery center, instead. 

“Jackson Hospital, because we’re basically diverting people from their emergency room, is actually contributing some of the funding,” Cohen said. “The judge is a fundraising expert, and there’s all kinds of support from the city commissioners and the mayor, there’s public bond money being allocated for it, and the Corrections Department contributed as well — because, again, they were dealing with this population, and won’t anymore.” 

SBLM’s design-build task was to renovate the building into a one-stop-shop for mentally ill people who were being picked up by the police, and divert them from the judicial system into a system that is custodial but can also deal with their underlying mental health problems.  

In formulating a blueprint, Cohen, along with the judge’s staff, visited correctional facilities to see how they were dealing with the mentally ill population. 

In Miami, those inmates would normally be taken to Jackson Hospital and into a special emergency room where they would be stabilized before being transferred to third-party providers who provide mental health services. Judge Leifman’s idea was to have a building that could handle that whole process starting at the intake stage all the way through to an eventual noncustodial living arrangement, with treatment and support along the way. 

Each floor of the center has a specific use. The ground floor serves as the intake point, and also is used for assessment and legal procedures. The second floor features a crisis stabilization unit, outpatient clinics and office suites for support services, a conference room for training, and also a “respite area.”

“There was no good facility to handle from A to Z,” Cohen said. “So, we created this respite area, where if you come into intake, are examined, and you don’t meet the criteria but you’ve got nowhere else to go, you can go there and social services — part of the services that we offer — will be able to help find the right place for you.” 

Resident sleeping areas are on the fourth through seventh floors. 

The property also features a gym and a 33,000-square-foot secure outdoor recreational area, with walking paths and a basketball court. 

As the center prepares to open its doors, officials from other cities have contacted the judge’s office to ask to see the center as a potential prototype for other urban areas. 

“Judge Leifman had this vision, and he is constantly giving dignitaries tours through the facility, he’s been down in D.C. talking to Congress about the facility and its programs,” Cohen said. “I’m so proud to work with him. He’s really solving a problem.” 

As for Cohen’s own role in the Miami Center for Health and Recovery, “For me, as an architect, working on a building like this that hasn’t been built before and figuring out its programs and how you move through the building was a fun challenge,” he said. “We did a gut rehab of the building — which had great bones — but it was the decisions as to how we best reuse it that was a great group effort. It was like putting together a jigsaw puzzle, where you’re trying to fit all the pieces.”