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City Council Looks at Reducing Recidivism for People with Mental Illness


council comm cj

Elizabeth Ford of Health + Hospitals, left, & Becky Scott of DOC (photo: John McCarten/City Council)


City Council members on Monday held an oversight hearing to examine how New York prevents formerly incarcerated mentally ill persons from returning to jail. The hearing made clear that the de Blasio administration, Health + Hospitals public hospital system, and City Council members all want to reduce the number of mentally ill persons who rely on the jail system for their mental health care and keep those with serious mental illness out of jail altogether.

But, it was evident at the hearing that there is much more emphasis on services for the imprisoned mentally ill than on keeping those with serious mental illness out of jail, whether for the first time or in all-too-common recidivism.

The psychiatric services offered in city jails -- like nurse and doctor staff, therapeutic groups, and medicine -- are robust but someone with a serious mental illness often loses the best care upon leaving jail. This then contributes to high recidivism rates.

The hearing centered several key data points: roughly 43% of those held in city jails are suffering from mental illness (14% have serious mental illness); the recidivism rate in New York City is 20%, but for those with mental illness it’s 47%.

Held by the Council’s Committee on Justice System, Committee on Criminal Justice, and Committee on Mental Health, Disabilities and Addiction, the hearing looked at the different ways the city Department of Correction and Correctional Health Services, a part of New York’s public health care system, New York City Health + Hospitals, provide care for the mentally ill in prison and once they leave. Two pieces of legislation dealing with notifying defense attorneys of their detained clients’ mental health and returning unused commissary money to recently released inmates were also discussed with various stakeholders who testified.

As the overall jail population has declined significantly, the proportion of New Yorkers with mental illness in city jails has risen in recent years: the overall average daily population of city jails decreased from around 11,500 in 2014 to around 8,900 in 2018, and the percentage of people with mental illness increased from 38% to 43%.

The percentage of those with a serious mental illness, defined by Correctional Health Services as anyone with schizophrenia, bipolar disorder, major depressive disorder, or post-traumatic stress disorder, has increased from 10.2% to 14.3% in that same time frame.

Council Member Keith Powers, a Manhattan Democrat and chair of the Committee on Criminal Justice, asserted that the City Council and the different city agencies in attendance all agree that jail is not the place to help seriously mentally ill people. However, jail is often where people with serious mental illness wind up, and jails often offer medical services – city jails have many psychiatric services located in one place (in fact, Rikers Island is the third-biggest provider of psychiatric care in the United States behind jails in Los Angeles and Chicago).

Currently, city jails put inmates diagnosed with mental illness in “mental observation houses” (MOs), where there are advanced levels of service and psychiatric nurses available, or the more intensive option, PACE (Program to Accelerate Clinical Effectiveness) units where there’s 24/7 embedded staff and more therapeutic groups, according to Dr. Elizabeth Ford, who testified for Correctional Health Services.

However, through questioning from Powers, Ford admitted right now there are people who qualify for PACE but due to spacing issues are only in MOs. THE CITY reported in April that the de Blasio administration is well behind on its planned 12 PACE units by 2020 (currently there are six).

Council member questions made clear that there are many mental health services available in prison, but the key organizing question of the hearing was: what happens when an inmate/patient is released? Ford said CHS gives inmates seven days of their medicine so they don’t drop off too preciptiously after leaving jail, a 30-day prescription which can be fulfilled at a pharmacy of their convenience, and many referrals to outpatient treatment programs.

Outpatient treatment is the primary way people with mental illness are treated in New York, most of which are run by New York City Health + Hospitals. Outpatient care requires patients to appear at appointments, as opposed to inpatient care or state institutionalization – mental health care nationwide over the past 60 years has transitioned away from state-run facilities once known as “insane asylums” or “psychiatric hospitals” and towards outpatient care.

When asked how CHS can make sure recently-released inmates follow through on getting care, Ford mentioned they are hiring more social workers and focusing on making sure existing services, like existing mobile care teams, work well rather than accepting “new mandates.”

In terms of keeping mentally ill people out of prison in the first place, Ford brought up the new plan from the administration of Mayor Bill de Blasio of helping mentally ill people go to the Health + Hospitals system, instead of prison.

Furthermore, two diversion centers -- in East Harlem and South Bronx -- will offer police officers a place to bring emotionally disturbed people who exhibit signs of mental illness instead of arresting them. They’re not open yet, but are supposed to open later this year.

Ford hopes the community-based aspect of the diversion centers will be especially useful as the centers will be located to existing outpatient care.

Supportive housing is another way to prevent recidivism, according to Ford. Supportive housing offers mental health services to people struggling to find housing. The de Blasio administration plans to build 15,000 supportive housing units over 15 years.

If the roughly 1,200 city jail detainees diagnosed with serious mental illness were to be released tomorrow, the relatively minor supportive housing options and short-term diversion centers combined with New York’s disinclination towards inpatient care throw doubt on how the seriously mentally ill would be treated without jail-based services.

The city has created what they call Community Re-Entry Assistance Network (CRAN) teams, which are six-month transitional teams to help those with serious mental illness re-enter the community after release.

On the two pieces of proposed legislation being considered at the hearing, the lead sponsor of the defense attorney notification bill is Manhattan Council Member Margaret Chin, while Queens Council Member Donavan Richards is the lead sponsor of the commissary bill.

Chin’s bill, Intro. 1590, would require the Department of Health and Mental Hygiene to notify the defense attorney of a person who is in the custody of the Department of Correction and who has been diagnosed with a serious mental illness.

The bill, co-sponsored by City Council Speaker Corey Johnson and six other Council members, is not supported by Correctional Health Services in its current language. Although Dr. Ford chose to keep some reservations of Correctional Health Services private, she did mention that the agency has a newly-created court liaison program intended to act as a go-between for defense attorneys and medical officers.

The current process for notifying the defense attorney of a seriously mentally ill person who is accused of a crime is the patient must give consent to Correctional Health Services and CHS gives information relevant to the mental illness diagnosis to the defense attorney.

The bill “attempts to break the cycle of imprisonment,” said Chin, as ideally more cases could take mental illness into account.

The most intense exchanges of the hearing occurred in regard to the other piece of legislation discussed Monday. Intro. 0903, Council Member Richards’ bill, would require the Department of Correction to notify all recently-released former inmates if there is money in their individual jail commissary account as well as return that money within 60 days of release.  

A commissary account, which can be deposited into by an inmate’s family, is essentially a bank account that the inmate can use to purchase snacks or personal products while in jail. Currently, the Department of Correction is holding $3.7 million from as far back as 2012 in unclaimed commissary money for the over 140,000 individuals who have not claimed it.

Richards, indignant, heavily implied DOC wasn’t making any effort to return the money, while DOC testifiers stated multiple times they don’t use the unclaimed money for their own purposes.

According to those who testified for the Department of Correction, the only outreach done by the DOC has been to put posters -- only in English -- in the jails. DOC representatives said the often unpredictable nature of inmates’ release schedules as well as the general difficulty in remaining in contact with released inmates makes returning the money difficult. DOC does not support the bill, citing difficult logistics.

In a fitting summary of the hearing, Council Member Diana Ayala of Harlem and the Bronx said if the Department of Correction cannot find people leaving prison to give them their money back, how can they ensure the mentally ill leaving prison get the mental services they need?

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by Truman Stephens, Gotham Gazette

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NAACP, Anti-Smoking Groups Press City Council Speaker on Bills Banning Flavored Cigarettes


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Council Members Levine, center, & Cabrera, behind him (photo: John McCarten/City Council)


The New York chapter of the NAACP and four of the nation’s largest anti-smoking groups are urging City Council Speaker Corey Johnson to support two bills that would effectively ban the sale of flavored tobacco products in New York City. The groups recently sent a letter urging Speaker Johnson to bring the two proposals up for a vote in the City Council.

The first bill, Intro. 1345, sponsored by Bronx Council Member Fernando Cabrera, would end an exemption in a previous city law that banned the sale of flavored cigarettes to allow for the continued sale of menthol, mint, and wintergreen flavors.

The second bill, Intro. 1362, sponsored by Manhattan Council Member Mark Levine, who chairs the Council’s Health Committee, would ban the sale of flavored e-cigarettes.

The American Heart Association, Campaign for Tobacco-Free Kids, American Lung Association, and American Cancer Society joined the NAACP’s New York State Conference in calling for flavored tobacco products to be banned in New York City. They say the tobacco industry uses flavored products to specifically target young people and communities of color.

“We strongly urge you to enact two proposals pending before the Council – both cracking down on flavored tobacco products that lure and addict our children,” reads the letter.

The letter states that 85% of African-American smokers use flavored productions (compared to 29% of white smokers). These organizations believe this is a leading reason why “African Americans suffer the greatest burden of tobacco-related mortality of any racial or ethnic group in the United States.”

Last year, youth e-cigarette use, which increased 80% in 2018, was declared an “epidemic” by the U.S. Surgeon General. The advocacy groups’ letter points to a survey that found that “81.5% of youth e-cigarette users and 73.8 percent of youth cigar users saying they used the product ‘because they come in flavors I like.’”

The letter calls these trends “simply unacceptable” and implores Speaker Johnson to act on the issue. Both bills were first introduced in January and hearings were held in that same month, but there has been no change in the legislation’s status for five months, save additional sponsors signing on.

In May, all five borough presidents signed on to a letter drafted by Brooklyn Borough President Eric Adams supporting the two bills. Both Adams, who has made public health a signature issue, and Bronx Borough President Ruben Diaz Jr. are considering runs for mayor, as is Johnson, who has also had a focus on health and chaired the Council’s health committee last term.

Johnson has been waging a public battle to quit smoking cigarettes, recently tweeting that he had hit 40 days without one (he told Gothamist he bought a juul, but did not indicate if it is flavored).

“The Council is always working to improve the public health outcomes of all New Yorkers, and we are continuing to review these proposals as they go through the legislative process,” according to a spokesperson for Johnson, who did not indicate where the speaker himself falls on the bills.

Neither bill has a majority of sponsors in the Council.

Eighteen of 51 Council members have sponsored Cabrera’s bill. “Flavored tobacco leads to the preventable deaths of thousands of New Yorkers each year and it is people of color and our children who are most at risk of getting hooked,” Cabrera said in a statement to Gotham Gazette. “We must move quickly to significantly restrict menthol cigarettes and flavored cigarettes in our city.”

Fourteen Council members have sponsored Levine’s bill. Twelve of the 14 also sponsor Cabrera’s bill. “To protect kids and our communities, we have to end the sale of flavored tobacco products in New York,” Levine said in a statement, adding that he is “working hard in the City Council to pass legislation to ban these products and ensure they can no longer be used to addict the most vulnerable New Yorkers.”

Some anti-tobacco advocates have posited that the bills haven’t moved because the National Action Network, a civil rights organization led by Rev. Al Sharpton, has come out against Cabrera’s proposal.

During the Council health committee hearing on the bills in January, Kyra Stephenson-Valley, NAN’s cessation coordinator, said “it is proven that increased regulation does not necessarily stop users, but rather criminalizes addicts without resource,” pointing out that there have been “disparate impacts.”

She went further, declaring that “bans and prohibitions can lead to an increase in negative interactions between law enforcement and African-Americans.” She also alluded to Eric Garner’s death, saying “history has shown us here in New York City that can take your life over a loose cigarette.”

In addition to City Council testimony, according to Politico, NAN “has held town halls at prominent black churches throughout the United States to talk about how menthol bans criminalize the black community.” According to a spokesperson for Council Speaker Johnson, Sharpton has mentioned the issue to him in passing, but has not directly lobbied Johnson or the Council.

City Council Member Keith Powers, a Manhattan Democrat who supports Levine’s bill but not Cabrera’s, said in a statement, “I have been an ardent supporter of stricter laws on smoking but want to ensure that no community feels targeted.” He did not respond when asked whether any individual or group personally lobbied him against Intro. 1345.

According to FairWarning, NAN receives funding from R.J. Reynolds, the second-largest tobacco company in America. The company produces Newports, which are the nation’s best-selling menthol cigarette brand. According to FairWarning, R.J. Reynolds’ donations to NAN are part of a broader corporate strategy of “seizing on the hot button issue of police harassment of blacks to counter efforts by public health advocates to restrict menthol sales,” with the help of prominent African-Americna leaders and advocacy groups.

The tobacco industry has a long history of employing similar tactics. According to the CDC, tobacco companies have historically attempted “to maintain a positive image among African Americans have included such efforts as supporting cultural events and making contributions to minority higher education institutions, elected officials, civic and community organizations, and scholarship programs.”

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by Andrew Millman, Gotham Gazette

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De Blasio Administration Doesn't Support Council Bill to Create Department of Sustainability & Climate Change


Costa Constantinides City Council

Council Member Constantinides (photo: Jeff Reed/City Council)


At a recent hearing of the City Council Committee on Environmental Protection, the de Blasio administration expressed its opposition to a bill that would establish a New York City Department of Sustainability and Climate Change.

The bill, Intro. 1399, was introduced in February by Council Member Costa Constantinides, a Queens Democrat and chair of the environmental protection committee.

It would make New York City among the first in the nation to implement a municipal-level agency dedicated to sustainability and climate change, according to Constantinides, and would repeal the Mayor’s Office of Sustainability and replace it with the new department, led by a commissioner. This change, going from part of the mayor’s office to a separate department, would likely mean more funding and staff for the responsibilities involved, signifying greater emphasis on the city’s efforts to fight climate change and prepare for its effects.

The commissioner of a Department of Sustainability and Climate Change would be responsible for all matters pertaining to recovery, resiliency, and sustainability, the three main pillars of the work involved as the city takes additional efforts to deal with and fight climate change. The department would develop and coordinate the implementation of policies, programs, and actions to meet the long-term needs of the city.

The proposed bill would also establish a Sustainability Advisory Board with members to include, at a minimum, “representatives from environmental, environmental justice, planning, architecture, engineering, oceanography, coastal protection, construction, critical infrastructure, labor, business, and academic sectors.” Most members would be appointed by the Mayor though it would also include the Speaker of the City Council and the chair of the Council’s Committee on Environmental Protection or their designees.

“It’s time for us to make as a city a larger investment, a deeper investment, and one that when this mayor leaves, and when this City Council leaves, that we’re leaving behind a stronger apparatus, an apparatus that would be in perpetuity in relation to climate change,” Constantinides said during the hearing.

But Mark Chambers, the director of the Mayor’s Office of Sustainability, testified before the Council committee at the June 12 hearing, which also dealt with two other bills related to reducing methane emissions and leaks in the city, and expressed the de Blasio administration’s opposition to the bill to create a new department.

After highlighting what he deemed the many successful initiatives of the Mayor’s Office of Resiliency, the Mayor’s Office of Sustainability, and the Mayor’s Office of Climate Policy and Programs, Chambers said a new department is not necessary. Key measures and structures are already in place to ensure that resiliency, sustainability, and recovery are embedded in all New York City agencies and initiatives, Chambers argued.

“Climate change is a cross-cutting issue requiring the specialized expertise of almost every city agency. By giving the Mayor’s Office of Sustainability, the Mayor’s Office of Resiliency and the Mayor’s Office of Climate Policy and Programs the power to coordinate agency efforts, we are able to act with the urgency that our residents demand,” Chambers said in his testimony.

“Having said that, while the administration believes that our current climate teams are structured appropriately to meet the challenge, New York City residents need every tool at our disposal in this fight,” he continued. “We share your goals that were put forward in Intro. 1399 to prepare New York City for the impacts of climate change, build a more sustainable city and effectively respond to and recover from climate emergencies. In the coming months, we look forward to discussing strategies for effectively meeting these goals together.”

“I completely agree that doing more is not only advantageous but it’s absolutely necessary. To your original point about the benefits of making sure there is a legacy of this work, making sure that it has to continue, one of the hallmarks of our approach to our climate work is codifying it wherever possible,” Chambers said in his testimony. “So it’s not just working with the Council, it’s also with changing the energy codes, changing the building codes, changing the zoning codes to make sure that it is not subject to just prioritization but it’s become a culture of how we do work internally in the city as well as how the city at large has to redefine our environment.”

Constantinides acknowledged the work that the mayor’s office and the City Council have done to address climate change, its threats and impacts, but said the city needs a single agency to act as a conduit for all resiliency work moving forward. “The men and women of MOS and MOR have done an outstanding job and I want to thank them for that,” he said in his opening statement. “We cannot expect, however, that the several dozen employees in this office have the capacity to manage the sustainability policies for the over 300,000 strong city workforce. We want to give them more help.”

The new department would implement and monitor sustainability initiatives in New York City that have been launched in recent years such as the city’s commitment to an 80% reduction in carbon emissions by 2050 and the city’s initiative to install 1 gigawatt of solar capacity citywide by 2030 -- enough to power 250,000 homes -- among many others. Led by Constantinides, the City Council just passed, with de Blasio’s support, sweeping legislation to mandate major carbon emissions reductions and green upgrades at the city’s largest buildings, and the de Blasio administration is moving ahead not only with continued recovery efforts from 2012’s Hurricane Sandy, but new resiliency efforts like the Lower Manhattan Coastal Resiliency Project.

The proposed bill would also require the commissioner of the Department of Sustainability and Climate Change to present a long-term sustainability plan for the city that would detail interim goals based on planning and sustainability indicators. The city would have to achieve each interim goal by no later than April 22, 2030 and long-term goals no later than April 22, 2050. (April 22 is Earth Day.)

Additionally, the commissioner must prepare and submit to the mayor and the speaker of the City Council an initial report on the city’s performance with respect to the identified sustainability indicators and long-term planning and sustainability efforts no later than April 22, 2020.

At the hearing, Constantinides asked Chambers how a new mayor would affect the Mayor’s Office of Sustainability’s current $17 million budget. “The discretion would still stand with the mayor, whether it’s agency or whether it’s mayoral office,” Chambers responded.

After Chambers and other representatives of the de Blasio administration testified, members of the public appeared before the Council to discuss the bills at hand, raising some questions about the proposed department bill.

“I’m concerned that there do not appear to be any enforcement mechanisms if agencies fail to meet their stated goals,” said Amy Ruther of the New York City chapter of the Democratic Socialists of America. “I’m also concerned that the members of the Sustainability Advisory Board are all appointed, not elected, and they are not required to seek input from the communities that their decisions will impact the most.”

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by Jewel Antoine, Gotham Gazette

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