jails

City Scrambles to Open Special Units for Mentally Ill Inmates

The road to Rikers Island on Hazen Street in Queens.
The road to Rikers Island on Hazen Street in Queens. Photo: Ben Fractenberg/THE CITY

Nearly three years ago, Mayor Bill de Blasio vowed to dramatically expand the number of specialized jail units for inmates with mental illness.

His administration set a goal of 12 units by June 30, 2020 — but only three have opened since 2016, adding to three that already existed. At that pace, jails experts fear the city won’t complete the other six by its deadline.

“I am very concerned about delays in opening of the units,” said Dr. Robert Cohen, a member of the city’s Board of Correction, which has oversight over the jail system.

“Delays in setting up these units have real consequences for people in custody and staff,” he added, noting one inmate in a standard Mental Observation Unit was killed, allegedly by another inmate, last summer.

But city officials maintain the expansion of the so-called Program to Accelerate Clinical Effectiveness (PACE) is on schedule.

“We are currently on track to complete all six units by 2020,” said mayoral spokesperson Raul Contreras in an emailed statement. “Construction is underway on four of the units. We have identified locations for the other two and will begin construction as soon as possible on those.”

And despite a 2016 press release specifically saying that funding would be in place by “fiscal year 2020,” mayoral spokesman Raul Contreras insisted on Wednesday that the administration’s deadline to complete all the new units is actually by the end of “calendar year” 2020, which would give them six more months.

Frustration Over Lack of Progress

The six operational PACE units together have a capacity of approximately 148 beds, according to Correctional Health Services. The city plan includes funding to cover two more PACE units in 2019 and another four by fiscal year 2020, according to Ventura.

“Sites and capacity are being determined,” she said.

Cohen and inmate advocates are frustrated more haven’t opened already. City lockups hold an estimated 1,100 inmates with serious mental illness – representing 16% of the jail population, records show.

“There are 15 months until the city’s deadline for six more units,” said Board of Correction Executive Director Martha King. “Concrete plans and action are needed now.”

Most mentally ill inmates are placed in so-called Mental Observation (MO) units, where medical care is limited compared to the clinical PACE units.

Some MO units house large cohorts of up to 50 inmates, have not been fully renovated in years and lack structured day-long programming.

“They are just people wandering around looking quite dazed,” said an official who’s familiar with the unit.

Early Signs of Success

Last July, an inmate housed in a Mental Observation Unit allegedly strangled another inmate. Casey Holloway, 35, died after he was set upon by Artemio Rosa, 27, as he sat on a chair in the Anna M. Kross Center on Rikers Island, according to authorities.

By comparison, PACE units have proved a success so far, albeit on a limited level, jail officials say. The units have helped to decrease violence and rehospitalization while boosting “medication adherence by providing intensive coordinated security and clinical services,” Cohen said.

Inmates in PACE units also are less likely to miss medical appointments because care is provided directly to them.

In February 2019, inmates throughout the system missed 38% of the 21,845 mental health clinical appointments scheduled, according to a report published in March by the Board of Correction. The main reason is that officers did not take them to the appointments, records show.

The slow rollout of the PACE units also comes as the de Blasio administration moves to shutter jails on Rikers Island and replace them with four modern facilities near courthouses in all the boroughs, except Staten Island.

As part of that broad plan, Correctional Health Services last month announced it was looking into the possibility of providing additional specialty care for inmates with mental health issues, drug-related problems and complex medical needs.

The so-called “therapeutic housing units” — different from the PACE system — likely will be located “in or near three to six existing” city hospitals, according to a solicitation sent to nine preselected vendors on March 8.

Correctional Health Services on Tuesday told THE CITY they had selected Lothrop Associates LLP to conduct that feasibility study. The contract is estimated to cost at least $109,000, according to Ventura.

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