(7-6-18) In today’s New York Daily News, Cheryl Roberts, the executive director of the Greenburger Center for Social and Criminal Justice, writes about the need for mental health “asylums.”
During my travels and recently in Washington, I’m hearing more and more discussions about the need for longer-term residential facilities for the sickest of the sick. Americans always react with horror whenever anyone talks about rebuilding “state hospitals.” That is a real fear based on the atrocious abuses that happened when state hospitals were dumping grounds in our nation.
Two factors are rarely mentioned in such discussions. The first is the widely accepted Rule of Thirds, which states there is a percentage of individuals with schizophrenia who we simply don’t know how to help and have little chance of ever recovering. Can everyone be helped through Housing First and ACT team programs in our communities? Can everyone live independently in supportive housing – an important question given the U.S. Justice Department’s drive to close group homes in favor of everyone having the right under the American Disabilities Act to their own apartment.
The second factor: while dumping individuals in shoddy institutions is unforgivable and unacceptable, no one faults long term residential facilities that currently exist in our nation that are generally so expensive that only the very rich can afford them. These are often farms or hospital connected residential facilities that appear more like college campuses than the locked wards of the past. Are institutions – by their very nature – destructive to the human spirit or did state hospitals become despicable monuments to man’s inhumanity because they were never adequately funded and dreadfully understaffed by an uncaring public? If the latter is true, is it realistic to believe that any public funded residential facility could ever operate on the same par as their private and prohibitively expensive rivals?
In her OP Ed, Roberts joins an mounting chorus of advocates demanding an end to inappropriate incarceration. The question that lingers is how best can we help those who often are so ill they become entangled in our criminal justice system? Now that is a loaded question! I’ll be interested in hearing your thoughts on my Facebook page.
The Greenburger Center was created by New York philanthropist Francis Greenburger, whom I met decades ago when my first book agent operated out of Greenburger’s literary agency. I’ve written before about how Greenburger’s son, Morgan, was arrested during a mental health crisis and jailed at Rikers Island, which is what led to his politically influential and loving father to found the Greenburger Center.
Out of jail cells & into havens: Rikers must give way to humane alternatives for the seriously mentally ill
By Cheryl Roberts,
OP Editorial published in the New York Daily News
“Bring back the asylum” is a buzzphrase popularized by President Donald Trump, who reaches back in time for a simplistic solution to mass shootings.
For more than 10 million Americans with serious mental illness, asylum — defined as “an inviolable place of refuge and protection” by Merriam-Webster — is a concept that urgently needs to be reclaimed and realized, without recreating the inhumane asylums of the past.
When government began closing asylums 50 years ago, few new institutions emerged to absorb this population. That’s how jails, prisons and homeless shelters became the default housing options for those struggling with mental illness. But some people with serious mental illness still need asylum.
Places that provide asylum can be psychiatric hospitals, psychiatric units in general hospitals, Department of Defense or Veterans Affairs medical centers, private psychiatric hospitals, or treatment centers that provide 24-hour care but are not licensed as hospitals. What they can’t be are prisons or jails.
Today in the U.S., about 170,000 people with serious mental illness live in such institutions — but more than 350,000 live in jails and prisons and another estimated 350,000 are homeless. The nation’s mental health system is undeniably broken.
We need a new contract with Americans that puts mental health concerns on par with physical health. We need to continue to train police to de-escalate interactions involving people in mental health crisis, and crisis centers so police can take seriously mentally ill people to a treatment facility instead of jail.
And we need more institutions that cover a wider range of care for the seriously mentally ill — just as we don’t expect people with cancer to fit into a one-size-fits-all treatment regime or type of facility, but instead treat some on an outpatient basis and others with inpatient care.
People with serious mental illness must have places to receive treatment, and in some cases to live, where they can get stabilized, gain life and work skills, and become part of a community. In short, we need a new set of institutions that offers a place of refuge, a place of asylum. And they shouldn’t be jails.
As New York City works to close Rikers Island, it is critical to create a new contract, new institutions, and a new direction for those suffering from serious mental illness, as Rikers is home to the largest concentration of people with serious mental illness in the state.
As planning efforts inevitably turn to this population, they should focus on creating new institutions outside of jails, rather than retrofitting a correctional setting for treatment. Jails and prisons cannot provide asylum; they are the wrong institution, run by the wrong staff. The option to reuse a jail institution in place of a mental health system should be off the table.
Instead, our notion of mental health “institutions” must be expanded to include new kinds of institutions like the residential diversion facility being developed in Miami by Judge Steven Leifman or the Greenburger Center’s Hope House, a planned community residence for those whose untreated serious mental illness resulted in serious criminal behavior. We must also expand community-based housing options such as those run by Argus Community and Fountain House’s clubhouse model of supportive and supported housing.
Just as the #CloseRikers campaign had the audacity to say that Rikers must close, we must have the audacity to say that jails can no longer be an option to house those with serious mental illness.
New York City and State have been leaders in developing innovative mental health and substance use disorder diversion and treatment programs. Closing Rikers represents an important opportunity to spur innovation and lead, not only on criminal justice reform but on real mental health reform, too.
Roberts is executive director of the Greenburger Center for Social and Criminal Justice.
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