New psychiatry units at Rikers delayed despite renewed focus on mental health and justice

A de Blasio-era plan to expand specialized units for people with mental illness at Rikers Island has stalled without any timetable from the Adams administration, even as the new public safety plan for the Mayor claims to place a strong emphasis on psychiatric help.

The slow rollout of the so-called Accelerating Clinical Efficiency (PACE) program comes as 52% of the island’s total population has been diagnosed with some type of mental illness, according to data from prisons on the island. end of last year – or an estimated 2,728 people “known for mental health” on Monday.

Early research has shown that designated mental health units have been successful so far.

According to a 2020 study, people in PACE housing areas are less likely to fight, get hurt, or refuse to take their medication.

But the majority of inmates diagnosed with mental illness remain in slightly modified general population living areas called mental observation units, according to Department of Correction records. The city’s jails have about 455 beds in specialized mental health units where inmates receive additional counseling and intensive medical care.

Prison medical experts and inmate advocates are frustrated that additional mental health units have not been opened so far.

Dozens of criminal justice reform supporters protest outside Rikers Island after the death of an inmate on the island on February 28, 2022.
Ben Fractenberg/THE CITY

“They need more,” said Dr. Robert Cohen, who sits on the city’s board of corrections, which oversees the department. “They provide vastly improved care compared to overcrowded mental observation units.”

The city has recently been rocked by a string of high-profile crimes with suspects who have a long history of mental illness and a string of prior arrests. Mayor Eric Adams announced a subway safety plan focused on mental health after Michelle Go was shoved to death in front of an R train at Times Square-42nd St. on Jan. 15.

Martial Simon, who was diagnosed with schizophrenia according to his family and spent years homeless and in prison, has been charged in Go’s death.

No details

But Adams has not released a broader plan or specifics of how his administration hopes to help the city’s mentally ill, who often come into contact with the criminal justice system.

For prisons, the Adams administration told THE CITY it is working with the state’s Correctional Oversight Agency and the city’s Correctional Health Services “to create a plan for the future of PACE units.” , said DOC spokeswoman Shayla Mulzac.

But the town hall did not provide any details on how many new units the administration is seeking to create or when that might happen. The planned creation of 392 outpost beds at three public hospitals is also at least a year away as the plan slowly goes through bureaucratic paperwork and design tinkering.

“The mental, physical and emotional well-being of the people we care for is our top priority,” Mulzac said. “As we continue to reopen and get back to normal, we look forward to expanding services, resources and programs for everyone in our care.”

Mulzac acknowledged that “staff are essential to the management of any accommodation” and will be a “major factor in our plan”.

For months during the pandemic, the city’s prisons have been plagued by massive staffing shortages, as hundreds of workers at a time called in sick.

On January 31, the department issued a press release announcing that “more than 1,000 uniformed personnel – including correctional officers – have returned to work at city jails since January 1.”

The additional staff allowed the city to move 83 female inmates who had been sent to the state-run Bedford Hills Correctional Center in Westchester County to Rikers. Correctional officers at several institutions have also moved from 12-hour shifts to 8-hour visits.

Corrections officers prepare to meet with then-Mayor Bill de Blasio on Rikers Island on September 1, 2016.

Corrections officers prepare to meet with then-Mayor Bill de Blasio on Rikers Island on September 1, 2016.
Michael Appleton/Mayor’s Photographic Office

Yet each day for the past week, an average of 1,474 officers have called in sick, according to Department of Corrections spokesman Patrick Rocchio.

Former Corrections Department commissioner Vincent Schiraldi, who took office in May 2021, said he tried to expand the units last year but did not have enough officers to handle them. .

“It wasn’t something I could go into,” he said, noting that the women’s PACE unit is attached to another specialist accommodation area that ideally would be separate.

Unlike PACE, some mental observation units house large groups of up to 50 inmates, while PACE units are individual. They also haven’t been fully renovated in years and lack a structured day-long program. PACE units are made up of officers who receive additional training to work with this vulnerable population.

Former Mayor Bill de Blasio pledged to create 12 PACE units by June 20, 2020. That never happened. Ten are currently operational.

PACE’s expansion plans on Rikers Island have advanced even as the de Blasio administration moved to close all prisons on the island and replace them with four towers in the boroughs, a transition currently scheduled for 2027.

Annexes to the prison of the public hospital

For outpost beds at three public hospitals, the city has earmarked $662 million in capital dollars “to make this pioneering project a reality,” the health services spokeswoman said. Corrections, Jeanette Merrill.

City officials anticipate that a mix of people with severe addictions or with long-term medical conditions will be placed in specialized locations.

A 112-bed Bellevue unit will comprise the entire second floor of the historic Manhattan hospital. It is expected to be completed one year after approval by the State Corrections Commission, according to Merrill. This state approval is partly pending the creation of the required recreation space, which currently does not exist at the hospital.

The 30th Street men's shelter is just north of Bellevue Hospital on November 15, 2019.

The 30th Street men’s shelter is just north of Bellevue Hospital on November 15, 2019.
Ben Fractenberg/THE CITY

Woodhull Hospital is next, with 160 beds and a completion date of 2024. Recreational space for this Brooklyn location would be on the roof, according to renderings.

The North Central Bronx Hospital unit, with 120 beds, is expected to be completed in 2025, according to Merrill.

Dr. Homer Venters, who oversaw medical care for city inmates while leading Correctional Health Services and spearheading the creation of PACE units under the Bloomberg administration, supports the creation of the outpost beds .

He noted that Bellevue Hospital’s inpatient unit doesn’t have officers stationed at every bed, giving them more freedom than they would have on Rikers.

“Once you’re on the ward, it can operate a lot more like a regular hospital,” he told THE CITY last July.

Providing ethical care to incarcerated people is consistent with calls to reduce the prison population, Venters said.

“We have to recognize that patients who are incarcerated should not be in dilapidated or non-functioning facilities,” he said.

“Not something to aspire to”

Some advocates and family members of people with mental illness behind bars argue that they shouldn’t be in the criminal justice system at all.

Cheryl Roberts, executive director of the Greenburger Center for Social and Criminal Justice, objects to Department of Corrections staff running therapy units.

“If you’re looking at a long-term closure plan and looking to do something different in the next 50 years, basically creating hospital facilities or hospital units inside a prison or a prison, is not the solution,” she said. . “It’s not something to aspire to.”

The goal should be to stop criminalizing people with mental illness and ensure they receive community treatment, she said.

“That’s pretty much the money,” she said, noting that the federal government should change the Medicaid reimbursement formula to allow funding for institutional mental health services, a change “promised ago.” 50 years old”.

“We were supposed to be closing beds and having these great community mental health systems,” she said. “That never materialized and we’ve been living with the results ever since.”

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