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Opinion

The Invisible Toll of Hurricane Maria


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Puerto Rico (photo via the governor's office)


The physical damage caused by Hurricane Maria on the island of Puerto Rico was undoubtedly devastating. Fortunately, homes and buildings can, have been, and will be rebuilt, but it’s often trauma from these natural disasters that leaves the most lasting and destructive mark on a community.

The psychological impact of months without electricity, access to food and clean water, and unexpectedly losing loved ones – experienced on an island-wide scale – cannot be overstated. This kind of stress and instability is shocking, and that’s why so many professionals in the mental health community have prioritized working with victims of Hurricane Katrina in New Orleans, Superstorm Sandy in the northeast, and other natural disasters over the years.

It's not unusual for storm victims to have feelings of fear, anxiety, sadness, or shock in the immediate aftermath of these destructive events. It becomes a problem when these feelings continue for weeks, months, or years after such disasters. Mental health professionals know that if communities are not given the proper help and support to cope with trauma from a horrific storm, they may never truly recover.

Earlier this month, political and community leaders from New York City gathered in Puerto Rico to assist with recovery, and work together to help chart a path forward. At the core of the discussion was mental health and health care – in fact, New York Mayor Bill de Blasio made it the signature announcement of his trip. He and First Lady Chirlane McCray announced a $200,000 commitment to help a nonprofit health care provider hire additional psychiatrists for some of the neediest communities – including one dedicated to children.

This help could not come soon enough. While on the island myself two weeks ago, I helped deliver supplies to a Federally Qualified Health Center, which is trying to do as much as it can with the little it has. Equipment as basic as medical gloves is frequently needed, and doctors are forced to meet with patients – some even struggling with drug and alcohol addiction as well – in rooms the size of large closets. All the while, quality primary and specialty care for these communities is needed more than ever before, with thousands of doctors fleeing the island in the years leading up to Maria and during its aftermath.

For too long, mental health has been an afterthought of medical care, especially in Latino communities. In a recent citywide study we conducted of New York’s Latino patients – Invisible: The State of Latino Health – we found that only one-third of Latinos think that behavioral or mental health services are easily accessible. This lack of access to care can have severe consequences, as untreated trauma can push the most vulnerable to substance abuse and addiction. The New York City Department of Health and Mental Hygiene reports that almost two-thirds of New York City Latinos who die from drug overdose are, in fact, Puerto Rican.

We know another Hurricane Maria will hit – it’s just a matter of when. Until then, we need governments, public leaders, and community groups to ensure Puerto Rico has the right support systems in place to help families rebuild their spirits and psyches, not just their homes. While the financial costs of these disasters may make the biggest headline splash, it’s the often unseen damage that may demand our greatest attention and action.

[Read: State of Latino Health: Dismal, and Invisible]

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Ricardo is the Chief Business Development Office for SOMOS Community Care, and the former executive director of Medicaid in Puerto Rico.

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Enact Sweeping Criminal Justice Reform Responsibly


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(photo: Spencer T. Tucker/Mayor's Office)


The Governor and the Legislature should use this once in a generation opportunity to make New York State the world leader in thoughtful and effective public protection policies that hold offenders accountable in a humane and forgiving way, and which allows those who offend to, within reason, receive opportunities to make amends and start afresh.

They could start strong by creating a grand blue ribbon commission with multiple subsidiary groups consisting of cross-partisan experts representing a broad public justice and human services spectrum.

And they should forego the impulse, admittedly hard to resist in the afterglow of strong electoral results 10 days ago, to pursue ideological approaches at the expense of posing honest questions and hunting for approaches that work.

The poisonous blue versus red state rhetoric is polluting this conversation (this is happening all over the country where more liberal states seem to relish the chance to stick a finger into conservative eyes - and the contempt is mutual): this divisive tact has no place in devising rational, humane, and effective approaches. It presents the false choice that one has to pick a side: the ACLU or Jeff Sessions. We must do better.

This is a task that is bigger than the Legislature and the Governor. Indeed, it is our political system that has bequeathed the contemporary system that is criticized from all sides. It must be stipulated that much bad criminal justice policy was the product of scare-mongering politicians of a different era seizing on anecdotal, low-probability events as grounds for enactment of draconian laws, such as ones that target narcotics possession and sale. There should have been, but frequently was not, pushback when these laws and policies were gathering steam.

Now, the danger runs in the other direction.

Advocates have commandeered the conversation and this has dangerous implications. Far too frequently, this means that several shades of only one side of an argument are presented.

Bail and parole reform of some sort is a commendable pursuit, but the public must be leveled with: early release will mean that there will likely be more victims, and some may lose their lives. Will cashless bail mean that a defendant who has no skin in the game will be less concerned about skipping court appearances? This is not a reason not to embrace change, but advocates (who are often backed up by billionaires who are unelected and unaccountable and who are, themselves, and their families, unlikely to have violence fall on them) have a maddening tendency to obscure or dissemble in the face of evidence that runs counter to their objectives. When reforms are being discussed the lives put at risk are almost invariably not in affluent places.

And the voices of individual victims and communities as a whole have been marginalized or stifled altogether.

To be sure, there are daily miscarriages involving charged individuals -- people supposed to be presumed innocent -- locked up for prolonged periods, despite the presumption of innocence, in true Kafkaesque fashion. Dramatically speeding up adjudication will make much of the bail debate academic.

A blue ribbon commission can look in a sweeping and holistic way at the agencies charged with delivering justice, with a keen eye to unintended or collateral consequences to seemingly simple silver bullet reforms. It is far too easy for elected officials to succumb to sponsoring slapdash reforms that allow them to bask in the glow without considering the wider implications of the bills they sponsor.

Certainly, some legislative steps taken in the name of “police reform” have helped lead to the current death spiral of the police profession. There are a number of public officials who seem to believe, misguidedly, that it is a great accomplishment to create an atmosphere where the police avoid engaging festering community conditions. If they looked across the country before acting, they would know that urban police departments willing to take risks and bear the brunt of criticisms for defending communities against disorder and insecurity are becoming as rare as the dodo. They would also notice that police departments are struggling mightily to find someone, anyone, to put on a uniform these days. This may not seem like a pressing concern in our presently supersafe city, but what if the future sees dramatic shifts and upheavals?

The blue ribbon commission could launch its work by conducting in-depth, high-quality, sustained surveys to gauge the sentiments of people in communities (in my experience the feedback gathered will always contain surprises). And true justice would have a local flavor: it is folly to try to create one uniform, static standard in each of the state’s 62 very different counties. Indeed, even in a single NYPD precinct, there can be many different communities and seemingly, at times, as many opinions and sensibilities about safety as there are residents.

The country (and we could seek out leaders from overseas as well) has many current and former law enforcement, justice, and human services professionals who have progressive instincts but who will not forget that the duty is to strike a practical, humane balance.

We should pursue grand and workable ideas, research, and demonstration programs from all over the planet, rejecting the chauvinism and insularity that is a hallmark of a 50-state justice system.

Consideration should be given to creating a statewide super-agency, something like the Department of Community Well Being and Safety. Perhaps it should be led by a First Deputy Secretary or Deputy Secretary to the Governor.

Too often agencies continue to work siloed off from one another, law enforcement agencies separated from agencies with other portfolios, working at cross-purposes. Protecting the public and treating offenders decently demands that the education, health, employment, mental health, and drug and alcohol addiction infrastructure be central to any final package of reforms. Can the notoriously independent, aloof even, federal law enforcement community be looped into these efforts?

We must also not ignore hard truths. It is a noble and fiscally prudent goal to urgently seek to shrink prison and jail populations. But these populations would be significantly higher if the justice system was better at apprehending those who commit serious crimes. Most of these offenders are never apprehended. Can true justice system reform ignore this reality?

And despite all the rhetoric about shrinking the punitive footprint of the system, new laws continue to be added with each passing legislative session, while existing laws are almost never revoked.

The system has to be repaired but also defended and re-legitimized. There is a widespread misbelief that convictions of the innocent are commonplace. Elected officials must embrace, vouch for, and sell the system; after all, it is their creation. In the wake of serious crimes, people are sometimes not cooperating with investigators. What do lawmakers offer as a remedy?

We need a complete blue sky review of the uses of technology to prevent crime and to track offenders so that they are getting what they need to steer clear of re-arrest. How can technology be used to vitiate the need for the police to make custodial arrests?

What is the promise for treating breaches of public peace and order in a civil, rather than criminal, context?

We need to examine the work of all prosecutors’ offices, but also the concerning trend where “progressive prosecutors” pursue or decline prosecutions or overlook laws never repealed by the Legislature on the basis of what can be spongy, unstructured, idiosyncratic whims -- that Is not a system of laws, but of ‘men.’

There is also a need to provide affirmative policy preventing and responding to mass casualty shootings and terrorist acts ranging from unsophisticated lone wolves to catastrophic uses of chemical or biological warfare in our streets.

And we need to examine big business and white collar crime anew in the face of evidence that some business bottom lines are being topped off by what can only be described as scams, schemes, and frauds.

And essentially, it must be said that this economy is not working for millions of people. Anyone who interacts with young people knows of their fears and insecurities about finding a place in this society. High turnover, insecure, minimum wage jobs represent a menace to society's well being. In her new book, "The Job," Ellen Ruppel Shell sums it up succinctly: “Good work brings stability of the sort that staves off conflict…”

It is always hard to ask political folks to soar above political considerations and to deliver evidence-based solutions to thorny problems, come what may. New York’s political establishment has a chance to rise to the challenge. Will they take it? Will they go big?

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Eugene O’Donnell is a former NYPD officer and prosecutor in Brooklyn and Queens, and currently a professor at John Jay College of Criminal Justice.

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New York Votes for a State Senate that Trusts Women


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(photo: @PPESVotesPAC)


For years reproductive health advocates have pushed to update New York’s antiquated abortion law and increase access to affordable contraception, only to be stalled by our state Senate leadership’s refusal to consider any reproductive health legislation. That roadblock continued despite the federal administration's efforts to drastically alter our reproductive health care - including our constitutional right to safe, legal abortion.

This November, voters turned out in larger-than-usual numbers for state Senate candidates who trust women to make their own health decisions - because the clear majority of New Yorkers understand our autonomy relies on our ability to control our own reproductive health care.

New York voters consistently support access to abortion. According to a July Quinnipiac poll, 73% of New York voters agree with U.S. Supreme Court's Roe v. Wade decision establishing a woman's right to access abortion care.

However, the state Senate majority leadership refused to consider the will and values of New Yorkers. During the election, we saw the same old rhetoric to shame and stigmatize women and their providers. But we also saw an energized electorate in New York and across the nation that trusts women, supports women, and believes that everyone should have equal access to health care.

You can outlaw safe, legal abortion, but you can’t legislate away the need. More than one-in-four women receive abortion care before age 45, and 59 percent of women who obtain an abortion already have at least one child. That’s your mom, your friend, your sister, or your fellow commuter on the train.

While approximately 90 percent of abortions happen in the first 12 weeks of pregnancy, serious complications can arise at any time during pregnancy. Providing access to needed abortion care throughout pregnancy simply ensures proper medical care for those who require it.

Our current laws restrict our ability to access abortions to safeguard our health and fail to consider complications throughout pregnancy. Voters saw this clearly even if the Senate leadership refused to.

Now we have a state Senate that will truly represent women, not one that seeks to control them. We expect real progress, including protecting our right to abortion in our state law and keeping essential reproductive health care accessible to all New Yorkers.

In 2019, the voices of all New Yorkers will clearly be heard, not only in the streets but in the legislative chambers. That’s a trend we expect to see continue in our state and across the nation as voters realize that they can create the change they demand by casting a ballot.

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Robin Chappelle Golston is the Chair of Planned Parenthood Empire State Votes. On Twitter @PPESVotesPAC.

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