Justice for the Neurodiverse, with Judge Ginger Lerner-Wren | EXPLORING DIFFERENT BRAINS Episode 21


In this episode, Harold Reitman, M.D. speaks with Judge Ginger Lerner-Wren, a County Court Judge in The Criminal Division of the 17th Judicial Circuit, in Broward County of Florida, and one of the pioneers of America’s first mental health court, dedicated to the decriminalization of people with mental illness. Judge Lerner-Wren discusses the genesis of the mental health court, the pitfalls the neurodiverse can come across in the criminal justice system, and what she hopes the entire criminal justice system can do to better recognize different brains.

To learn more about Anlor, visit: 17th.FLCourts.org

And follow the Judge on Twitter: twitter.com/judgewren

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HACKIE REITMAN, M.D. (HR):

Hi I’m Doctor Hackie Reitman welcome to another episode of Exploring Different Brains and we have today a fantastic judge who has done amazing things right here in Broward County, Florida. Judge Ginger Lerner-Wren of the criminal division of the seventeenth judicial circuit here in Broward County, welcome to Different Brains, we’re Exploring Different Brains.

JUDGE GINGER LERNER-WREN (JGLW):

You know Hackie I am so thrilled to be here I feel like I explore different brains every day of the week and just enjoy the process and serving people so this is a real honor to be here.

HR:

Well the honor is all mine and as W.C. Fields said in one of his movies “Your Honor this is indeed an honor” and you are one of the nation’s pioneers in the mental health courts going back to the first national mental health court I believe was in 1997. Tell us how that came about?

JGLW:

You know it was I cannot believe that we’re edging on twenty years and you know I came to the judiciary from a disability rights background and I worked with former circuit judge Marcia Beach you may remember Marcia before she came onto the bench, was the Executive Director of the Florida Advocacy Center for Persons with Disabilities and I was hired to oversee a very interesting federal class action settlement agreement right here in Pembroke Pines and to oversee the implementation it was really fascinating and I learned all of these different areas, psychiatric rehabilitation and consumer rights and disability law and mental health law and systems of care, nothing, nothing that anyone would have ever learned in Law School, obviously. And so when that position wound down I always wanted to run for office and at the time as luck would have it, a lot of luck when I was running for judge in Broward County, Broward County was going through a number of problems, the first being that there was an overpopulation of individuals just flooding into our local jail with serious and persistent mental illnesses and there was a federal class action filed against the jail system and there was an incredible high profile case and it was a murder case.

It originated as a murder case involving a young man named Aaron Wen actually did not have mental illness he actually was involved in a very serious motorcycle accident and he suffered traumatic brain injury and the story is a long story but I’m going to make it very brief but his parents were unable to access any help for Aaron he revolved through the criminal justice system ultimately his condition worsened and the traumatic brain injury was now one of numerous diagnoses. He was very diverse in terms of his neuro problems and it included now Post Traumatic Stress Disorder, as well as schizophrenia and the story very briefly which is really the legacy of the mental health court in Broward and for our nation is that he was checking out of a local grocery store, had some kind of a panic attack or something as he was going through the cashier he ran out of the grocery store, he collided with an elderly woman who fell to the pavement and she died of her brain injuries and Aaron found himself charged with murder and Howard Finkelstein of the Broward County now our Broward County public defender at the time was an assistant chief and he was selected to represent Aaron.

Howard tells a very heartfelt story of sitting down in the living room with Aaron’s parents and his family basically explaining to Howard what it was like to try to find any kind of help for their son which they couldn’t find any and they couldn’t care for him because of all the behavioral problems he bounced around through different ALFs and living facilities there were no programs and Howard really began to awaken, he had an incredible awakening of conscience in terms of the short files of Broward County’s community system of care and he wrote the grand jury and he requested a grand jury investigation and sure enough the grand jury accepted his request and a year later, they issued a 153 page scathing grand jury report that was basically saying that Broward County had absolutely no existing mental health community system of care there was no one in charge and essentially no one was accountable to anybody.

The mental health court believe it or not was an outgrowth of that grand jury report and it was Howard, Howard was the thought catalyst behind the development of the specialized court, I happened to get lucky I got into office they were looking for somebody who understood who had a specialized knowledge working with individuals with all kinds of neuro disabilities and diversity and mental health problems and they asked me as a new rookie judge never did anything in the criminal justice certainly there was no real road map to follow in the mental health court other than the work that I did in the protection an advocacy system for Florida and that proved to be the road map that Broward used for our mental health court and that legacy really belongs to Aaron Wen. It was really Aaron and Howard’s perseverance and dedication to create a refuge. A court of refuge for individuals would not be misunderstood or marginalized by judges and quite frankly by systems that just didn’t get it.

HR:

Now we fast forward approximately twenty years down the pike and let’s see when I came here in 1978 the population of Broward County, Florida, Greater Fort Lauderdale was 400,000 I believe. Now it’s about 1.8 million.

JGLW:

Correct.

HR:

So now tell us how the mental health courts have performed during that time.

JGLW:

I really am much more interested in how we performed in my court in Broward County and the reason I say that is because I just feel very strongly that the mental health courts really should be one of delivery of social justice and human rights and offering treatment over punishment and certainly about holding systems accountable and there’s a lot of mental health courts now there’s hundreds of them across the United States and around the globe, some are doing really stellar work some I think are a little overreaching in terms of who they’re holding accountable and for what and that is just kind of reflects the cultures and the values of the community perhaps but in Broward, I think that we obviously are a court of excellence. We are part time I have a regular criminal division that I’m responsible for. In addition to the mental health court but we have no funds we never got any grants we were the model for congressional legislation in 2000 so new courts coming online actually get federal money. We get nothing, we don’t want it and we’ve diverted over 20,000 people out of our local jail system into care, into the community and out of a quite frankly an inappropriate system of care for people you know that have neurological and mental health type of problems.

HR:

Let’s extrapolate this to the greater prison system of the United States where this political season that’s of course being said the United States of America has a bigger percentage of people incarcerated than any place else on earth. I just interviewed a gentleman who is William Packard who is very involved in the prison system and in our interview he feels that within the overall prison system that if I’m recalling the numbers correctly approximately thirty to fifty percent of the inmates have some kind of intellectual disability or significant mental health problem. What’s your experience been in that regard?

JGLW:

Absolutely well first of all we know that the failures of the institutionalization movement back in the 60s and 70s really morphed our criminal justice system into serving as our largest de facto psychiatric hospitals.

HR:

Excuse me. Tell our audience about that transition you just referred to, regarding the institutions.

JGLW:

I will you know and first of all I teach this at Nova I’m an adjunct professor for Nova Southeastern University and I teach on the graduate level and the criminalization of people with disabilities is not a new phenomenon by any stretch and back during the Civil Rights Movement particularly as a result of Robert F. Kennedy and John F. Kennedy both the exposure of what was happening to individuals that were locked away in these beautiful, beautiful state hospitals I mean they looked gorgeous, these asylums from the outside they were majestic and grand and on these sprawling campuses but on the inside they were snake pits and that’s what they were referred to.

It wasn’t really until the early 1970s for example when a reporter leaked information to Robert F. Kennedy that he started investigating Willow Wood a very large children’s really for developmentally disabled children the term back then was children that suffered from mental retardation we don’t use that term anymore but when Robert F. Kennedy got into Willow Wood and invited Geraldo Rivera to come with him, that expose was one of the events that completely turned the nation around in terms of what was happening in these institutions. The other precipitating event that moved to a deinstitutionalization movement was all of these federal class actions similar to the one that I described that I worked at South Florida State Hospital that was somewhat of a much later downstream federal class action but they were a flurry of civil rights actions being brought by attorneys against state hospitals for failure to treat, for a lack of privacy, for horrendous conditions that they were living in and one by one, federal judges were creating these very very extensive settlement agreements surrounding these state hospitals and this litigation and the states ultimately, many of them began to close the state hospitals they didn’t want to quite frankly pay the costs that were involved in meeting the compliance of the judge’s orders and with new medications online individuals were able to quite frankly become functional and rehabilitation was starting to come into play and in 1963 John F. Kennedy passed the 1963 Community Mental Health Act and the Community Mental Health Act at the time was intended to transform mental health in America.

Unfortunately we never realized that dream but the idea was for community mental health centers to be established all across the country and unfortunately that never happened largely because of stigma discrimination and also just kind of a lack of evidence space if you will as to how to do that and so you had the closure of all of these state hospitals people were being discharged and released without places to go their families couldn’t manage them they didn’t have the continuum of care or services to do that most of these individuals became homeless they started just really being trans-institutionalized into jails and in 1998 almost a year Broward began its mental health court the New York Times threw the famous Fox Butterfield special report declared America’s jails and prisons as the new asylums and quite frankly not much has changed in terms of community access and care unfortunately since then although there’s been tremendous strides in mental health and recovery and rehabilitation since then. So we’re kind of living if you will the best of times and the worst of times at the same time when it comes to individuals with mental health and other kinds of neuro-disorders.

INTHR:

Now do you see it the way I do at differentbrains.com where basically all of the mental health labels if you will and all of the developmental disability labels and the psychiatric and the neurological. To me they’re just one big spectrum, not just an autistic spectrum but of autism and everything else if we try one size fits all whether its in the schools or the place for employment or the judicial system, that it’s not going to work. What kind of training is going on in the judicial system as we speak regarding neurodiversity and different brains?

JGLW:

None, really. When you’re talking about it from that perspective which is really a person centered perspective, no labels right, and I think that we haven’t quite gotten that far upstream yet I think first of all I think in Broward County and other parts of the country I think there’s been tremendous progress having said that. I mean think about where we were before there was a mental health court and that was where you had individuals like you’re talking about with all kinds of neuro-disabilities and diversity types of issues but judges only really cared or focused on one thing and that is they’re responsible for administrating their cases. They want to get through their dockets. They want to be able to manage what’s happening in their court rooms so think about you know when an individual comes in and they just don’t fit.

They’re not able to respond to simple questions by the court, the court’s trying to decide what direction to take whether or not the person is going to hire a lawyer, needs a lawyer, qualifies for a lawyer what if the person is having some kind of a psychotic type of episode and they’re belligerent to the court not because they’re actually being disrespectful but because they can’t process right, well and so you had judges that were so frustrated they would end up holding individuals in contempt largely as a manifestation of symptomology when the judges perceived them as being contemptuous and disrespectful you had individuals that couldn’t make bonds and they couldn’t figure out who to call and so the idea that the court system back before there was a mental health court just wasn’t equipped to respond to the complexity of neurodiversity and now because of mental health courts because of where we are today now at least you know the knowledge base has come I think lightyears forward and people now matter.

Before I really think that there was a pervasive prevailing stigma of prejudice that a culture that you know wink-winks and nod-nods and laughter if somebody was acting in bizarre ways as opposed to looking at that person as somebody who wasn’t feeling well and really needed help and we’ve now turned that culture largely around. And I don’t think that we’re quite where we need to be in terms of neurodiversity I definitely think we’re moving in that direction.

HR:

And in the mental health courts if we wanted to give our viewers an idea of the type of people with what diagnoses you see there, what kind of neurodiversity are you seeing there? Could you give us a little brief on that?

JGLW:

I could well I think that the good news is and I think you would be so happy to hear the court was designed without labels essentially because we recognize that we wanted to really cast a very wide net meaning that we know for example in our state that we have such a diverse population we have a large population of seniors that have all kinds of neurological disorders some Alzheimer’s to dementia we have individuals who may have had brain injuries from traffic accidents like Aaron Wen. For example our veterans coming back with traumatic brain injuries neurological problems and PTSD and of course we know that the impact of adverse childhood experiences and trauma often leads to cognitive types of problems and then of course we have individuals with all kinds of intellectual learning disabilities and intellectual challenges.

And so the idea behind the establishment of the court was to cast really a neurodiverse net and we really wanted to get people into the court to see where we could help, mostly because Florida you might know this and if your viewers don’t know this they need to and that is Florida is the third largest in the United States and we are literally 49th funded in the entire country. We are in absolute crises and that was the outcome of the grand jury report, we live with that crises we have broken systems a lack of services and resources and the idea behind the court was that we knew this and so we wanted to create a court where we could centralize and martial highly scarce resources and that’s really the beauty behind the court and so people that need help can get the individualized type of care that they need based upon the population and where they are kind of situated and what their needs are and it is a person first approach.

HR:

What advice could you give to the family of someone who’s brain is a little bit different who gets into trouble? I’ll just make up a fictional example. Someone with Asperger’s who doesn’t make good eye contact, who is socially awkward, who is a truth teller, who comes across as quite rude and everything. At a routine traffic stop the policeman thinks that that Aspie is being very rude and says the wrong thing and comes across as combative and they bring him in. What advice do you have for that family and I know that’s a tough question but I’m just thinking, I’m trying to give an example of someone who’s probably not the best example.

JGLW:

Well but those examples happen every day. They happen all the time in all different kinds of contexts and then you have family members for example who are really then left in crises because that’s a family crisis, that certainly is. When you have a loved one that is now just as involved whether they’re children, or teens, or young adults, or whatever you know that is going to potentially change a trajectory of a life, let’s be real about that. It could really happen and it happens every single day. People get enmeshed in criminal justice systems, they begin to escalate through we start out with something minor, they get put on probation they can’t satisfy conditions of probation because they’re too burdensome for an individual with neurodiversity types of problems and then all of a sudden they’re back in a jail system or maybe they pick up a new charge or they’re in a vulnerable state in an incarcerated setting so you can see just by that one little example.

It’s not a small problem. It is a real potential problem and I really believe in what I advocate to my families that we see every day is a number of strategies, a number of strategies. And the first is to ensure that your loved one is linked, you know gets a good quality screening and assessment, correct? So you can find out from a precise vantage point as precise as possible you know what kind of treatment supports, interventions and strategies your loved one, your child or your family member needs. The second thing that I advocate very strongly because the bench from the bench we’re doing a whole lot of things at the same time but behavioral health this is a new term I’m going to start using in the court, neurodiversity literacy, is something that everyone really really needs to learn and develop a competency in and so I really encourage families to get online and start studying, take classes, read books, become an expert. An expert in mental health, or an expert in whatever area impacts your family and also become experts in advocacy. We need every advocacy voice to be heard because we have to be able to get this lack of resource problem turned around. Without treatment without access to care everyone is vulnerable. Everyone is vulnerable. All of us.

And so for example the National Alliance for Mental Illness for example has a fabulous family to family educational course given by Doctor Ken Duckworth the National Medical Director for the National Alliance for Mental Illness take it immediately. Join groups. Join advocacy groups read your book, become an expert. The other thing is you really want to make sure that your family member is correct, always operating through protective strategies. So for example, if from a personal vantage point, if that child shouldn’t be driving because he or she may not be able to handle encounters, correct, with anxiety then that really needs to be built in to their daily life and family decision making, I think, because you don’t want to expose a family member to unnecessary risk and risk of incarceration for example in my view is a very very real risk. So education, learning how to educate, ensuring that your family member is getting wrapped in services and treatment and the importance of always coming from a strength-based vantage point.

Always coming from a strength-based vantage point meaning if your child isn’t performing or doesn’t meet your expectations because of a neurodiversity type of a problem, it’s not their fault. They’re not doing it intentionally, correct? And that you really ought to come from a strength-based place and at the same time we encourage individuals to activate their own health, meaning take responsibility get on top of that curve, correct? And become an expert for yourself.

HR:

The point about advocacy I want to stress to our audience that you just heard directly from the horse’s mouth from Judge Ginger Lerner-Wren not from me, from her is you can make a difference, advocating, getting active, joining groups you can and do make a difference. It’s not just voting, it’s doing all of these other things too, and now that we have the age of Google where you don’t have to go to the library and you don’t have to go exploring or buy the encyclopedia Britannica you can go online and become as expert as many many have. What are your personal goals coming up? Are you writing any books?

JGLW:

I am thank you for asking, I actually am writing a book it’s being considered right now and it does run right to my personal goals it does in one part tell the story about the power of community, how a small group of people could make great change and I think that’s such an inspirational story I think the story behind Broward County’s mental health court I mean think about what we did I mean no money, no grants, just the will of a few people coming together to say we need to do something we cannot go on like this we cannot blindly allow people with neurodiversity problems to go into jail settings when in fact they need to be in community based linked with care, they need to be treated humanely with dignity and respect and to be treated under the law equally and so the fact that we did this to me even twenty years later inspires me every single day and I really think that the story is a gorgeous story, it’s an inspiring story that out of desperation comes innovation and I love that part of the story and then the second part of the book project really is going to focus on the idea from a public health vantage point we have to move away from this over reliance on the criminal justice system, reducing mass incarceration has to include funding mental health and all other kinds of neurodiversity matters on a public health basis. This is not about bad people. This is about people that have neurodiversity problems and we need to treat it as a public health urgent matter and if we’re going to reform the criminal justice system then these populations need to be included and that is my goal. My goal is to see the end of the criminalization of people with disabilities and neurodiverse disabilities and that was really Broward’s goal from the beginning.

HR:

That is extremely well said and I salute you. You’re a real champion of the underdog.

JGLW:

Thank you I mean I don’t box and I never did but I consider myself quite a social justice warrior.

HR:

You’re a fighter and you’re a warrior and that’s for sure. When you were young, when you were a kid, not that you’re not young now.

JGLW:

That’s okay I’m not young now.

HR:

But when you were a kid did you think you wanted to be a judge?

JGLW:

Yeah you know I had a different brain I’m probably one of these different brains, I mean when all my other friends at my age were like back in the early 60s were watching Romper Room or whatever else might have been on at the time we didn’t have all of those great choices that we do now obviously and Sesame Street. But I was watching Biography I mean I was really different and I was attracted to segments that dealt with civil rights and injustices and I knew very very early that I wanted to run for office, that I knew. Which office, I wasn’t so sure that was kind of by a process of elimination and going around and shadowing friends of ours back when after I graduated from law school am I interested in this office, or a legislative office, or a local office or whatever, but the judiciary for me seemed like a really good fit and the answer is absolutely I’ve always wanted to do civil rights work I just lectured a symposium at the law school yesterday and I told these law students you know if you want to be a change agent and you want to work in the public interest or the social justice field you know you should do it because we need everybody. We need everybody. And you know I’m living the dream.

HR:

Well that’s great and we’re lucky to have you as part of the judiciary.

JGLW:

Thank you it’s a joy.

HR:

Well, that’s it for another episode here of Exploring Different Brains we’ve had the privilege of talking to the pioneer in the mental health courts right here in Broward County for the whole nation, Judge Ginger Lerner-Wren of the seventeenth judicial circuit right here in Broward County and thank you so much for being here Judge.

JGLW:

Thank you so much Hackie it’s a real thrill, it’s an honor and I am going to champion neurodiversity in the courts and I’m really excited about that so thank you.

HR:

We’re talking today with Judge Ginger Lerner-Wren, the seventeenth judicial circuit in Broward County in the criminal division.

 

This video is owned by Different Brains Inc, kindly donated by it’s original producer PCE Media LLC.

Author Image
Dr. Harold “Hackie” Reitman is the founder of DifferentBrains.com. He is an entrepreneur, philanthropist, children’s activist, retired orthopaedic surgeon, and a former professional heavyweight boxer. He who currently serves as the CEO of Fort Lauderdale, Fla.-based PCE Media, LLC, the multi-platform production company he founded in 2004. Dr. Reitman wrote, executive produced and co-directed the full-length independent film, “The Square Root of 2” (starring Darby Stanchfield of ABC’s “Scandal”), and is the author of the book “Aspertools: A Practical Guide for Understanding and Embracing Asperger’s, Autism Spectrum Disorders and Neurodiversity” from HCI Publishing. He also hosts the DifferentBrains.com interview show “Exploring Different Brains.”
Author Image

Harold Reitman, M.D.

Dr. Harold “Hackie” Reitman is the founder of DifferentBrains.com. He is an entrepreneur, philanthropist, children’s activist, retired orthopaedic surgeon, and a former professional heavyweight boxer. He who currently serves as the CEO of Fort Lauderdale, Fla.-based PCE Media, LLC, the multi-platform production company he founded in 2004. Dr. Reitman wrote, executive produced and co-directed the full-length independent film, "The Square Root of 2" (starring Darby Stanchfield of ABC's "Scandal"), and is the author of the book "Aspertools: A Practical Guide for Understanding and Embracing Asperger’s, Autism Spectrum Disorders and Neurodiversity" from HCI Publishing. He also hosts the DifferentBrains.com interview show “Exploring Different Brains.”

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