As the campaign to close Rikers Island gains momentum, leaders and activists have proposed a host of reforms, from eliminating cash bail to ending solitary confinement for young inmates. But if the City wants to meet its goal of reducing its incarcerated population by half, it must shift more attention to one key area of reform: keeping individuals with mental illnesses out of Rikers.
Here’s one surprising statistic that has emerged in light of recent reports about violence in NYC jails: nearly 40% of inmates – over 4,000 people – on Rikers have a mental illness. Thus, keeping individuals with mental illness out of jail is essential to reducing the city’s incarcerated population, and some studies have shown that mental health services reduce crime among certain populations. A 2006 study from the Journal of Policy Analysis and Management, for instance, found that youth who completed mental health diversion programs were less likely to be rearrested. However, the question remains: how can NYC reduce incarceration among people with mental illness when it continues to face a lack of mental health services?
In an era of tight budgets, it is unlikely that NYC will reopen psychiatric institutions that closed during the era of deinstitutionalization any time soon. With reduced access to mental health institutions, individuals with mental health issues are less able to receive treatment and more likely to end up in jail. Thus, the answer instead lies in innovative partnering between the mental health and criminal justice systems in NYC.
To understand how Rikers came to be a de facto mental health institution, some historical context is necessary. The large number of mentally ill inmates in NYC is primarily the result of two national policy waves: the movement to deinstitutionalize the mentally ill and the rise of harsh crime and drug policies.
Beginning in the mid-1900s, there was growing concern about the costs and inhumane conditions of state psychiatric institutions. Governors, mayors and mental health professionals across the nation began to favor the community mental health model, which allowed people with mental illnesses to receive treatment in their homes and communities, rather than in institutions. This concern led to the closure of many state hospitals and psychiatric institutions. According to expert Helen Barr, there were 93,000 hospital beds available in the New York State hospital system in 1972, and this number dropped to 6,000 beds by 2001.
However, the government did not sufficiently fund community-based alternatives for people with mental illness, so that poor people with mental illness were left to find care on their own. Fortunately, New York State has allocated more money for these alternatives in recent times, and in 2015, spent just under $200 per capita on community-based mental health programs.
Secondly, in the 1970s, the city began cracking down on petty crime, leading many poor and homeless people with mental health issues to the criminal justice system if they behaved disorderly or experienced mental crises in public. But although jails and prisons are becoming substitutes for mental health institutions, they are not equipped to carry out this function, even causing mental illness to develop or worsen.
The goal of efforts to reduce the number of individuals with mental illness at Rikers should be to divert them from going there in the first place. Recognizing this, leaders have implemented several programs designed to do so.
NYC Safe is perhaps the most elaborate and direct example of innovative coordination between the criminal justice and mental health systems. The goal of NYC Safe is to proactively find, target, and serve people with serious mental illness, thus diverting them from the criminal justice system.
One of its most innovative aspects is the creation of a centralized hub managed by the Mayor’s Office of Criminal Justice (MOCJ) to coordinate information sharing between law enforcement, homeless services, and people providing clinical treatment. These workers may call the hub to report people acting violently, and MOCJ gathers information from different agencies to identify people with serious mental illness who need services.
Other components of NYC Safe include “co-response” teams consisting of NYPD officers and Department of Health clinicians as well as Intensive Mobile Treatment teams, which aim to expand mental health services for the homeless and are dispatched upon learning of someone who needs them.
NYC Safe is an example of the innovative approaches needed during a neoliberal era of shrinking budgets – an era that will likely not see the reopening of mental health institutions.
Proactively finding and assisting people with mental health issues before they have the chance to experience the trauma of Rikers is an effective policy strategy for reducing the city’s incarcerated population and recidivism rates.
As the City looks to close Rikers, it must continue investing in innovative ways to actively divert people with mental illness from jails and prisons. This will not only help the city meet its goal of reducing its incarcerated population, but ensure that our criminal justice system does not criminalize people with mental illness and instead gives them equal opportunity to succeed.
