Judges find an increasing number of criminal defendants in state courts in New York City who are mentally unsuitable for trial. This means that according to city health data obtained by Gothamist, the charges should be abolished or detained in a hospital rather than in a prison.
However, the hospitals that defendants are supposed to go to for treatment are unable to keep up with the increased demand, mental health staff, researchers and legal experts said. Instead, the defendant is in custody on Rikers Island, facing the threat of federal acquisition amid a high rate of violence. So far, five people have died in city custody or shortly after their release.
If the hospital doesn’t have the space for criminal defendants with mental illness, it could slow their lawsuits and delay justice for all involved. Mental health experts said prisons are crowded with people with severe, untreated mental illnesses, making it even more difficult for everyone to get the care they need.
“They should be removed from the prison setting as quickly as possible and sent to treatment,” said Douglas Stern, a mental health lawyer and professor.
While it is impossible to identify all the reasons why more defendants have decided they are not worthy of being mentally endured trial, experts at the intersection of mental health and criminal justice systems said that the psychological sacrifice of Covid-19 and the disruption of treatment during the pandemic are likely to contribute to the increase. They also cited an increase in arrests in recent years.
While elected officials have vowed to fund more psychiatric beds to mitigate the shortage, some advocates and mental health experts have said more are still needed. Others said hospitals should have fewer states to deal with the surge in demand for treatment.
A ripe process of delay
new york State Law A judge may order a criminal defendant a psychiatric examination if he finds that the defendant cannot understand the case against them due to mental illness.
According to court system lawyers and observers, psychiatric examination orders set up a multi-step process. First, the psychiatrist should evaluate the defendant and write a judge’s report explaining whether the judge thinks he is suitable for trial. Recent reports from Independent Riker Committee This part of the process alone took an average of 43 calendar days to complete. In the meantime, the defendant will be held or awaiting consequences outside the prison, depending on the conditions of his release before trial.
Prosecutors and defense attorneys can agree or challenge the psychiatrist’s findings. The judge then decides whether the person is mentally suited to trial. If so, the case will proceed normally.
However, if the judge finds the defendant to be mentally ineligible, there are two possible consequences, depending on the severity of the charge. Legal experts say people charged with misdemeanors may be observed for weeks, but are usually dismissed. Due to a felony, the case is usually suspended while the defendant goes to the hospital for treatment and education courses regarding the legal system. The lawsuit will resume after the defendant is “recovered to competency.” This means that a person’s mental state is stable enough to understand what is going on and participate in their own defense.
Defendants in New York City who are mentally unable to stand trial usually go to one of two state hospitals: Kirby Forensic Psychiatry Center on Words Island or Mid-Hudson Forensic Psychiatry Center in Orange County. The number of beds is low and the turnover rate is low. This means that accused who are not suited to trial will wait for Riker for weeks or months to go to the hospital. According to a report from the Independent Rikers Committee, the average wait time was 79 days as of last fall.
“It certainly increases the likelihood that their illness will become even more established and resist treatment,” Stern said. “The more someone is amputated from treatment, the more difficult it becomes to treat that individual.”
The number of court-ordered psychiatric exams has been rising in recent years, with an increasing number of people deeming this unsuitable for exams that are even more tense in the system.
Data from city agencies providing health care to Riker, a correctional health service, shows the number of people deemed mentally ineligible, more than twice as many as 372 to 898 across the city between 2020 and 2024.
Due to the pandemic, the number of people passing courts was unusually low in 2020, but correctional health services data shows that the number of defendants who find themselves mentally unsuitable for trial continues to increase each year. As of March 31, 184 people were waiting for treatment beds at Riker.
Experts disagree with the solution
Since taking office, Gov. Kathy Hochul has been working to increase the number of psychiatric beds, including criminal defendants. She has already added hundreds of beds to state and community-run hospitals. We proposed $160 million in funds To create 100 additional forensic psychiatric beds on ward island, patients who have been found to be inappropriate can be treated.
“For the past three years, we have made important and concrete investments to meet the growing need for pre-trial services and to ensure prompt access to restoration services due to the increase in the number of individuals placed in our care by court orders.”
But more beds are needed, according to the Independent Rikers Committee. In a recent report, the group urged the governor and state legislators to fund another 500 forensic psychiatric beds over the next three years.
Correctional health services are Promoting legislation That allows local prisons like Rikers Island to treat criminal defendants until their mental health is improved enough to face their accusations in court. Dr. Patricia Yang, vice president of Correctional Health Services, said the department already has staff and resources to provide services in the city’s detention to many patients.
“We have people who have recovered effectively,” she said. “They are still in prison waiting to go to the restoration bed, but only to be reassessed and come back to us for their case.”
Yang said some patients need to go to hospital for more acute care. But when patients are already responding well to treatment during city detention, she said correctional health services could “quickly” recover them. She said patients are likely to receive that care either in the Rikers Island treatment unit or in the front post unit of a municipal hospital, such as Bellevue.
“A day is too many unnecessary days in prison,” Yang said. “This is a clear solution to reduce the likelihood of that for those in that situation.”
But Crystal Rodriguez, who helped draft the independent Rikers committee report, said officials should prioritize making Rikers safer before they can transform into a rehabilitation treatment space for people with mental illness.
“I think there are some clinical elements and pillars that are missing from an environment that is plagued by violence and dysfunction,” said Rodriguez, director of policy at Data Collaborative for Justice.
In prison Surveillance meeting last falla mental health care provider who started working at Rikers Island in late 2023 said that Corrections staff routinely locked up people with severe mental illnesses in solitary confinement for weeks without receiving medication as punishment for “acting.” Justina Luzewinski, former associate director of mental health at Correctional Health Services, said the men were screaming, smacking and plastering shit.
“I couldn’t believe what I saw,” she said. “I’ve never seen anyone live in these types of situations.”
Rzewinski said Correctional Health Services staff “did the best they could,” and that patients can be kicked out of isolated confinement due to showers and medication doses. However, she said “permanent advocacy with sympathy” was needed [correction officers] And a lot of adjustments as if we were looking for elaborate favors. ”
Rzewinski said that many of her patients were found to be unsuitable to endure trial mentally, and while waiting for the state hospital bed to open at Riker, she said, “it got worse.” She resigned less than a year later, and was troubled by what she had observed.
Dr. Joseph Otonicher said at the Surveillance Conference that Correctional Health Services had developed a surveillance system that sought to identify when patients were trapped in solitude. Later, the Corrections Bureau, Linell McGinley Liddy He told the monitoring staff She had asked the city’s Department of Investigation to conduct an independent review of “troubling allegations.”
Some supporters distrust the plan that had been planned, including treating people at Riker. Instead, they recommend reducing the demand for hospital beds by providing outpatient care to people who do not need to be kept in safe facilities.
Nadia Chait, mental health policy analyst at the Unofficial Group Center for Alternative Volume Judgment and Employment Services, said the default is to treat people in the community rather than sending everyone to more expensive and restrictive state hospitals.
“When you do that, you’re actually restoring, and you often set up to improve public safety, but it also leads to community-based services,” she said.
