New York Digs a Mental Hospital-to-Prison Pipeline

I spent a number of hours over the past several weeks listening to the worried voices of mental healthcare professionals. These union-protected caregivers to some of the most vulnerable members of our communities see New York State authorities attempting to dismantle a century-plus legacy of publicly-provided mental healthcare services, replacing state facilities with non-profit organizations or private, for-profit firms that are known to provide inferior care.

What will happen to usas individuals, families and communitiesif we allow our already diminished mental healthcare infrastructure to be further weakened? Approximately one in five American adults becomes mentally ill in the course of a given year, and they are unlikely to feel comfortable admitting it. Dhanu Sannesy, President of the Orange County chapter of the National Alliance on Mental Illness, acknowledged the taboo against mental illness when she asked over dinner in a Newburgh restaurant: “If I go to a hospital with a heart condition, people bring me flowers. If I have a psychiatric illness, do I get the flowers? No. There is a stigma.”

Our society’s neglect of psychiatric health has dire consequences. Leaving aside for a moment that our way of life generates major and minor forms of mental illness in large numbers of us, our leaders’ failures to create and adequately train, staff and fund institutions capable of addressing the crises that afflict some 44 million people is a blueprint for widespread social disaster. Scandalously, health matters requiring the care of doctors and therapists are permitted to become public safety problems that fall to the force of police, courts, jail and prisons. Just one day before my dinner with Sannesy and others, N.Y.P.D. officers shot and killed a mentally ill black man who was pretending to shoot people with a welding torch on a street in Crown Heights, Brooklyn. Thirty-four year old Saheed Vassell had a diagnosis of bipolar disorder. Police said they mistook the piece of metal for a gun.

“Why did they have to just kill him?” Vassell’s father asked a reporter for The New York Times after his son’s tragic death. Indeed, why? Vassell’s illness was long known to neighbors and local authorities. He did not start out in life antagonizing others; he became increasingly disturbed after 2008 when a police lieutenant shot and killed his closest friend. Before he died, authorities summoned Vassell more than 120 times and arrested him at least 20 times. On several occasions, police were enlisted to help emergency medics take him to a psychiatric hospital.

What kind of society persistently and chronically neglects people who are in such trouble? What kind of society abandons its most vulnerable members, allowing them to deteriorate until they are ultimately dealt with by brute force?

More than a decade ago, “64 percent of local jail inmates, 56 percent of state prisoners and 45 percent of federal prisoners [nationwide] had symptoms of serious mental illnesses.” Today, the U.S. has 10 times more mentally ill people in prison than in psychiatric hospitals. Incarcerating a mentally ill person can cost taxpayers more than three times as much money as providing community healthcare services.

“People with mental health issues have nowhere to go,” said one of the caregivers, who asked that their names not be published for fear of punishment by their employers. “The housing is not there, the beds are not there, waiting lists are enormous. Treatment facilities are closing and the state has no plan to care for these people. Many patients don’t have families, and many who do will still end up homeless or in jail. Jail populations increase when mental healthcare facilities close. Jails are the biggest mental healthcare providers in New York State state. They are modern day mental hospitals.”

The caregivers summarized: “Mentally ill people need treatment, not to be arrested and thrown into prison.” That this needs to be said at all, much less in hushed tones between appetizers and a main course, is disgraceful and maddening.

A version of this piece appeared in the Hudson Valley News