Mental Health & The Justice System, with Judge Ginger Lerner-Wren | EDB 221



Mental Health Court trailblazer Judge Ginger Lerner-Wren discusses community and legal support for the neurodiverse.

(30 minutes) Judge Ginger Lerner-Wren is a county court judge in the Criminal Division of the 17th Judicial Circuit, Broward County, Florida. She is an adjunct professor, Nova Southeastern University, Criminal Justice Institute. Judge Lerner-Wren was appointed by Chief Judge Dale Ross to administer and preside over the Nation’s first Mental Health Court. She is responsible for leading and coordinating this specialized criminal, problem solving, diversionary court to address the complexities of mentally ill offenders arrested on nonviolent misdemeanor offenses and to improve the administration of justice for those with serious mental health and psychiatric disorders.

The Broward County Mental Health Court, through its application of Therapeutic Jurisprudence, is recognized as best practice and showcased at The White House Conference on Mental Health in 1999. It was the model for the Federal Legislation passed by Congress in 2000. Judge Lerner-Wren was appointed by former President George W. Bush to serve on the President’s New Freedom Commission on Mental Health in 2002. She served as Chair of The Criminal Justice Sub-Committee. Judge Lerner-Wren speaks nationally and internationally on wide variety of topics, including problem-solving courts, cultural change leadership, mental health courts, therapeutic jurisprudence, and legal innovation

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Welcoming back Judge Ginger Lerner-Wren

DR HAROLD REITMAN (HR): Hi I’m Dr. Hackie Reitman, Welcome to another episode of Exploring Different Brains. It’s not every day that we get to interview real, real pioneers here. And my friend, Judge Ginger Lerner-Wren, who is the pioneer who founded the first mental health courts, right here in Broward County. Judge Ginger, welcome, thanks for being here again.

JUDGE GINGER LERNER-WREN (GLW): Hi Dr. Hackie, it’s so great to be here. I am absolutely thrilled to be back. And I can’t wait to talk, you know so many things have happened since our last interview. I think about what maybe five years ago, I don’t remember.

HR: Time flies especially in these coronavirus times, I’ve lost all sense of time.

GLW: That’s true, I was saying I don’t even know what day it is half the time.

HR: And we have three, three things kind of happening at the same time here. We have the coronavirus times, we have everything going on in mental health, and along with somebody I know has a new book coming out, I hear rumors. The third thing was a news item just today that has to do with mental health and the courts, and we’ll get into that once we get rolling. That’s one of our, I’ll just tell you and the audience, this just came across the news files now, but it’s very pertinent to what we are talking about, a prominent Broward county Florida, right here in Fort Lauderdale, attorney, Robert Fencedishy, his son, who has mental health issues and drug addiction issues, shot and killed him.

GLW: And died by suicide. And died by suicide. I heard that on the news, I read the article. This morning. You know, in the sun sentinel, you might not know this, but I also sit as a member of the Executive committee of the National Alliance for Suicide Prevention. So suicide right now as a matter of fact, that’s what I was writing on, just before we started this interview, is very very prominent. You know, in my life, suicide prevention, justice is just one of those real high priority subjects that everyone is talking about.

Depression and Suicide

HR: Depression and suicide amongst the many, many different forms of mental health and neurodiversity issues that are magnified, as though they are on steroids, during these coronavirus times.

GLW: It is, it is. You know, doctor, the combination of social isolation, all of the uncertainty, and just not having our regular routines and all of the disruption, you know, young people that were going to go to college, and you know looking forward to that life and that, you know, so many dreams have been interrupted.

HR: Yes, and we’re so fortunate at least, for the younger kids, that here in Broward county we have been able to keep the boys and girls clubs open, so at least we have a place where there’s pods for learning, there’s food, there’s supervision. For working moms, and everything, it’s tough going now, and we’re going to be seeing the effects. But let’s talk about positive tools, positive things we can do, and let’s start with you telling us how your mental health courts and your job have changed during these virtual times, as you and I speak virtually here instead of in person.

GLW: First of all I was really hoping you would ask me something like that, because you know, right now, I am wearing my judicial robe, because as soon as I hop off here, I’m going to hop off to the court, my zoom court room, so you can see that my virtual background, is in fact my court room. Again, you know, hoping that one day I do get back, but I have to say, you know, you are the one, that I think when we were talking on a panel at Nova Southeastern University, some years ago, you know really spoke a great deal about technology. And you know, I noticed a few things about making this very sudden leap, you know, into technology, for court purposes, it really on the one hand created a tremendous amount of positive opportunity. And that is that people you know really need the ability to access their court hearing, you know they don’t have to worry now about getting into a car, or being around people, or anything like that. They can use their phone, they can use their tablets and you know all of a sudden, there they are. They are in court. It creates a dynamic, which you know not only enhances the access to court process, but I think it adds a whole different paradigm to the way we just handle the courtroom, over zoom for example, it’s lighter, we have to be more flexible, we can ask people, because now we are all kind of close. There is this closeness, I think, in proximity to my computer, I look at the people, you know look at us, we’re like sitting side by side, right, and I can say hey, to the lawyers, “how you doing?” You know, tell me what’s happening, how are you feeling? You know we can talk about resources available to the courtroom, we can share what’s happening, and I like the informality of the court process over technology. And I thought it was informal, in my courts, coming from a therapeutic approach, and really humanizing the court process, but I think there’s an added quality over zoom.

HR: What a great insight, that is. I would not have thought of that, but when you think about it, it’s a great leveling of the playing field. And I noticed that, with our neurodivergent interns, they don’t have to come into the office, they are much more comfortable, when we have our meeting with about twelve or thirteen of us, they are still interacting with other people. Yes there are drawbacks, you just discussed is very enlightening. I mean I would not have expected that.

GLW: I mean if you really think about it, you know, just thinking about it from a structural sense, typically people would walk into a courtroom, there would be deputies, you know I would be sitting, judges will be sitting higher on the bench, there’s that big well area that keeps us distanced. All of the formality that a courtroom and a courthouse brings, and now we’re just all in a box on a screen, and we could flip, like I was just in a United Way of Broward County Board of Governors meeting this morning, and you know, they were all, it was a very large meeting, and here we all looking like the brady bunch. You know, that everyone had their little boxes, it’s just a really fascinating interpersonal way of relating, and in a court process, it does take down some of those barriers I think.

HR: Now are you able to do your full case load during these virtual times?

GLW: We’re not, we’re not, we’re pretty limited. I have a county court judge, I am a criminal court judge, you know crimes up to a year, and jail, and right now we’re not doing jury trials. We’re not doing jury trials because the courthouse has not been opened for jury trials yet. There’s some court functions going on, but juries, nor right now.

Mental Health in the Community

HR: What is the biggest issue in mental health that you’ve been able to perceive from your perspective as a mental health court judge?

GLW: I want to circle back to something you said earlier because as a topic it just has to be the number one topic right now, and that is the impact that the covid 19 pandemic has had on mental health, in our community across the country and globally, so I think we always new that mental health, for example, in our state we’re in Florida, in most states around the united states, there’s always resource shortfalls. Is that correct?

HR: Yes.

GLW: You know that there’s always stigma surrounding mental health, and that that is a barrier to care, that we’ve had highly fragmented systems of care, and that we lack what we would call the capacity to really treat people in terms of really meeting the demand for mental health. That was pre-covid 19. And here we are now, in the midst of this pandemic that has now brought on a triple-crisis. Now we have the existing mental health crisis, or suicide epidemic crisis, we know we’ve already had an existing opioid crisis, and so now it’s really turned into everything really conflating. And I think that we have our essential workers, and that are experiencing their own problems on the one hand, and we have people that are facing economic and financial insecurity, you know, hardship. Many have lost their jobs because of the closures, and it is just really, really challenging time in mental health that we have never experienced, I don’t think, before, in our lifetimes.

HR: Well, let’s look at your new book and see if we can find any answers in there. Tell us about our new book.

GLW: Do I have a new book?

HR: Well tell us about your new book.

GLW: Well my book, which is I don’t know if you can see this, it’s a court of refuge story from the bench, but what I was writing, actually is a chapter for a book that isn’t mine, per say, but that I was asked to write an introduction, and this book is on criminal justice and suicide. And why suicide prevention is so important to be integrated into the criminal justice system, and we know it is, for so many reasons.

Neurodiversity in the Justice System

HR: How interesting, you know when I interviewed William Packer, who wrote a book on neurodiversity, in the justice system, in the prison system specifically, what was really interesting to me was not the unfortunate high numbers of inmates with various neurodiversities and mental health issues, and autism and different things, but the corrections officers themselves, and the rates they are seeing are quite high, you know, for suicide. Can you comment on the prison system at all?

GLW: Well you know I can certainly say this, that as you said you know the data is such that more than half of individuals in our prison system suffer from a whole range of mental health disorders, and other kinds of neurodiverse, cognitive disabilities. Our prison systems are not equipped, they’re simply not equipped to be treatment providers, and there really isn’t any rehabilitation going on, in prisons, and that people are certainly, the story is certainly that in Broward county is really based on a young man who went to a forensic jail or prison as a result of traumatic brain injury and was treated so negligently that when he was released, and this is the story of Erin Win, that PBS frontline called the unlikely savior of a new system of justice for the mentally ill, in one of their reports for the court, when he was released there was no discharge plan, his parents that lived right here in Broward county, right here in Plantation, Florida, you know they couldn’t effectively manage him at home. There was no housing, there were no hospital beds, and he ultimately had an episode at a local grocery store, popular chains here in south Florida, had an episode as he was checking out with the cashier, and the story of course, and it’s in the book, and that he ran out of the store in a panic, and he tragically collided with an 85 year old, who crashed to the pavement, fell to the pavement, and ultimately died of head injuries and now Erin was charged with murder. This was back in 1993 and that really, that case led to a grand jury investigation of Broward county’s mental health system which proved in a 153 page report to be essentially deplorable. That’s how the sun sentinel described, at the time, Broward county’s mental health system. There was no system, we had no wrap around services, so if you had a neurodiverse disorder, if you were diagnosed with autism, if you were diagnosed with any sort of serious mental illness, you were pretty much out of luck.

HR: And now with coronavirus times, what I’m hoping has come about is that perhaps the forced use of telemedicine, telepsychiatry, will increase the availability of these resources to all, to prisons and everywhere else. You know people don’t realize how getting a thing, transportation, logistics, is, you know.

GLW: I don’t even know if we realized it.

HR: No, we don’t. It was thrust upon us, and now we do, and that’s why so many companies, and so many institutions, will never be going back, fully to the way it was.

GLW: It’s true Dr. Hackie, you know if there is innovation out of desperation, I agree with you, I think that the telehealth, tele mental health, and new use of apps, you know that this is absolutely the new frontier in mental health because the early emergent studies that I’ve been seeing have been really excellent in terms of the effectiveness of telepsychiatry, the effectiveness of tele-mental health, of the use of technology for the purposes for developing a new form of a warm line that people don’t really necessarily need counseling, but they do need someone to connect with, someone who is empathic, and someone who is supportive. And so, I just think that, because you know I am constantly looking at the research, because I am also an adjunct professor. I stay up to date on the data. The data is looking really, really great although I have to say that from a clinical vantage point, it’s the psychotherapists that are really starting to feel the pain of the burden of the workload. That the demand versus the workforce supply is so great that like many of these essential health workers, they’re feeling the back burn.


HR: It’s very interesting and it reminds me of the old days, when I was chief resident of orthopedics at Boston city hospital, it was like crazy, people coming in from all over, thrown off of roofs, and it’s everything, and that constant, and now we have that constant of the mental health issues. It’s a constant, that’s constant. Do you want to remind our viewers and our listeners of the National Suicide Hotline and other resources.

GLW: You know first of all, you know you are in Broward county. If you remember, really in the country, if you remember nothing else, remember 211. 211. Eventually we are going to have nationally our own designated mental health 3 digit number. That’s going to be 988. But right now that is not implemented, that’s going to take a few years. So that is going to be, so 211. Now, the 211 will get you right to the national suicide lifeline. So 1-800-talk, I think 2733, I want to make sure I’m saying that right, but the National Suicide Lifeline is just incredible. They have privacy lines for first responders, they have special counselors for veterans, you can hit a chat button, there’s wonderful resources in place now for anybody in terms of needing to talk to someone. If you are a younger person all you have to do is go to the Jet foundation for individuals that, for the lesbian, gay, bisexual, transgender community, the TREVOR project, so many sources now, there’s crisis text lines. But you know, no matter where you are it’s 211, or the national suicide lifeline, will get you right to a crisis counselor.

HR: That’s great, that’s great information. You know, you’ve mentioned some, a particular part of our population is having a tough time, the LGBTQ community, the trans, nonbinary, can you comment on that population here in Broward county, and some of your observations?

GLW: Well I can, and I think that there’s so many, to me you know, it’s extremely complicated in the sense that there’s a lot of challenges that those men and women have, that are very specialized and targeted to that area. I think the first hardship is family alienation. For example, you know there’s families that, you know, will literally not have support. You know, their children, they’re adults, teens, whatever, you know they come out and they are afraid to come out. A lot of these individuals, especially these teens and younger adults, they’re homeless. So that in and of itself, I think that type of alienation and then the cascading consequences of that really lead to some really significant challenges, and then of course I think the issue is, you really want to talk to somebody who really gets you. Correct?

HR: Yes.

GLW: I think that’s why it’s really important, you know in Broward county, we have some, and you know the clinicians, the counselors, and some serve with Fort Lauderdale, you know that is their population, these are the people that they serve. From a cultural competency vantage point , that’s really what we’re talking about, right? Cultural competency, and really having that lived experience when they were talking about culture, race, ethnicity, cultural competency is everything. It’s everything because, anytime anybody goes to see a doctor, we want to be able to have a rapport. You want to have a rapport, you want to feel comfortable, to trust your healthcare provider, and I think we have to remind all our viewers that mental health is health, right? It’s no different than any other kind of healthcare, mental illness, no different than any kind of physical illness, it’s all health. We really have to feel a good rapport with the people that are our healthcare providers.

HR: How can our Different Brains audience learn more about you?

GLW: Well, they can certainly just look me up on the internet, there’s a lot of good blog posts that I’ve done over the years, both for Huffington Post, and now for medium. There’s so many different subjects, just so many different, wonderful subjects, and really about, you know, they do come from an advocacy voice, why? Because I am a judge who comes out of the civil rights, disability rights phase. You know when I was a young lawyer, and certainly on the bench in mental health court, I am advocating to mitigate and eliminate stigma and shame, and really make sure that everybody knows, you know, that you’re entitled to dignity. Right? We all are. We all deserve love, and we all deserve to live our dreams. We must understand that dignity really is the essence of justice. I feel that’s a lot of the main themes of my writing.

Closing Thoughts

HR: Judge Ginger, what’s the one thing society does not realize or understand about Mental Health?

GLW: You know Society doesn’t understand that mental health is as essential as all health and that we have to make sure that people get access to the health care that they need.

HR: Thank you. Well Judge Ginger Lerner-Wren, it’s been a pleasure to have you here yet again at Different Brains, and we thank you for your pioneering work in the mental health courts, and for all that you’re doing. Keep up the great work, thanks so much for being with us again.

GLW: Thank you, thank you so much again for having me.