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About Mental Health

New York City Plans Focus on Mental Health in Justice System

The New York Times, DEC. 1, 2014

In an effort to reduce the growing number of inmates with mental health and substance abuse problems in New York City’s jails, the administration of Mayor Bill de Blasio announced plans on Monday to significantly expand public health services at almost every step of the criminal justice process.

City officials, who are allocating $130 million over four years to the project, said their goal was to break the revolving door of arrest, incarceration and release that has trapped many troubled individuals in the system for relatively minor, quality-of-life offenses.

The new plan will shift emphasis from punishment for minor crimes to treatment.

The changes include tripling the size of both pretrial diversion programs and the amount of resources devoted to easing the transition from jail back into society. This would represent a significantly different approach to criminal justice in the city, experts said. But they cautioned that nothing of such scale had been tried by a municipality before, and that putting the plan into effect would be difficult. Mayor Bill de Blasio on Monday, the same day a task force released a report detailing changes to the criminal justice system.

“I think this is what criminal justice looks like in the 21st century,” said Elizabeth Glazer, the mayor’s criminal justice coordinator, who was a co-chairwoman of a task force of city officials and community leaders that released a report on Monday detailing the changes. “Preventing crime is about more than the police and more than about prosecutors and defense lawyers and courts.”

The overhaul in New York City comes at a time when police departments across the country have faced scrutiny after several shootings of unarmed individuals, many with mental illnesses.

In New York, the portion of inmates at the city’s jails who are mentally ill has increased to nearly 40 percent in recent years, even as the overall number of people incarcerated has shrunk.

Many of these inmates are so-called frequent fliers, constantly cycling in and out of Rikers Island, the city’s main jail complex. The task force report identified more than 400 people who had been jailed at least 18 times in the last five years, accounting for over 10,000 jail admissions during that period. It said that 67 percent of these inmates had “a mental health need”; 21 percent were severely mentally ill, meaning they had diseases like schizophrenia or bipolar disorder; and 99 percent had a substance abuse problem.

The task force’s report reads, in some ways, as an effort to moderate the prevailing policing methods of the last two decades, in which large numbers of people, including many who were homeless, were swept off the streets and incarcerated for low-level crimes like fare beating, loitering and trespassing.

Mr. de Blasio, a Democrat, appears to be trying to forge a middle ground, at a time when violent crime is at historic lows.
Twenty years ago, as crime in the city surged to record levels, Mayor Rudolph W. Giuliani, a Republican, initiated a policy, known as broken windows, to aggressively police quality-of-life offenses. More recently, Mayor Michael R. Bloomberg, a political independent, championed the use of stop-and-frisk tactics in neighborhoods where crime persisted.
With this plan, Mr. de Blasio is essentially seeking to continue the aggressive policing of minor crimes, while seeking to keep many of the offenders out of jail. The test will be whether the two approaches are compatible and a low crime rate can be sustained.

Among the many innovations suggested by the task force is the development of community based drop-off centers, where police officers with specialized training could bring people they have taken into custody for minor crimes. The centers would “provide an option for people who need neither to be held for arraignment on low-level charges nor emergency room services,” the report said.

Each center would have detox services, beds for short-term stays, and case managers who could make referrals to existing programs in the community. The first such center would be opened in fall 2015 in Manhattan and the second in an unspecified borough in early 2016, the report said.

While Police Commissioner William J. Bratton served on the task force’s executive committee, the success of several of the programs will depend on the attitude of rank-and-file police officers, who would need to buy into such major changes.
The city also hopes to improve mental-health screening before arraignment. At present, an emergency service worker assesses people for serious physical ailments before they appear in court. Under the new plan, a medical worker would screen for serious psychiatric problems and possibly divert people from court to treatment programs.

Also planned is an expansion of supervised pretrial programs for low-level offenders who might otherwise fail to make bail. The amount of people the programs could serve would increase to 3,400 from the current capacity of 1,100.
Each year, the mayor’s plan would provide community services for an additional 4,100 inmates with serious mental illnesses who are being discharged from jail. For a decade, the city has been under court order to provide such services, but has repeatedly failed to meet basic standards set by the court, including transportation to a residence or shelter, and referrals for mental health treatment.

In April, Justice Geoffrey D. Wright, of State Supreme Court in Manhattan, extended court oversight for two more years because the city had again not met the basic standards.

Another major problem identified by the task force is the difficulty of immediately restarting Medicaid services for inmates; Medicaid coverage is canceled by the state during incarceration. Without coverage, former inmates cannot fill prescriptions to treat their mental illnesses.

City officials and criminal justice experts said various aspects of the de Blasio administration’s plan had been put into effect by other cities, but none of the other programs had been as ambitious.

“I don’t know of any other major city that has done something that is so comprehensive,” said Jim Parsons, research director of the Vera Institute of Justice.

Of the funds allocated to the project, $90 million will come from tax revenues, and $40 million from the Manhattan district attorney’s asset forfeiture fund. Whether or not that amount will be sufficient remains to be seen, experts said.
“Until you try these initiatives, it’s hard to know exactly what kind of investment will be needed,” Mr. Parsons said.
Inmate advocates, long critical of the city’s approach to criminal justice, spoke highly of the new initiative.
“It’s a comprehensive plan that, if implemented, could have a significant impact,” said Jennifer J. Parish, director of criminal justice advocacy at the Urban Justice Center.

In February, Jerome Murdough, a 56 year-old veteran with schizophrenia and a substance abuse problem, was found dead after a heating malfunction drove the temperatures in his cell at Rikers to over 100 degrees. Mr. Murdough had been arrested for sleeping in the stairwell of a public-housing project.

In October, the city paid his family $2.25 million to settle a wrongful-death suit.

Mr. Murdough’s case is illustrative of many of the issues in the criminal justice system that the de Blasio administration is now seeking to address.

“We see these frequent fliers, people who commit relatively small low level offenses, cycling through the system over and over and over again,” Ms. Glazer said. “And the question is, how do we stop that? Clearly what we’re doing now is not all that effective.”