Is the NYPD the Best Response to New Yorkers in Crisis?

By Carla Rabinowitz, Advocacy Coordinator, Community Access, Project Coordinator, Communities for Crisis Intervention Teams in NYC (CCINYC)

Coalition Says the City Needs More Options

Recent police shootings of people in emotional distress have catalyzed our coalition of mental health advocates and organizations to further reform efforts. We testified about needed efforts at a recent City Council hearing, focusing on the need for alternatives to police responding to New Yorkers in crisis. On the day we testified, another NYC resident, Miguel Richards, was shot and killed by the NYPD. He was only 31 years old. Video of his shooting was recently released.

To create change, we need the Mayor to revive the defunct Taskforce on Behavioral Health and Criminal Justice. We need to bring all stakeholders together to build efforts to solve issues of community policing. And, we need the coordination of the Mayor’s office to find non-police alternatives to 911 calls of people in emotional distress.

We are planning a press conference for Wednesday, October 18, at the steps of City Hall in Manhattan at Noon. Everyone is invited to join us as we bring these pressing needs to the media to better inform elected officials.

My Testimony at the City Council Hearing on the NYPD Response to Mental Health Crises
“Thank you to the members of the Council for hearing this testimony today. My name is Carla Rabinowitz. I am the Advocacy Coordinator at Community Access and the Project Coordinator of CCINYC, a coalition of 75 organizations and stakeholders whose mission is to improve relations between the NYPD and the mental health community by advocating for a fully responsive Crisis Intervention Team approach and diverting mental health recipients away from the criminal justice system.

“Community Access is a 44-year-old non-profit that helps people with mental health concerns through quality supportive housing and employment training.

“CCITNYC and Community Access request that you revive the Mayor’s Task Force on Behavioral Health and Criminal Justice. This Taskforce met twice in 2014 and has since been defunct.
“We ask that you recommend the Mayor assign this Taskforce to the oversight of a Deputy Mayor.

“We need all stakeholders and all city and state agencies at the table to suggest alternatives to police responding to these EDP calls. Expanding co-response teams throughout the city, more mobile crisis teams, and pairing mental health peers with police to calm down these encounters are a few ideas to explore.

“Some of the contributions of the Taskforce have already been taken up by the city, including the implementation of CIT training for some members of the NYPD.

“The NYPD training is going well, though there is still a significant need for adequate training.

We ask that at least 15,000 officers be trained, especially since Rikers is closing and there will be more of these encounters. Countless people have been saved by CIT officers. CIT officers saved a child threatening his mom with a knife, and stopped many potential suicides.

“But CIT training alone is not going to prevent these recurring deaths.

“Since the NYPD started CIT training, at least 6 mental health recipients have died in police encounters:

“Mario Ocasio, age 51, in June 2015; Rashan Lloyd , age 25, in June 2016; Deborah Danner, age 66, in October 2016; Ariel Galarza, age 49, in November 2016; Dwayne Jeune, age 32, in July 2017; and Andy Sookdeo, age 29, in August 2017.

“We need to solve issues before mental health recipients get into crisis, and for that we need funding of community services.

“We need alternatives to hospitals, which recipients fear, like Respite care, where people in crisis can learn to recover and get connected to long-term support.

“We need to support the police by building diversion centers to provide a rapid handoff of New Yorkers in acute crisis from police custody to get immediate care and long-term connections to community resources.

“We need community forums with police and mental health recipients to reduce the fear in the mental health community when the police arrive.

“And most importantly, we need the Mayor to revive his 2014 Taskforce on Behavioral Health and Criminal Justice. And place this Taskforce under a Deputy Mayor, with the resources to get things done.

“We need all stakeholders and all city and state agencies at the table to suggest alternatives to police responding to these EDP calls. Expanding co-response teams throughout the city, more mobile crisis teams, and pairing mental health peers with police to calm down these encounters are a few ideas to explore.

“Therefore, we ask that you recommend the Mayor revive his 2014 Taskforce on Criminal Justice and Behavioral Health.”

Report Finds Barriers to Justice for Individuals in New York City Courts

Report Finds Barriers to Justice for Individuals in New York City Courts

By Nahid Sorooshyari, Senior Staff Attorney, MFY Legal Services, Inc.

We Examine the ADA Liaison Program

People with disabilities should have equal access to justice. Disability rights laws, like the Americans with Disabilities Act (ADA), require courts to make their programs and services accessible to people with disabilities. The New York Unified Court System (UCS) has a program for helping people with disabilities, called the ADA Liaison program. However, a recent report by MFY Legal Services found that the program needs to be improved.

The ADA requires courts to be accessible to people with physical disabilities. Courts must also make reasonable accommodations to their rules, policies, and procedures so that people with all types of disabilities—including psychiatric and invisible disabilities—can participate in the court’s services, programs, and activities to the same extent as people without disabilities. UCS has assigned at least one “ADA Liaison” to each courthouse. ADA Liaisons are court employees who should know about the ADA and how to work with people with disabilities. People with disabilities can contact their local ADA Liaison to request a reasonable accommodation or get information about their rights and are encouraged to do so before they come to court. The program could be a great help, but it has serious flaws.

Many people who need the program do not even know it exists. UCS is supposed to advertise information about the ADA and the ADA Liaison program. It uses an “Accessibility Information Webpage” to do so, but this webpage is not always highlighted on individual court websites or on other parts of the UCS website. UCS is also supposed to advertise the program in courthouses. UCS has posters to do so, but the posters are poorly designed. For example, they include four symbols—a person in a wheelchair, two hands symbolizing sign-language interpreting, an ear with a bar over it indicating services for the deaf, and a person with a cane. These symbols do not make it clear that people with psychiatric disabilities may also get accommodations.

Someone who finds out about the program faces another problem—reaching an ADA Liaison. UCS’s webpage provides a directory of ADA Liaisons. People are told to use the directory to contact their local ADA Liaison at the listed phone number. In May 2016, MFY tried to confirm the contact information of all forty-nine civil court ADA Liaisons listed for the five boroughs. MFY had a problem contacting the listed ADA Liaison more than 65% of the time. For example, 24% of the names and numbers listed were either for retired or former staff, or someone who stated they were not the ADA Liaison and 18% of the phone numbers simply did not work. Either the number was not in service or the call was sent to voicemail, but the caller could not leave a message. When we could leave a message, 24% of the voicemails were not returned within eight business days.

During the phone survey, MFY spoke to court staff who did not know about the program, or said that there was no ADA Liaison at that court. One person stated that she was given the position, but was never trained. In 2012, MFY requested all training materials provided to ADA Liaisons and documents stating which ADA Liaisons receive training and how often. The Office of Court Administration provided only a two-page pamphlet titled “Communicating with People with Disabilities,” and stated that there were no records about which ADA Liaisons received training or how often.

Probably due to poor training, ADA Liaisons often get the law wrong. For example, an MFY client requested to appear in court by telephone because a medical condition made her incontinent. The ADA Liaison incorrectly said that this was impossible because the client “lived in New York City.”  Also, ADA Liaisons too often suggest guardians ad litem (“GALs”)—people appointed to advocate for those who are unable to advocate for themselves. Though some people with disabilities may need a GAL, most can advocate for themselves with a reasonable accommodation. For example, someone with agoraphobia should be allowed to appear by telephone, not be assigned a GAL.

MFY’s report recommends ways to improve the ADA Liaison program. Since the report’s publication, MFY has met with court officials and community groups to try to implement these solutions and make justice for all a reality. If you would like to read MFY’s report, please visit our website at www.mfy.org. 

Preserving Consumer's Rights Behind Bars

Preserving Consumer's Rights Behind Bars

By Susan Goodwillie, LMSW, Social Worker, Urban Justice Center

The Mental Health Project: A Service of the Urban Justice Center 

It is well known that the stigmatization of mental illness results in policies that seek to punish rather than treat individuals with psychiatric conditions. For low-income New Yorkers living with mental illness, in particular, this means being subjected daily to discrimination by landlords, employers and law enforcement officials. The criminalization of mental illness, and an overwhelming lack of community supports, have contributed to the era of mass incarceration, where jails and prisons have become the largest “mental health care providers” in the United States. Far too many people are incarcerated for symptoms that need to be properly treated, not punished.  

The Mental Health Project (MHP) of the Urban Justice Center provides free civil legal and advocacy services to lower income New Yorkers living with mental illness, and fights to preserve the rights of those who become involved with the criminal justice system. While MHP provides an array of civil legal services, we put a heavy emphasis on our criminal justice advocacy. MHP advocates for discharge planning rights for people coming out of jails and prisons, provides reentry connections, and contributes to several coalitions focused on the conditions of jails and prisons for people with mental illness.

With the support of co-council Debevoise & Plimpton and New York Lawyers for the Public Interest, MHP won a victory in the Brad. H vs. City of New York settlement, which requires the Department of Corrections to provide comprehensive discharge planning to individuals living with mental illness who are returning to the community from Rikers Island. MHP has provided independent oversight to ensure the city’s compliance with the settlement by making weekly visits to Rikers Island and speaking with individuals about the kinds of services they’re being offered. 

The Mental Health Project was a founding partner in Mental Health Alternatives to Solitary Confinement (MHASC), a statewide coalition concerned about the impact of solitary confinement on people in state prisons. Largely in part to MHASC’s efforts since 2003, New York State passed the SHU (“special” housing unit or solitary confinement) Exclusion Law in 2008. Finally enacted in 2011, the SHU Exclusion Law prohibits individuals classified as having a serious mental illness from being placed in solitary confinement. 

In order to build on the progress made by the SHU Exclusion Law, MHP helped form another coalition called the Campaign for Alternatives to Isolated Confinement (CAIC). Currently, CAIC is advocating for NYS representatives in Albany to pass the Humane Alternatives to Long Term (HALT) Solitary Confinement Act. HALT would vastly limit the types of infractions that would result in an individual being placed in solitary confinement, as well as the length of sentences in solitary. HALT would also prohibit vulnerable populations from being placed in solitary confinement for any amount of time and would provide more transparency and oversight of the use of solitary confinement. 

MHP is excited to offer more frequent advocacy courses to assist individuals returning to the community from jail or prison in navigating the multiple systems they might interact with, so that they may obtain or acquire the knowledge and skill base necessary to best advocate for their rights. The course introduces speakers from different organizations to discuss a range of issues, including employment, housing, and public benefits. We also hope that these courses will assist people who have had some involvement in the criminal justice systems to connect to peer supports such as clubhouses and peer advocacy training programs. MHP also provides individual case management services to individuals living with mental illness who are returning to the community from jail and prison. We assist individuals to apply for supportive housing and SSI/SSD benefits, connect people with mental health treatment and additional resources such as peer services and other employment and educational opportunities.

For more information about MHP’s services, please contact our intake coordinator, Kaitlin Hansen at (646) 602-5658. For more information about MHP’s Reentry workshops or our Advanced Advocacy Course, please contact our Advocacy Workshop Coordinator, Koretta McClendon at (646) 602-5661. 

Meet the New Deputy Executive Commissioner

Meet the New Deputy Executive Commissioner

By Dan Frey, Editor in Chief

Crucial Issues to the Mental Health Community Discussed

On January 20^th at Fountain House clubhouse in Hell's Kitchen, members of New York City's mental health community met the new Executive Deputy Commissioner for the New York City Department of Health and Mental Hygiene (DOHMH), Division of Mental Hygiene: Gary Belkin, MD, PhD, MPH. The event was organized by the DOHMH Office of Consumer Affairs whose mission is to ensure that the consumer perspective is heard and integrated at all levels of government. Carlton Whitmore is the director of this office and Teena Brooks, LMSW, assistant director.

Dr. Belkin responded to questions from a planning committee whose members were: Wendy Brennan, Lynnae Brown, Angela Hebner, Carla Rabinowitz, Samene Reid, Rachel Saloman and Moneer Zarou. Topics ranged from housing and criminal justice to employment and managed care. Some topics listed in the evening's program such as cultural competence and the assisted outpatient treatment program were barely touched upon.

Housing

On housing, Dr. Belkin said that governor Cuomo might approve funding for around 5,000 units of housing for New York State's homeless, mental health, HIV/AIDS, substance abuse, and domestic violence populations, including families and youth. The campaign for supportive housing, known as NY/NY 4, requested 30,000 units for these disadvantaged groups in New York City over ten years.

Criminal Justice

On criminal justice, Dr. Belkin said that, in response to the unnecessary death of a mentally ill Rikers' inmate, mayor de Blasio's criminal justice taskforce will address issues of mental illness and substance abuse at every stage of the criminal justice system, including proper discharge planning from jail to the community. He said “drop-off centers” will be created as alternatives to incarceration for people with mental illness, with the first one to roll out in the fall of 2015 in upper Manhattan. These drop-off centers should offer an array of services to help keep our peers out of the justice system. As part of a comprehensive plan, corrections officers and police officers will receive training on “deescalation” and understanding behavioral health issues similar to what other states have been doing with good results.

Employment

The unemployment rate among people with serious mental illness is a staggering 90%. Dr. Belkin said his department funds 15 different employment programs and continues to advocate for more peer hiring. He said that in the future managed care environment, providers will be held accountable for improved employment outcomes and that peer services will be Medicaid reimbursable. He said an “RPC” or regional planning consortium will be created that brings advocates and stakeholder groups together to discuss issues of standardization, performance, service planning, and resource allocation.

Medicaid Managed Care

On the future of service delivery in a Medicaid, managed care environment (see “Medicaid Managed Care: Rising to the Challenge” by Briana Gilmore, Winter 2015 edition), Dr. Belkin said “HCBS” (home and community-based services) will be offered through the “HARP” (health and recovery plans) for individuals with significant health and behavioral health needs. Fully integrated dual advantage plans (FIDA)will be available for people with both Medicaid and Medicare who use community-based long-term care services.

Peer Jobs

There was a concern among those in attendance that peer workers who lacked a GED or high school diploma, which is currently required to become a certified peer specialist, would lose their jobs in this new billing environment, but Dr. Belkin assured us that not all services will be billable to Medicaid and some will continue to receive funding from the city. The smaller provider organizations will receive technical support to help them make the transition to Medicaid billing. He said he was unsure how many city contracts, if any, will be displaced by the shift to Medicaid billing.

Conclusion

Although Dr. Belkin and his senior staff were weary from a long day at the office, we were glad that they made it to the forum that evening. His liberal use of acronyms was a bit off-putting, but he did his best to explain some difficult concepts. The crowd seemed pleased with the event, but I was left wondering how much influence we would have on future policies that will affect our lives. Most of us don't even know how to speak the language that large bureaucracies use, let alone how to affect change within them. For those of us who do, I hope you step up to the plate and get involved. We desperately need representation with sensitivity, intelligence and strength.