Mental Health Association in New York State

Between the legislation, the settlement agreement and the $9 million allocated in this year’s budget specifically for housing units in state prisons for people with psychiatric disabilities, this is a major step forward in the reform of the prison system for people with psychiatric disabilities.

There are many people to give credit for in fighting to make this prison reform legislation possible led by the Legislative sponsors who were tireless and courageous in their efforts----Assemblyman Jeffrion Aubry and Senator Michael Nozzolio. We are also appreciative of Governor Spitzer and his efforts in negotiating this bill.

The members of the MHASC Coalition are family members, former inmates, recipients, providers, legal assistance groups and advocates. This group defined advocacy at its best. They were tireless, dedicated, savvy and intelligent. Their passion kept the legislation alive and ultimately resulted in the changes that will take place that will enhance the lives of individuals with psychiatric disabilities. As was true with the Timothy’s Law campaign, the SHU campaign exemplifies how a group of committed and thoughtful advocates in partnership with dedicated policy makers can help create real system change.

On another note, at this point we are unclear of the status of the Presumptive Eligibility Bill. However passage of this bill would help establish a good practice for a continuum of care. The hope with the SHU Legislation is that there would be more appropriate treatment in place and that people with psychiatric disabilities upon release would have greater opportunities to live productively in the community. The next step is to insure that there would be no disruption in receiving Medicaid Eligible services. This is where the Presumptive Eligibility legislation would help create a continuum of care.

With presumptive eligibility, individuals with psychiatric disabilities released from jails and prisons would not have to reapply for Medicaid. The current six to eight week gap that exists for people with psychiatric disabilities, when Medicaid is pending after release, is often filled through utilization of the Medication Grant Program (MGP). However, the MGP is not always well publicized, it is not available in every county and would not have the extensive benefits available through the automatic presumption of Medicaid.

MHANYS will also continue our efforts around other areas of criminal justice including the continued inclusion of mental health courts, training around the Memphis Police Training Intervention Model and juvenile justice initiatives.

Attached are some articles about the agreement on the SHU Legislation.

Solitary-confinement bill advances -
Senate acts, Assembly to vote later, after Spitzer, lawmakers reach a deal
Rochester Democrat and Chronicle
By Cara Matthews, Albany bureau

ALBANY — Gov. Eliot Spitzer and lawmakers announced Monday that they have agreed on a compromise bill to ban solitary confinement for seriously mentally ill prison inmates because legislation passed this session faced a certain veto by the executive.

The Senate passed the bill unanimously during a special session Monday, and the Assembly is scheduled to vote on the measure when it returns to Albany later this year. The legislation would require the state Department of Correctional Services to set up residential treatment units for inmates with serious mental illnesses. Prisoners would be offered at least four hours a day, five days a week, of therapeutic programming and/or treatment out of their cell.

Senate Crime Victims, Crime and Corrections Committee Chairman Michael Nozzolio, R-Fayette, Seneca County, said the bill is a "landmark legislative measure, fully agreed upon with the Assembly and the governor" that "encourages, establishes and requires the different treatment of the mentally ill who are incarcerated."

Correction officers would receive special training on how to work with this population, and the state Commission on Quality of Care and Advocacy for Persons with Disabilities would monitor the program on behalf of inmates.

"This legislation will make our prisons safer, will make our prisons more humane," Nozzolio said.

Mental Health Alternatives to Solitary Confinement, a coalition of groups that favor the legislation, have opposed solitary confinement — also known as the box — for seriously mentally ill prisoners because members believe it exacerbates inmates' conditions.

Cells in the box are 6-by-9-feet, and occupants eat what's known as the loaf, made from bread and cabbage, as punishment. The agreed-upon legislation ensures that would no longer happen in most cases.

"We know that people who are very sick are not going to be stuck in the toxic environment of special housing, where they're only going to get worse," said Bob Corliss of the Mental Health Association of New York.

About 12 percent of the prison population in New York, or some 8,000 inmates, has serious psychiatric disabilities, according to the bill's sponsors, Nozzolio and Assembly Correction Committee Chairman Jeffrion Aubry, D-Queens.

The bill would not ban solitary confinement entirely for this population.

http://www.democratandchronicle.com/apps/pbcs.dll/article?
AID=/20070717/NEWS01/707170321/1002/NEWS

Spitzer, Lawmakers Agree to Limit Solitary for Mentally Ill Inmates
New York Law Journal, July 19, 2007
BY Joel Stashenko

ALBANY - Consigning state prison inmates with severe psychiatric illnesses to solitary confinement would, in most cases, be prohibited by legislation agreed to by Governor Eliot Spitzer and the state Legislature.

The Senate approved the measure, 60-0, on Monday and the Assembly is expected to follow suit when its members reconvene, said Assemblyman Jeffrion Aubry, chief sponsor of the bill in his chamber.

Inmate advocates have long criticized the confinement of mentally ill inmates in what are known as "special housing units," or SHUs, in New York's prison system. They argue prisoners often violate disciplinary rules because they are ill and by sending them to solitary confinement, inmates are essentially being punished for being sick.

Another prison practice decried by critics is feeding the "loaf" to inmates who misbehave while in solitary. The "loaf" is a pasty flour mixture that is served three times a day, usually accompanied by cabbage, for up to 30 days at a time. Under the agreed-to bill, mentally ill inmates would no longer be subject to the "loaf" regimen.

"We have a long history of misuse of the special housing units for inmates who have serious mental illnesses," said Mr. Aubry, a Queens Democrat who chairs the Assembly's Correction Committee. "In some cases, what it would mean is that someone would complete their entire sentence in SHU and then go back into the community without being adequately treated. It might have kept the prison system safe, but it wasn't safe for the public having these people confined and made worse and then sent back into the community without treatment."

Subjecting mentally ill inmates to solitary is "state-inflicted brutality," said Robert Gangi, executive director of the Correctional Association of New York.

"It often leads to their decompensation and their need for intensive psychiatric care," Mr. Gangi said in an interview yesterday. "The rates of self-harm, the rates of suicide, are much higher for these inmates than for the general inmate population."

Under the legislation (A9342/S6422), severely mentally ill inmates facing disciplinary actions would be housed in newly created alternative housing units. There they would receive treatment and also be allowed out of their cells for four hours a day.

Inmates confined to special housing units get one hour each day outside their cells and, advocates say, little or no treatment if they are mentally ill.

The legislation designates the Commission on Quality of Care and Advocacy for Persons with Disabilities as the state watchdog to monitor housing and the level of treatment for mentally ill inmates. The commission is to regularly report to the governor and the Legislature on prisons' compliance with the law.

Currently, no agency or group comprehensively monitors the treatment of inmates with mental illnesses, said Harvey Rosenthal, executive director of the Association of Psychiatric Rehabilitation Services.

The law would not completely prohibit the mentally ill from being sent to special units. Prison administrators would still be able do so when the safety of staff, other inmates or the mentally ill prisoner himself is at issue if he were moved to an alternative housing unit. Inmates who refuse to participate in treatment in alternative housing units could also be kept in solitary.

The legislation will build on - and, in some cases, codify - the terms of an agreement the state reached in April with Disability Advocates Inc. and the Legal Aid Society over the treatment of state prison inmates with severe mental problems.

That agreement, which was approved by Southern District Judge Gerard Lynch, settled federal litigation filed against the state on behalf of mentally ill inmates, Disability Advocates v. New York State Office of Mental Health, 1:02-cv-04002 (NYLJ, May 28, 2002).

More Screening

The settlement requires more extensive screening of mentally ill inmates being sent to solitary and better treatment of them while they are confined. It also requires the state to explore the use of residential units for mentally ill inmates being segregated from the general prison population for disciplinary reasons and to let inmates out of their cells for two to four hours a day for treatment.

The Spitzer administration added $9 million to the 2007-08 state budget for the creation of segregated housing units in state prison for the mentally ill. That additional funding, which brought to $57.5 million the amount in the budget for services and treatment for mentally ill inmates, is expected to result in dedicated residence cells for about 300 prisoners.

Mr. Aubry estimated that at any one time, between 400 and 500 inmates with severe mental problems are in solitary confinement in state prisons.

In all, about 8,300 of the 64,000 inmates in state prisons have been diagnosed with some form of mental illness, according to the state Office of Mental Health. The plaintiffs in the Disability Advocates suit placed the number of mentally ill state inmates at twice the state's estimate.

The Department of Correctional Services operates about 100 behavior health units for the confinement of mentally ill inmates who are disciplinary problems.

In 2006, former Governor George Pataki vetoed a bill similar to the legislation agreed to this week. Among his objections was an estimate that the bill would cost as much as $500 million to build new facilities and for additional prison system operating costs.

But Mr. Aubry said those estimates were based on building new facilities and not on the much lower cost of converting space in existing prisons. Mr. Aubry said this year's legislation would be phased in over four years, allowing the Department of Correctional Services and the Office of Mental Health time to make the necessary renovations in prisons and staffing changes to screen and treat mentally ill inmates.

The legislation will strengthen gains made in the Disability Advocates case, according to Mr. Aubry.

"You needed to do more than the agreements that were reached between plaintiffs and the state," he said.

Mr. Gangi said the legislation is a "very positive step" in the direction of giving mentally ill inmates humane treatment.

"Essentially, what we were seeking through the SHU bill was the banning of the confinement of mentally ill people through the SHU as a matter of policy," he said. "The [Disability Advocates] consent decree did not achieve that."

The legislation does not apply to local jails. Jack Beck, director of the prison visiting project at the Correctional Association, said the focus has been on state prisons because the stays in SHUs are longer there than in county and city jails. He added that most studies done on the effects of solitary confinement have been in state prisons. Further, he said that many counties do not have the resources to dedicate special residential/health units to the mentally ill.