Imagine dropping your child off at school in the morning and receiving a phone call hours later telling you they’ve been transported to a psychiatric facility; without your knowledge, without your consent, and without any opportunity to say goodbye.

This is not a hypothetical. In Florida, it happens every day.

Over the past decade, Florida residents have been subjected to more than 1.5 million forced psychiatric examinations under the Baker Act, including 335,000 involving children; some as young as five years old. At peak, Florida was Baker Acting nearly 200,000 adults and 40,000 children per year, the highest rate of involuntary psychiatric examination of any state in the country. And a significant portion of those holds were not driven by genuine psychiatric emergencies. They were driven by revenue.

Let me explain how the math works.

A Crisis Stabilization Unit contracted by the state receives approximately $300 per day per bed. A private for-profit psychiatric hospital billing the same patient’s insurance can collect $1,200 to $1,400 per day for that same hold. When you have 200,000 Baker Act initiations a year, the financial incentive to fill beds, and keep them filled, is enormous. One Tampa-area facility was documented averaging more than eight days per admission, filing repeated petitions to extend holds and then dropping them before they could be heard by a judge.

This is not mental health care. It is a billing strategy.

The Fraud Is Documented. The Settlements Are Real.

CCHR Florida has spent years not just raising alarms but providing documented evidence to state and federal regulators. In 2017, we publicly demanded an explanation for why psychiatric hospitals under active federal investigation were still operating as Baker Act receiving facilities; still receiving state contracts to hold Floridians involuntarily.

We named the facilities. We named the company: Universal Health Services, which operates the largest chain of for-profit psychiatric hospitals in the United States with annual revenue of $7.5 billion. Four of its Florida facilities; Central Florida Behavioral Hospital, River Point Behavioral Health, University Behavioral Center, and Wekiva Springs, were simultaneously under investigation by the Department of Justice, the FBI, the OIG, the Department of Defense, and HHS for fraudulent billing.

In July 2020, UHS agreed to pay $122 million to settle False Claims Act allegations for billing Medicare and Medicaid for medically unnecessary inpatient behavioral health services across 49 states.

That settlement did not happen by accident. Years of documented complaints by patients, families, and advocates; many of them channeled through CCHR, contributed to the regulatory and legal pressure that produced it.

Acadia Healthcare, another for-profit chain with facilities in Fort Myers and Wesley Chapel, followed a similar path. In September 2024, Acadia paid $19.85 million to the federal government and four states to settle allegations of billing for medically unnecessary inpatient stays, inadequate staffing, and improper patient care. Florida’s Attorney General’s Office followed up in January 2025, independently recovering an additional $2.2 million from Acadia for the state Medicaid program.

Last year alone, Florida’s Agency for Health Care Administration recovered more than $72 million in fraudulent Medicaid payments from behavioral health providers, with nearly 3,000 active fraud cases under investigation.

This money did not disappear when it left patients’ lives. It was extracted from public health dollars that should have funded legitimate, compassionate care.

Reform Is Working — But More Is Needed

Here is what sustained advocacy actually produces: results.

In 2024, Florida passed House Bill 7021, a landmark Baker Act reform package that, for the first time, gave law enforcement officers discretion over whether to initiate an involuntary examination. Officers can now refer individuals to mobile crisis response teams or clinical alternatives rather than automatically transporting them to a psychiatric facility. The law also established the Office of Children’s Behavioral Health Ombudsman, strengthened parental notification when a minor is Baker Acted, and required individualized discharge planning.

The Florida Department of Children and Families reported in November 2025 that these reforms, combined with prior advocacy efforts, have contributed to a 20% decline in overall Baker Act initiations over five years and a 17% decline in juvenile commitments. Total annual initiations have dropped from more than 200,000 to approximately 158,000.

That is tens of thousands of Floridians each year who are not being involuntarily transported to psychiatric facilities.

But the number of children being Baker Acted, while reduced from its peak, remains unacceptably high. Despite Florida’s Parents’ Bill of Rights, which explicitly reserves to parents the right to make mental health care decisions for their minor children, the Baker Acting of minors can still proceed without prior parental consent. Children are still taken from schools. Parents are still learning about it after the fact.

This is a parental rights issue as much as it is a mental health issue.

What We’re Not Saying — And What We Are

Critics occasionally mischaracterize this work as opposing mental health care. Let us be direct: we are not opponents of mental health care. We are opponents of fraud, coercion, and abuse committed by the mental health industry in the name of “help”.

Florida has an opportunity to lead the nation in building a behavioral health system built on transparency, accountability, voluntary engagement, and genuine patient outcomes.

But that path requires continued vigilance. As long as there are for-profit operators who view involuntary psychiatric holds as a revenue line, and as long as the system allows them to operate with inadequate oversight, patients and families remain at risk.

Diane Stein is the President of CCHR Florida (Citizens Commission on Human Rights), a nonprofit mental health patient rights watchdog organization based in Clearwater, Florida. CCHR Florida can be reached at 727-442-8820 or diane@cchrflorida.org.