City Plans New Approach to Disciplining Mentally Ill Inmates
By Vivian Yee New York Times May 12, 2013
New York City will soon change the way mentally ill inmates are disciplined after breaking rules while in jail, creating alternatives to the more traditional approach of solitary confinement used for most inmates.
Instead, the city Correction Department will transfer severely mentally ill inmates to an internal clinic where psychiatrists will administer treatment and medicine, and the less seriously mentally ill will go to counseling programs designed to help them change their future behavior. Inmates will not be released back into the regular jail setting until they complete treatment.
The new approach, to begin in July, is intended to address what both city officials and prisoners’ rights advocates say is a growing problem: not only are there a disproportionate number of mentally ill inmates in the city’s jails, but they are also more likely to break rules multiple times and stay in jail longer than others.
“The jail has become one of the major providers for people with mental illness in our society, and it’s just now that our systems are keeping up with that,” said Dr. Thomas A. Farley, the city health commissioner, adding that solitary confinement does not work for the mentally ill. “For an inmate with mental illness, that’s not going to make them more likely to improve their behavior,” Dr. Farley said in an interview. “It’s going to make the symptoms of their illness worse.”
More than one-third of New York City’s inmates have a mental illness, according to the city. Of those, about one-third are considered seriously mentally ill, with conditions like major depression and schizophrenia.
Currently, all mentally ill inmates who break prison rules are moved to the same segregated unit, regardless of their condition. Like healthy inmates in solitary confinement, they live in isolated cells, kept in lockdown as long as 23 hours a day. They may also get an hour of group counseling a day and a weekly session of individual therapy.
Under the new policy, seriously mentally ill inmates will get medication and therapy in a setting similar to a hospital psychiatric ward, living in dormitory-style units with other inmates or in more isolated cells. Those not considered severely mentally ill - generally, those who do not require medication - will still be segregated from the general population and from one another. But they will take part in a three-phase program with group and leisure activities aimed at teaching them behavioral control, reducing their time in the program if they actively participate and exhibit good behavior.
The correction commissioner, Dora B. Schriro, said the change would turn a “one size fits all” policy into a tailored program that would do more to help inmates succeed both in jail and once they return to the outside world.
Prisoners’ rights advocates have condemned the use of solitary confinement - in industry parlance, “punitive segregation” - which they say amounts to cruel and unusual punishment. Its use in New York City has increased 44 percent over the past several years, prisoners’ advocates said, giving New York City one of the highest rates of solitary confinement in the nation even as its overall jail population has declined.
Donna Lieberman, executive director of the New York Civil Liberties Union, said the city should reduce its use of solitary confinement for all prisoners, not just the mentally ill. “The irony should not be lost on us that solitary confinement creates mental illness itself,” she said, referring to what she said were the devastating psychological effects of being kept in extreme isolation.
The civil liberties union filed a federal lawsuit in December against New York State’s prison system, accusing it of overusing solitary confinement.
The new system is ultimately expected to shrink the number of solitary confinement units in the system, as mentally ill inmates go through the counseling and treatment programs instead, said Linda I. Gibbs, the deputy mayor for health and human services. The programs are expected to lower the number of rule infractions and shorten mentally ill inmates’ stays in jail.
Steven Banks, the chief lawyer at the Legal Aid Society, said that while the changes were for the better, more needed to be done to improve services for the mentally ill throughout the city so they did not end up in jail. He said he was skeptical that the city would deliver on its promises of reform.
“The fact that Rikers Island has essentially become a de facto mental health facility for a third of the jail population speaks volumes about the need for more resources and more attention to the mental health system over all in the city,” he said, “instead of simply focusing on counseling versus punishment for those that end up falling through every crack in the social services system.”
Ms. Gibbs said the new policy was one of several efforts by the city to improve services for the mentally ill, including a program that works with the courts to treat low-level mentally ill offenders rather than sending them to prison, and another to make sure mentally ill people continue to receive treatment after leaving jail.