An upturn in violence at New York City’s Rikers Island Jail has been the focus of recent media attention, most notably in the February death of veteran Jerome Murdough in an overheated cell and the arrest of a correction officer charged in the August 2012 death of another inmate with a history of psychiatric needs detained in the jail. Mayor Bill de Blasio has subsequently promised reform at Rikers Island, one of the nation’s largest jails at a capacity of nearly 15,000 people.

According to data from the New York City Department of Correction, in the past decade the use of force by correction officers at Rikers Island has increased nearly 240% despite a decline in jail population. Simultaneously, the department reported that the percentage of inmates diagnosed with a mental health condition has doubled in the past eight years from 20% to 40%, an increase common in other major cities that is causing criminal justice and mental health leaders to push for stronger community-based behavioral health services to curtail the influx of this population into jail cells.

To facilitate a discussion on the intersection between those with behavioral health needs and the justice system during a new mayoral administration, Vera hosted a panel of experts on March 12 for an event entitled, “Cops, Courts, and Corrections: Can NYC’s Justice System Help Those with Mental Illness?”

Panelists were Steve Coe, Chief Executive Officer, Community Access; Judge Matthew D’Emic, Brooklyn Mental Health Court; Jim Parsons, Director of the Substance Use and Mental Health Program at Vera; and Homer Venters MD, Medical Director for NYC Department of Health and Mental Health at Rikers Island. The panel was moderated by Robert Lewis of WNYC.

The panelists spoke on a range of issues, including:

• Identifying the needs of people with mental health needs - With the average stay at Rikers Island lasting 7-8 days, Homer Venters said that it is vital to capture a person’s medical needs before they are admitted to the jail to ensure that each individual receives the proper care and treatment.  
• Reforming pre-arraignment screening units (PASUs) – The medical needs of the 320,000 individuals arrested annually citywide are assessed at PASUs located in the city’s central booking units. The current PASU process relies on a paper-based, self-report screening mechanism and takes place in a fast-paced, overcrowded environment. As a result, patients’ health needs are often not captured and communicated to medical staff in the jail. Reforming the PASUs represents a critical opportunity to identify treatment needs earlier on.  
• Providing screeners access to electronic health records – Jim Parsons discussed Vera’s new collaboration with the NYC Department of Health and Mental Hygiene, supported by the Langeloth Foundation, to improve the health screening process in central booking by providing screeners access to an electronic health record system overseen by the Bureau of Correctional Health Services.  
• The potential impact of the Affordable Care Act (ACA) – The implementation of the ACA creates momentous collaborative opportunities to enroll people into a health insurance plan and connect them to community-based treatment networks that prioritize keeping people engaged in care and out of corrections. The development of new health care programs, along with expanding access to existing diversion tools such as crisis intervention teams (CITs) and mental health courts, points to promising opportunities for reform to Rikers Island.

The panelists were unanimous in their belief that the next big front in terms of advocacy and reform in the NYC justice system is bringing the focus to the front-end of the justice spectrum, and even to points before the system starts. Parsons said that he’s already seen a shift from the traditional discussion on reentry to one about diversion: “We’re starting to move further upstream.” While grappling with difficult questions such as the extent to which mental health prognosis in corrections facilities are the result of the environment, panelists agreed that best thing we can do is narrow the net and keep people, especially those with mental health needs, out of jail and prisons and in their communities.

We invite you to view the trailer and full video of this event.