On February 7, 2014, Jerome Murdough, a former Marine, was arrested in New York City on charges of trespassing. Unable to afford his bail, Murdough was placed in jail at Rikerâ€™s Island. He was housed in a mental-observation unit due to his diagnosis of bipolar disorder and schizophrenia. On February 14, without notice, the temperature of Murdoughâ€™s cell climbed to above 100 degrees. Video surveillance revealed the guard on duty neglected the required regular checks of the unit.
The interaction of the high heat and Murdoughâ€™s medication resulted in hyperthermia. He baked to death overnight. His body was found early the next morning.
Murdoughâ€™s death is tragic, but it is not singular. In the United States, over 80 mentally ill inmates have died in prison as a result of abuse or neglect since 2003. These deaths highlight significant problems with the treatment of mentally ill individuals, specifically with regard to incarceration.
Pushed to action by the death of Jerome Murdough and reports of additional problems at Rikers Island, Mayor Bill de Blasio announced a $130 million dollar plan to address mental health and criminal justice in New York City on December 2, 2014. The plan covers the four phases of an individualâ€™s interaction with the justice system: pre-arrest, arraignment, incarceration, and release.
Resources for mental healthcare remain staggeringly low. The National Alliance on Mental Illness (NAMI) reports that one in four Americans experiences mental illness in a given year. Despite this high ratio, states decreased their mental health budgets by a combined $4.35 billion between 2009 and 2012. Today, six out of ten Americans living with serious mental illness have no access to mental healthcare. As a result, mentally ill individuals are often unable to maintain steady employment, and engage in behaviors that have become increasingly criminalized. Petty, non-violent crimes, such as trespassing, result in referrals to jail rather than treatment. Without supportive services after release, individuals enter into a cycle of release and re-arrest. The New York City Mayorâ€™s Taskforce on Behavioral Health and Criminal Justice reported that the same 400 people accounted for over 10,000 jail admissions over the last five years, 67% of which needed mental health services.
U.S. prisons house ten times the number of individuals with serious mental illnesses as state psychiatric hospitals. The number of mentally ill individuals in jail is so high that prisons are often referred to as de facto mental institutions â€“ Rikers Island is among the three largest providers of mental health services in the country.
The policy of deinstitutionalization, beginning in the 1960s, is frequently cited as a key driver of the rise in the incarceration of the mentally ill population. Concern over human rights violations and poor conditions in mental hospitals prompted states to begin moving individuals out of institutions, eventually leading to the closure of numerous psychiatric hospitals nation-wide. However well-meaning, deinstitutionalization resulted in the release of high numbers of mentally ill individuals into communities with limited resources to provide proper care. Additionally, the closure of state-run hospitals without the provision of appropriate alternative treatment services means the need for mental health services exceeds their availability in virtually all states.
The problems with using jails as de facto treatment facilities are numerous. Imprisoning someone with serious mental illness not only deprives them of quality care, it often makes them sicker. Mentally ill prisoners become more symptomatic once incarcerated, are more likely to spend time in solitary confinement, and are disproportionally beaten, raped, and/or abused. Prison guards and jail staff regularly shoulder the burden of dealing with a population they are ill-equipped to manage.
Mayor de Blasioâ€™s new mental health and criminal justice policy is a laudable effort to improve outcomes for mentally ill individuals in New York City, break the cycle of incarceration and re-arrest, and increase access to appropriate services. It includes screening for serious mental health conditions pre-trial, expanding mental illness recognition training for police, and encouraging the diversion to treatment services for individuals who do not pose a public threat. Additionally, the policy aims to triple the amount of resources allocated for reintegration services post incarceration, including creating an additional 267 permanent housing slots. The planâ€™s effectiveness depends upon its ability to change a broken system and the continued allocation of sufficient funds for public community-based services citywide, to ensure that the poorest and most at-risk individuals receive the critical care they deserve.
Mayor de Blasioâ€™s plan should serve as a call to action for U.S. government officials to reform mental health and criminal justice policies within their own cities, and states. It should not take repeated instances of tragedy for officialsâ€™ to work to prevent gross injustices within their own jurisdictions. Itâ€™s time to recognize that serious mental illness is a chronic, treatable condition, rather than a criminal offense.
Kasia Orzechowski a Master of Public Administration candidate at NYU Wagner. She previously worked for Management Sciences for Health, a global health non-profit in Washington, D.C.