A de Blasio-era plan to expand specialized units for people with mental illness at Rikers Island has stalled with no timeline from the Adams administration, even as the mayor’s new public safety plan purports to have a heavy focus on psychiatric help.
The slow rollout of the so-called Program to Accelerate Clinical Effectiveness (PACE) comes as 52% of the entire population at the island lock up has been diagnosed with some type of mental illness, according to jails data from late last year — or an estimated 2,728 people “known to mental health” as of Monday.
Early research has shown that the designated mental health units have been a success so far.
People in the PACE housing areas are less likely to get into fights, injure themselves, or refuse to take their medication, according to a 2020 study.
But the majority of inmates diagnosed with mental illness remain in slightly modified general population housing areas known as mental observation units, Department of Correction records show. City jails have just about 455 specialized mental health unit beds where detainees get added counseling services and intensive medical care.
Jail medical experts and inmate advocates are frustrated that additional mental health units haven’t opened up so far.
“They need more,” said Dr. Robert Cohen, who serves on the city’s Board of Correction, which oversees the department. “They provide substantially improved care than the overcrowded mental observation units.”
The city has recently been rocked by a series of high profile crimes with suspects who have a long history of mental illness and a series of prior arrests. Mayor Eric Adams announced a mental-health-focused subway safety plan after Michelle Go was pushed to her death in front of an R train at Times Square-42nd St. on Jan. 15.
Martial Simon, who had been diagnosed with schizophrenia according to his family and spent years homeless and in and out of jail, has been charged in Go’s death.
But Adams hasn’t released a broader plan or finer points on how his administration hopes to help the city’s mentally ill, who often come in contact with the criminal justice system.
For jails, the Adams administration told THE CITY it is working with the state correction oversight agency and the city’s Correctional Health Services “to create a plan for the future of the PACE units,” said DOC spokesperson Shayla Mulzac.
But City Hall has provided no details on how many new units the administration seeks to create or when that might happen. The expected creation of 392 outpost beds in three public hospitals is also at least a year away as the plan slowly goes through bureaucratic red tape and design tinkering.
“The mental, physical and emotional well-being of people in our care is our top priority,” said Mulzac. “As we continue to reopen and return to normalcy, we look forward to expanding services, resources, and programs for everyone in our custody.”
Mulzac acknowledged that “staffing is essential to running any housing unit” and it will be a “major factor in our plan.”
For months during the pandemic, city jails were plagued by massive staffing shortages, as hundreds of workers at a time called out sick.
On Jan. 31, the department issued a news release announcing “more than 1,000 uniform staff — including correction officers — have returned to work in city jails since January 1.”
The added staff allowed the city to move 83 detained women who had been sent to the state-operated Bedford Hills Correctional Center, in Westchester County, back to Rikers. Correction officers at multiple facilities were also moved from 12-hour shifts back to 8-hour tours.
Still, each day last week, an average of 1,474 officers called out sick, according to Department of Correction spokesperson Patrick Rocchio.
Former Department of Correction Commissioner Vincent Schiraldi, who took over in May 2021, said he tried to expand the units last year but didn’t have enough officers to man them.
“It wasn’t something that I could tackle,” he said, noting that the PACE unit for women is attached to a different specialized housing area that ideally would be separated.
In contrast to PACE, some mental observation units house large groups of up to 50 inmates, while PACE units are individual. They also have not been fully renovated in years and lack structured day-long programming. PACE units are staffed by officers who receive additional training to work with that vulnerable population.
Former Mayor Bill de Blasio vowed to create 12 PACE units by June 20, 2020. That never happened. Ten are currently operational.
Plans to expand PACE on Rikers Island moved forward even as the de Blasio administration moved to close all jails on the island and replace them with four towers in the boroughs, a transition currently projected for 2027.
Public Hospital Jail Annexes
As for the outpost beds in three public hospitals, the city has earmarked $662 million in capital dollars “to make this pioneering project a reality,” said Correctional Health Services spokesperson Jeanette Merrill.
City officials anticipate a mix of people suffering from serious addiction or battling long term medical issues will be placed in the specialized spots.
A Bellevue unit with 112 beds will comprise the entire second floor of the historic Manhattan hospital. It is scheduled to be completed a year after approval from the state Commission of Correction, according to Merrill. That state sign-off is in part waiting on the creation of required recreation space, which currently doesn’t exist at the hospital.
Woodhull Hospital is next in line, with 160 beds and a 2024 completion date. The recreation space for that Brooklyn location would be on the roof, according to renderings.
North Central Bronx hospital’s unit, with 120 beds, is expected to be finished last in 2025, according to Merrill.
Dr. Homer Venters, who oversaw medical care for city inmates while heading Correctional Health Services and spearheaded the creation of the PACE units during the Bloomberg administration, supports the creation of the outpost beds.
He noted that the inpatient unit in Bellevue Hospital doesn’t have officers stationed at each bed, — giving them more freedom than they would have on Rikers.
“Once you are on the ward, it can function much more like a regular hospital,” he told THE CITY last July.
Providing ethical care for people who are incarcerated is consistent with calls for reducing the jail population, said Venters.
“We have to acknowledge that patients who are incarcerated shouldn’t be in dilapidated or non-functional settings,” he said.
‘Not Something to Aspire To’
Some advocates and family members of mentally ill people behind bars contend that they shouldn’t be in the criminal justice system at all.
Cheryl Roberts, executive director of the Greenburger Center for Social and Criminal Justice, opposes having the Department of Correction staff the therapeutic units.
“If you are thinking about a long-term closure plan, and looking to do something different over the next 50 years, creating, basically, hospital settings or hospital units inside of a jail or prison, isn’t the solution,” she said. “It’s not something to aspire to.”
The goal should be to stop criminalizing people with mental illness and making sure they have community-based treatment, she said.
“That’s about the money,” she said, noting the federal government would need to change the Medicaid reimbursement formula to allow funding for residential mental health services, a shift “promised 50 years ago.”
“We were supposed to close down beds and have these great community mental health systems,” she said. “That never materialized and we are living with the results ever since.”