For almost 30 years, the ninth floor of the Miami-Dade Pre-Trial Detention Center served as the largest psychiatric ward in the state — despite only having one psychiatrist on staff.
Now-retired county Judge Steven Leifman called the conditions on the ninth floor a "hell hole": prisoners slept on the floor and were beaten, and, at times, when there was no running water, inmates drank from toilets.
"I couldn't believe they would treat people that way," Leifman told WLRN.
READ MORE: 'Clock is ticking' on Miami−Dade jails to reduce high number of inmate deaths
Speaking to host Tim Padgett on the latest episode of the South Florida Roundup, Leifman said he envisioned a center that could divert people away from the ninth floor into a facility where they would receive individualized mental health treatment.
After an over 20 year wait, Leifman’s life work has come to fruition in the Miami Center for Mental Health and Recovery.
Leifman talked about the long journey towards opening the center's doors in his appearance on WLRN's weekly public affairs radio show.
In 2000, Leifman was approached by the parents of a man whose case came across his desk.
"The mom was crying, the dad was shaking," Leifman said. "They told me their son had gone to Harvard — he had late onset schizophrenia. He was now homeless and cycling in and out of the criminal system."
At the time, there was no formal way to divert this man away from jail and into treatment.
"They told me that their son knows more about the mental health system than I do," Leifman said. "[Their son] was the head of psychiatry at Jackson Memorial Hospital."
After experiencing this difficult case, Leifman started the Criminal Mental Health Project in 2000, which now redirects eligible people with mental illnesses from the courtroom into treatment.
According to the program, recidivism for Miami-Dade’s misdemeanor population went from 75% to 20%. In the felony population, it fell from 75% to 6%.
Over 9,500 police officers in Miami-Dade were trained in identifying people in crisis and how to deescalate. Police officers were also able to access treatment themselves if they needed it — which reduced police shootings.
"It worked," Leifman told WLRN's Padgett. "The number of arrests in Dade county were reduced by more than half."
"But we were stuck with this small group who were just too sick for the services that existed."
According to the Miami-Dade Criminal Mental Health Project, people with mental illnesses remain incarcerated four to eight times longer than those who did not have a mental illness, despite having the exact same charge.
"We should look at it like any other illness, like cancer," Leifman said.
What happened during the 20-year wait
In 2004, Miami-Dade voters approved $50 million for the facility but it failed to win county commission approval to open.
"It was pretty frustrating because we were at the one-inch yard line to get it done," Leifman told Padgett. "We got hit with politics."
During the 20 year wait, the county was placed under a federal investigation because of the high rate of deaths and suicides in Miami-Dade jails.
The decades long wait was not only time consuming but it was also expensive, Leifman said.
"We did lose a lot of money," he told WLRN. "At least a million and a half dollars. [It was] so frustrating. We stopped fundraising through our not-for-profit foundation until we knew it was gonna open."
It was only last month that the Miami-Dade County Commission approved operating funds for the center on the condition that it also provide substance abuse treatment, include outpatient services and operate under the oversight of Jackson Health System.
Much of this funding came from Florida's settlement with opioid manufacturers.
Leifman's intention is for this facility to focus on those who have been repeatedly arrested for minor offenses, including residents that have been arrested under a law that criminalizes homelessness in the city.
Leifman refers to these individuals as "high utilizers" because they frequently cycle in and out of jails, hospitals and emergency rooms. He identified that these "high utilizers" spent over 300,000 days in jail over the past five years.
"More than 60% of those people are also on the Homeless Management Information list," Leifman said.
"People don't realize how often criminal offense, homelessness, substance abuse, and mental illness all intersect." Padgett said, in response.
The new facility
The 160,000-square-foot center in Miami’s Allapattah neighborhood will include 208 beds, a crisis stabilization unit, addiction receiving facility, psychological treatment, and a courtroom — among other areas.
The facility will also provide outpatient behavioral health and primary care, day activity programs, employment services, and educational spaces.
"It's exhilarating," Leifman said, reflecting on the opening of the center. "I think the community understood it, in some ways better than some of the current politicians."
How the center will be funded in the years ahead remains a source of anxiety. But even so, the center will still be the "first-of-its-kind" in the nation.
"Everybody knows somebody with mental health issues," Leifman said.
The center is expected to open next year on the 2200 block of Northwest Seventh Avenue.
Listen here to the full interview on July 10, 2026 episode WLRN's South Florida Roundup with host Tim Padgett, available on WLRN or wherever you get your podcasts.
