A Look at What Happens Next: After the arrest in Florida

Whether by the government(i.e., enforcement offer) and a citizen. In Florida, a person may be arrested or, in some cases, given a criminal summons to appear in court for arraignment.

If a person is arrested and taken to jail, they may get a Booking Officer Bond or may held for a judge to review the case at First Appearance judge is usually not the same judge who will hear the case.

A Bail Bond will be set at First Appearance unless the person is charged with a capital case, a violation of probation or a violation of community control. In Juvenile Delinquency cases, a bond hearing is held within twenty-four hours of arrest but is called a Detention Review Hearing.

If the person unable to make the bond set or if no bond has been set, then they are entitled to have a Motion to Set or Reduce Bond filed on their behalf.

Arraignment is where the person is formally charged by the State of Florida and the only question the judge will usually want answered is whether the person will plead Not Guilty, No Contest or Guilty. The case will not be tried on this date.

Arraignment Court tends to move quickly, and can be very dangerous for the defendant. Many people just want to get the whole thing over with quickly because the “not knowing what will happen” is driving them crazy. They plead out without a lawyer’s help, miss potential defenses and sometimes fall victim to Courthouse Surprise –an unexpected jail or prison sentence.

Arraignment is scheduled several weeks after the initial arrest or summons. A person must attend unless the court permits their attorney to file a Waiver of Arraignment. A Waiver of Arraignment is not allowed in most Juvenile Delinquency cases.

If a Waiver of Arraignment is field, the person is spared the embarrassment of having to appear in front of hundreds of people and being publicly accused in open court.

Along with a Waiver of Arraignment, your attorney can file a Notice of Appearance, a Written Plea o Not Guilty, and a Notice of Discovery. You many have gotten as Arrest Report and/or an Addendum of Probable Cause, but you weren’t given everything and you have a right to know what evidence the State has and whether it is accurate or not!

A Written Plea of Not Guilty can always be changed to one of the other two pleas after the Notice of Discovery has been reviewed by you and your attorney. Your attorney will be familiar with the rules of evidence, the Florida Statutes and what is called the law of the case. This knowledge is used to help you whether you decide to go to trial or settle your case through a plea bargain.

We file those motions even when people think they are guilty for several reasons:

• To check the evidence for defenses.
• To uncover “hidden defenses” a lay person would not know about.
• To prepare for trial and negotiate for a better plea bargain.
• To prevent “courthouse surprise” – an unexpected jail or prison sentence.

The State provides a Discovery Exhibit approximately three weeks after Arraignment. We review the Discovery Exhibit and we always send a copy to our client. We will schedule all appointments as needed as conveniently as possible.

The entire legal process usually takes 90 to 180 days from arrest to conclusion.

This Florida arrest guide explains the arrest process for most new cases and is generic. Violation of Probation/Community Control and Juvenile cases have a different format.

Florida Criminal Law Trial Services

There are two basic types of criminal trials in Florida: Jury Trials and Bench Trials.

Jury Trials are trials where six to twelve people are selected to render a verdict. Jurors do not decide legal issues such as whether someone's rights were violated or whether a case should be dismissed. Jurors decided issues about the facts, the judge decides issues of law.

For example, a person is prosecuted for battery, the defense is that no battery occurred, and the person claiming the battery has lied. The judge would not dismiss the case based upon a defense that the would-be victim has lied. Why? The jurors decide whether the person is lying. The issue of whether the person is lying is a factual issue, not a legal issue.

Bench Trials are where the judge decides both the legal and the factual matters. For example, in a Florida criminal law Bench Trial, the judge could find that the witness lied as a matter of fact because the judge would decide factual issues as well as legal ones.

In Juvenile Delinquency cases, all trials are Bench Trials unless the juvenile in question has been waived up to adult court by the prosecutor.

NOTE: Probation and Community Control Violation Cases are actually hearings, but they are more like Bench Trials since there is no right to a jury.

The Florida Bar Association Board of Legal Education and Specialization in Tallahassee, Florida, has designated Attorney Stephen G. Cobb as a Board Certified Criminal Trial Law Specialist. The Cobb Criminal Defense Law Firm handles all phases of Florida Criminal Trial Law, from pretrial discovery through verdict.

Florida Criminal Law Trial Services

Prosecutors and defense attorneys are required by Florida law to discuss settlement of all criminal cases. This is known as plea bargaining. Some plea offers may involve an offer of diversion, probation, house arrest, community control, jail, prison, or some combination.

Preparing for a plea bargain is just as important as preparing for trial: If you lose at trial, that plea offer for probation could turn into a sentence of probation and jail or prison. While some lawyers may try to 'pump you up' about the strength of your case when they are trying to encourage you to hire them, no lawyer can guarantee a win.

There are many reasons why someone may want to settle their case: Any reason a client believes settlement is in his or her best interest is justification to settle, but you should always strive for the best deal possible without damaging your case. If you have been accused of a first offense, then you may qualify for a diversion program which results in dismissal. However, the State of Florida is not going to offer a First Offender Diversion Program as their first settlement offer.

Therefore, your legal team should be thoroughly prepared to take your case to trial and to negotiate the best possible settlement.

TYPES OF SETTLEMENT SERVICES: Click on the link below for more information

Florida Misdemeanor & Felony Case Pretrial Diversion Programs
Reductions or substitutions in charge from greater charges to lesser offenses
Florida Punishment Code Departure Sentences
One Stop Therapy Program

*NOTE* First Offense Diversion Programs are rarely offered if someone has a prior criminal record, but they might be offered under some circumstances - such as Drug Court Diversion or if the case against you is weak. First offender diversion usually means first offender, first offense only.

Dress instructions for Court

How you look and dress for a court appearance – even if you are only in front of a judge or prosecutor for a single moment – can greatly affect your case. These instructions are the product of years of research, and they are not my opinion. These Dress Instructions have been proven to be effective by numerous scientific studies.

MEN

• Solid Navy suit, single breasted
• Black belt
• Black lace up dress shoes
• White shirt
• Regimental style tie (striped evenly)
• No earrings or tattoos or facial hair
• No jewelry other than a wedding band
• Short hair, but not a ‘buzz cut’ or ‘skin head’ hair cut

Women

• A conservative dress coming below the knees. Navy is preferred.
• Close-toed shoes of medium or flat height
• No jewelry other than a wedding set or band and a plain, unadorned, gold cross necklace (no hanging Jesus crucifix).
• Wear neutral colored hose
• Whether you are a man or a woman, you want to look like you just left a conservative, protestant church. You do NOT want to look trendy or flashy.
• Anyone sitting with you should be dressed the same way.

One final note: These dress instructions for court are never popular. They don’t have to be. We want the best possible outcome for you and these dress instructions help us help you. The simple truth is, people judge each other based upon appearance. This includes friends and family members who sit with you in court.

Coping with Stress During the Legal Process

Improve the quality of you Life

Introduction : You and your family member are more then a mere case number. The Florida criminal justice system often doesn’t care about what is happing inside of you and your loved ones. We do. After all :

People don’t care how much you know, until you care.

This simple philosophy has guided me for several years. We care about what is happing inside of you as you undergo this process, the support material below has helped many people overcome the emotional roller coaster prosecution causes

Most of the books below are available on cassette or CD at your local bookstore. Personally, I faver the CD’s because they can drive around with me all day long. You may prefer books: I actually use both because they impact me differently

One final note : people who use the support material handle their cases- and their lives- for more effectively the those who don’t

First start

Get the edge – Anthony Robbins (order this CD set and robbins research international will send you personal power II free of charge. contact tonyrobbins.com

Notes from a friend - Anthony Robbins(a short yet powerful book

The seven habits of highly effective people –Stephen covey (this is one of most effective audio series I know of. Especially helpful for people who tend to worry excessively. Also available in paperback.) for teenagers, the seven habits of highly effective teen – seen covey (teen love this book and they get a lot of it)

Life strategies – Phil McGraw (available as a book, cassette, or CD; oprah’s trial strategist doesn’t pull any punches. If you like someone who just tell it like it is, Phil’s your man

The magic of thinking big – Dr. David Schwartz
(a timeless classic great for those who have lost hope. Available as book cassette or CD}

The relationship cure john gottman (I have noticed over the years that criminal cases can cause a slight bit of marital discord.)

The four agreements- Miguel san-ruiz (most people beat themselves up. This is destructive and such behavior negatively impact their case . ( Available as a book, cassettes, or CD.)

Unlimited power- Anthony Robbins (change your life NOW!)

How to win friends and influence people – dale canegine (I use these techniques in life, and in the count room)

Ruby – ruby ruettinger (ruby overcame so much. More then movies.)

Rich dad poor dad- Robert kiyosaki (Financial challenges often lead to stress, which often leads to a visit to my office; Do you really think people hire me because things are peachy? You know the answer, and so does Robert. The best financial investment you will ever make. Available on cassette, CD, and Print.)

Unless the power within- Anthony Robbins (By far the best seminar I have ever attended. Want to change something In your life? If you are serious, this is the event to do it. Contact Tony Robbins.

Your minister, your doctor, AA/NA or even your therapist
(this takes absolute guts. Courage is not the absence of fear, it is overcoming that fear.

One Final Note : Help yourself and helf your case by helping your life. Yes I ask people if they have used the support material. If we agree to take your case, you will be expected to read at least one book and listen to at least one CD series. Obviously, we cant force you to use the support materials. However, if having a hard time dealing with the stress of criminal prosecution three months from now, I won’t have to ask if you have been reading and listening, I will know that you have not. Yes, support material makes that much difference- I have seen the result in thousand of cases

One Stop Therapy: Solving your loved one's Florida criminal law legal problem and the problem behavior that caused you to need a Florida criminal lawyer

Does your loved one have a history of problem behavior?

Many of our clients have a history of problem behavior. Their families are frustrated because the person seems to frequently do things that don't seem to make sense. The person in question isn't necessarily "crazy" (as in thinking they are Jesus or possessed by aliens) but their behavior has caused problems in several areas of their life, including Florida criminal law. This problem behavior is not caused by some imaginary factor - your loved one probably suffers from a real medical problem.

One Stop Therapy is a program designed by Florida criminal lawyer Stephen G. Cobb after many years of studying people accused of crimes. The goal of One Stop Therapy is simple: Solve the problem behavior that created the Florida criminal law legal problem and solve the legal problem at the same time. NOTE: OST is not a substitute for technical skill in Florida criminal law. Florida criminal lawyers will always need to be on guard to prevent the abuse of government power.

Here is a brief test to see if the person you love fits the One Stop Therapy Program criteria:

• Did your loved one fail to finish high school or get a GED instead?
• Was your loved one ever suspended or expelled from school?
• Is your loved one impulsive in matters of money or love?
• Does your loved one appear to sabotage themselves?
• Does your loved one make empty promises?
• Does your loved one have a substance abuse problem?
• Has your loved one been in substance abuse treatment previously, but it didn't work?
• Has your loved one ever been prescribed ADD/ADHD, anti-depressant or anti-anxiety drugs?
• Has your loved one ever sought out or been court ordered to attend counseling?
• Does your loved one attract people who are a negative influence?
• Does your loved one make ridiculous excuses for misbehavior?
• Is your loved one unreliable?
• Have some family members "written off" your loved one?
• Has your loved one been arrested before, even if it was a long time ago?
• Does your loved one have a history of "traffic tickets" such as speeding, broken tag/ tail light, careless driving and other non-criminal violations?
• If you marked two or more of the above questions, then your loved one may be a candidate for One Stop Therapy.

UPDATE: We are now using SPECT brain imaging by Amen Clinics, Inc., in addition to neuropsychological testing. As a result, we are finding that better diagnostic analysis is leading to more effective treatment plans. The Florida state sponsored "cookie cutter" programs are not nearly as effective.

One Stop Therapy: Mental Illness Explained describes what really may be going on in your loved one's brain: Your loved one may have a brain illness that is very real and requires immediate attention.

UPDATE: We have received many requests about non-profit and sliding scale mental health services providers. For example, in the Pensacola are, the Counseling Center of Lakeview (aka the Lakeview Center) uses a sliding scale for treatment services, but we do not recommend them for diagnostic evaluations at this time.

One Stop Therapy: A Life Changing Program

The legal system's solution for problem behavior is punishment. This isn't very smart because it just doesn’t work: The same people are arrested repeatedly, despite the risk of punishment. We have a better idea: solve our client's legal problem and any problem behavior patterns at the same time. This helps our clients and benefits everyone. This is the smart way to handle the social problem of crime.

The lawmakers who created our legal system had no idea that the system of punishments would fail to deter people from breaking the law. After all, the lawmakers assume that no one would risk harsh punishment because the lawmakers themselves would never risk it. So here is the fundamental flaw in our legal system: This assumes that the people most at risk for running into criminal prosecution think the same way as the lawmakers. They don’t.

The reason is very simple: Most of the people who break the law suffer from brain illnesses that affect their behavior.

When you think about it, it makes sense. Here's the math:

• Brain = Behavior
• Healthy Brain = Healthy Behavior
• Unhealthy Brain = Unhealthy Behavior

For most people, this is hard to fully understand. So think of it like this: If someone you loved were suddenly stricken blind or deaf, it would be obvious to them and everyone else. The same is true when someone is so mentally ill that they lose touch with reality hallucinate. But when someone slowly starts to have vision or hearing problems, they and everyone else may not be able to tell. The hearing or visually impaired person may not even know that they have a problem for a long time – if ever. Think about this carefully: You can’t tell if someone has a hearing or sight problem just by looking at them. Over time, the impairment may become obvious to others if the hearing impaired person continually turns the television volume up louder than other friends or family think is appropriate. The visually impaired person may have trouble reading or driving. Often, the person suffering the visual or hearing problem is the last to know.

Now imagine an illness of the brain that doesn’t cause headaches, sneezing or nausea – it can’t be seen or heard. How do the symptoms become apparent? Here’s a shocker: Your loved one gets arrested.

In many cases, some family members saw the pattern of behavior and correctly predicted it would cause problems. However, they may have attributed the behavior to a lack of discipline, character, morals or other personal failing. This will need to be examined, but in many cases, the problem behavior is not just a moral failure: In about 80% of all cases where the defendant is guilty, an undiagnosed, misdiagnosed, or improperly treated brain illness is involved.

Brain illnesses don’t always have obvious symptoms like instant blindness or the flu. Symptoms of a brain illness often show up in the form of problem behavior which results in arrest. Fortunately, most of these illnesses can be successfully treated.

One Stop Therapy: The Treatment Solution

Unfortunately, most brain illnesses in the United States are treated incorrectly. Most are difficult to detect. There are three steps to treating brain illnesses: Evaluation, Diagnosis, and Treatment.

Evaluation

A doctorate level psychologist is used to evaluate our clients. In addition to a Mental Status Examination, there are a variety of psychometric tests which are used, including the MMPI-II, Millon, and the Weschler IQ test. Other tests may also be used. Psychometric tests are used to accurately detect brain illnesses and to rule out faking. These tests provide the treatment team with the most accurate diagnosis possible.

A psychologist cannot prescribe medication, but may refer a client to a psychiatrist if medication may be needed.

UPDATE: We are now augmenting the above diagnostic methods with SPECT Brain Imaging by Amen Clinics, Inc.

Diagnosis

Diagnosis of brain illnesses is often done ‘on the fly’ in the United States without psychometric testing. We believe that this is a fundamental error: Would you let a doctor operate on your heart without running any tests? Of course not.

A complete client evaluation is necessary for a valid diagnosis, and that an accurate diagnosis is needed to ensure that the treatment meets the client’s needs. No one should be prescribed brain medicine they do not need, go to ineffective counseling, nor go without medication they need.

An accurate diagnosis is the best way to make sure someone gets the right type of treatment which has the greatest likelihood of success.

Treatment

There are two basic types of treatment for brain illnesses: Talk therapy (psychology) and medical treatments (psychiatry). As mentioned earlier, a psychologist cannot prescribe medication. A psychiatrist is a medical doctor who can prescribe medication.

In many cases, we have found that treatment has been attempted without proper evaluation and diagnosis. This can cause clients and their families a lot of pain because it frequently results in a misdiagnosis and a treatment routine that doesn’t work. One of two things has happened: A person will a) ‘go to a counselor’ or talk with a religious leader (talk therapy) without a proper evaluation and diagnosis, or b) they will go to a family doctor, describe their symptoms and get a prescription for medication - again without a proper evaluation and diagnosis.

If someone has a brain illness, talk therapy may be helpful but usually will not be sufficient by itself. Most brain illnesses are treatable with medication, but Americans are often resistant to medication for these types of illnesses for social reasons – especially men. Think of it as trying to treat diabetes with wishful thinking. However, wishful thinking alone will not work: This is why your loved one can’t just ‘buckle down’ or ‘become more disciplined’ and solve their problems.

Likewise, medication should only be used when it is truly needed, and determining the correct medication is critically important. Yet many Americans go to a family doctor, describe some symptoms, and walk out with a prescription in less than five minutes. In effect, our medical system encourages people to have chemical operations performed on their brains without a single test.

In our One Stop Therapy program, we believe that our clients deserve the best legal and medical care available. We use specialists is law, psychology and psychiatry rather than general practitioners. We believe that a customized treatment program is the best way to ensure success with the legal proceedings against our clients and the best way to ensure success in treating the problem behavior that led them to our office in the first place. Most cases can be successfully handled by using a combination of medication, talk therapy and legal assistance. To use our previous example, a specialist can determine the correct medical treatment for the diabetic patient, and a diabetes support group can encourage the patient to learn the emotional skills needed to successfully treat the illness. Since brain illnesses have a symptom of behavior, we add the component of legal treatment to the equation.

Our goal is to create an effective solution where our client never needs to use a Florida criminal defense lawyer to defend a new criminal charge.

One Stop Therapy: The Legal Solution

There are two basic ways to use our client’s medical condition to minimize the impact of the criminal prosecution: Legal Defenses and Mitigation.

Florida Criminal Law: Litigation

There are two basic legal defenses where our client’s brain illness is important: Incompetency and Insanity. Both involve expert evaluation of mental functioning and a judge makes the final determination based upon the expert evaluations. There are one to three evaluations of the defendant. When a defendant is evaluated, they are normally evaluated for both Incompetency and Insanity at the time of the incident which resulted in their arrest. Most Florida criminal defense lawyers have at least some familiarity with this process.

Incompetence is a severe, current, mental impairment. A criminal defendant is Incompetent to Proceed where they cannot effectively participate in the defense of their case. For example, they may not be able to testify competently or communicate with their attorney effectively. An incompetent defendant may ramble on about things that are unimportant in their case, be confused about what happened or refuse talk at all due to paranoia.

Upon a legal finding of incompetence, a defendant’s legal proceedings are suspended until competence is regained. The time frame for restoring competence varies from a few months to several years. In rare cases, it may never be regained. Occasionally, incompetence may give rise to a Motion to Dismiss the charges, but this, too, is very rare.

Insanity is legally different than incompetence. Insanity under Florida law means that a defendant, regardless of their sanity later, was unaware of what they were doing at the time of the incident due to mental illness or they were aware but under delusion.

Insanity is a complete defense to most crimes, but an acquittal based upon insanity is treated differently than a normal verdict of ‘Not Guilty.’ When someone is found to be ‘Not Guilty by Reason of Insanity,’ a judge will make specific findings and do one of three things:

• Discharge the defendant without any restrictions. This almost never happens.
• Discharge the defendant and order that the defendant comply with an outpatient mental health treatment program, or;
• Discharge the defendant and order the defendant committed to the Florida State Hospital for inpatient treatment according to a treatment plan created by government appointed medical doctors and psychologists.

Legally, incompetence and insanity are very rare since the level of mental dysfunction must be quite severe. Most clients who suffer from mental illnesses are neither legally incompetent nor insane, yet they have substantial behavioral problems that significantly impair their lives. If left untreated, they will often bounce in and out of the legal system until one day, the doors stay shut for many years, possibly a lifetime.

Florida Criminal Law: Mitigation

Most One Stop Therapy cases involve damage control in order to minimize the impact of problem behavior in the context of Florida criminal law. Damage control (mitigation) comes in many forms. Some of the ways include:

• Reductions or substitutions of more serious charges for less serious charges
• Reducing the number of counts prosecuted
• Reducing incarceration time periods
• Eliminating incarceration
• Substituting incarceration for community control, house arrest, or probation, and;
• Acceptance into diversion programs which results in eventual dismissal of legal charges.

In some cases, the evaluation, diagnosis and treatment plan are used to negotiate with the State Attorney directly. In other cases, they are used to affect the judge’s decision when the State will not agree to go along with our settlement suggestion. In either scenario, client confidentiality is maintained unless it advantageous to release the information. When it is released, we inoculate it as much as possible in the event settlement is not possible and trial becomes necessary.

Florida's state criminal law expressly recognizes mental illness as a legal ground for mitigation: Florida Rule of Criminal Procedure 3.992(b) specifically states that a defendant's mental illness, disease or defect (when unrelated to substance abuse) is a legal ground for a downward departure from the mandatory sentencing scheme of the Florida Punishment Code.

UPDATE: Most Florida criminal defense lawyers are not aware that SPECT Brain Imaging renders the substance abuse exclusion meaningless in most cases because we are able to show with great scientific accuracy whether a brain system is over active, under active or working correctly. In many cases where people chronically using substances such as drugs or alcohol, there is a brain system malfunction unrelated to substance abuse. Make no mistake, SPECT will show the impact of substance abuse upon the human brain, and the damage caused by it. However, an examination by a trained nuclear medicine psychiatrist will also show the brain system dysfunction that causes the self medication. In other words, the pre-existing brain system dysfunction causes the self medication. Our entire knowledge of how brain systems work has been changed since the legislature changed this area of mitigation: Knowledge has replaced ignorance.

The proper treatment of brain illnesses can affect just about any criminal case settlement. How much it affects settlement options depends on a variety of factors and is case specific. In every case, the proper treatment of brain illnesses will improve the client’s quality of life. Very few Florida Criminal Defense Lawyers focus on the treatment dynamic.

One Stop Therapy: Mental Illness Explained

The following article is republished here by permission of the author and the Florida Bar News. Explaining the biological component of mental health is difficult for many people to understand. I consider this to be the best article ever written on the subject.

Republished from the Florida Bar News

October 1, 2005
Stresslines: Treatment is key to mental health recovery and justice
By Angela D. Vickers

Mental illnesses affect a person’s thoughts, feelings, and behaviors. When a person’s actions and moods change noticeably over a period of time, people should know enough about common brain illnesses to consider the likelihood there might be a mental illness. With the mood disorders of depression and bipolar, the changed behaviors must occur for a period of over two weeks. Checklists are used to teach us when to see a doctor about a suspicious mole or skin problem. Checklists help people recognize a stroke or the beginning of a heart attack. A checklist of the most common symptoms of mental illness could alert a person to the need to see a professional.

Choosing the proper mental health professional is often where the real delay begins. What professional is right for recognizing a mental illness problem? Most families would think first of encouraging their loved one to see a “counselor” of some type. Most people consider a psychiatrist to be someone who sees only those “severely ill or crazy people.” The general public presumes that anyone might need to “talk with someone” every now and then. It is not viewed as being as threatening or as stigmatizing to talk with a social worker, a pastoral counselor, a family therapist, a school psychologist, or a clinical psychologist.

However, too many people dangerously delay needed medical treatment, while trying to “talk away” biochemical problems found in common mental illnesses through counseling sessions. Missed diagnoses are often the result of people avoiding an assessment by a psychiatrist. Some avoid this medical doctor out of shame. People fear the discrimination, including a possible loss of employment, that comes from being labeled as a “mental patient.”

Many citizens simply cannot afford to visit a specialist like a psychiatrist. Due to a lack of parity, health insurance policies often do not cover mental health treatment the way other illnesses are covered. Insurance companies may have restrictions and barriers to easy access to a psychiatrist. Many policies exclude mental health coverage. Most people cannot afford to pay for a psychiatric evaluation, the often expensive daily medications, and their follow-up doctor visits.

Many seeking treatment for their behavioral issues are receiving ineffective nonmedical treatment. Many lay counselors working in churches lack the training to recognize mental illness symptoms. They are untrained about the possible deadly consequences, through suicide, of not referring a person to a needed medical professional. Untreated, or improperly treated, mental illness gets worse. The faith community encourages medical help for cancer and heart disease. Many faith communities associate the symptoms of mental illness with a person’s relationship with God. Symptoms are viewed as sin. The illnesses worsen without proper medical treatment.

Talk therapies, without more, are often not sufficient to correct biochemical problems in the brain. Sure, the person may feel better after an office visit. Therapist and patient often discuss the patient’s past and find someone to “blame” for the patient’s problems. The person’s confidence is often boosted by having someone special with whom to talk on a regular basis. However, recovery for some people with mental illnesses requires more.

Peer support groups like the Depression and Bipolar Support Alliance — www.dbsalliance.org — have been successful for years in helping people recover. Participants all see their individual psychiatrists and take medications for their brain illnesses. The peer support groups are not professionally led. Group leaders have received training in facilitating and are knowledgeable about mental illnesses. Some counselors in substance abuse treatment and anger management programs are not knowledgeable about mental disorders. Many providers with mental health training never studied psychiatry and the medical model of understanding behavior. Peer groups offer a sense of compassion, accountability, and encouragement. A big plus is that they are free and confidential.

The report of President George W. Bush’s New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America, 2003, noted that much mental health treatment in America is 15 to 20 years behind the latest medical research and medical knowledge. A delay in receiving needed medical care can decrease a person’s chances of recovery. By delaying recovery, improper treatment can put a patient at risk of substance abuse, acts of bad judgment, and even suicide. In conditions like schizophrenia, bipolar, major depression, and many anxiety disorders, it is well accepted that “best practices” show that medications are routinely needed to restore, and maintain, proper chemical levels in the brain.

Trying to discipline away, punish away, or even reward and praise away symptoms of major mental illness is ineffective and inappropriate. If these treatments had been effective, we would not have a mental health crisis. The added stress of improper treatment can make brain illness symptoms worse.

Many in the legal community and the media do not seem to understand the vast difference in education and in treatment styles between a psychologist and a psychiatrist. Most talk therapists and psychologists are liberal arts majors in college. After college, therapists study for an additional two or four years, depending upon which type of degree they were pursuing. These nonmedical mental health providers did not study the biochemistry of the brain. They did not study genetics. They studied behavior changes, when using therapies such as behavior modification. They based their treatment on the studies and teachings of others in the field.

Psychiatrists are scientists and medical doctors who understand how behaviors, energy levels, sleep, and eating patterns are often tied to brain chemistry changes. The way a cardiologist looks at a person’s heart and how it affects health, a psychiatrist looks at the brain and how it affects behavioral health.

A psychiatrist first receives a college degree as a science major, studying chemistry and biology. Then he or she goes to medical school for four years of graduate study. The person must receive a doctorate from the medical school before he or she can pursue a psychiatry residency. The studies include genetics, so they can track illnesses like mental illnesses, which are inherited, by noting symptoms in relatives. Information about suicides, suicide attempts, substance abuse, and violence in family members can assist physicians in diagnosing a patient.

Psychiatrists understand how the brain affects thoughts, feelings, and behaviors in those persons who have inherited certain brain illnesses. Psychiatrists observe the changes in the chemical levels in the brain. Psychiatry understands how these changes affect a patient’s behaviors, thoughts, and feelings. They adjust levels that are either too high, or too low, using medications. When the brain chemical levels return to normal, the brain is restored to health. When the brain is well, the psychiatrist observes that the thoughts, feelings, and behaviors of the patient return to normal.

The talk therapists and the medical doctors should have a complimentary role in patient recovery. After the psychiatrist has the patient stabilized and recovering, the therapist can help the person understand his or her behaviors, and to decrease stress which may trigger episodes of illness. Since psychotropic medications can take a month or longer to become effective, therapists can monitor and encourage the patient who is waiting for the medicines to kick in. Therapists can spend the time it takes to educate the person about mental illnesses. This instruction will help explain how mental illness symptoms were affecting the person’s life. The therapist can also help their client understand how the behaviors and attitudes of others in their family might also be affected by symptoms of unrecognized brain illness. This type of knowledge helps a person develop proper coping skills. Forgiveness and acceptance is much easier when a person realizes that an undetected medical problem in the brain was the basis for much of the unacceptable behavior.

Angela D. Vickers is a mental health advocate and educator, and a member of the Bar’s Quality of Life and Career Committee. This column is published under the sponsorship of the Quality of Life and Career Committee. The committee’s Web site is at www.fla-lap.org/qlsm.

Visit one of the best websites on this subject: Angela Vickers Advocacy