Mayor’s Task Force on Behavioral Health and the Criminal Justice System

Smart reforms have made New York the safest big city in the country. Protecting the long-term public safety of New Yorkers requires that we remain committed to evidence-driven innovation and improvement.

Over the last twenty years, this City has experienced the sharpest drops in crime anywhere in the nation. As crime has fallen so has the City’s jail population – on October 30, 2014, there were over 1,000 fewer people detained than on the same day last year. While many factors contributed to this extraordinary achievement, at its heart, the success was due to a focused effort to identify who was committing crimes and where and then tailoring strategies to address those specific problems. Amid this success, though, the number of people in the criminal justice system with behavioral health issues has remained gridlocked.

Despite our success in reducing the overall jail population, the number of people with behavioral health issues has stayed largely constant, with individuals with behavioral health issues comprising a bigger and bigger percentage of the total number incarcerated. While in FY 2010, people with mental illness were only 29% of the NYC jail population, today they represent 38% of the overall jail population; approximately 7% of the jail population is made up of individuals with serious mental illness, meaning that they suffer from diseases such as schizophrenia and bipolar disorder.

The jails hold up a mirror to the rest of the criminal justice system. Although we need more data and better focus on these individuals – something that the continuing work of the Task Force will provide – the Task Force found that at every point, the criminal justice system has become the default for addressing the problems presented by people with behavioral health issues, whether at arrest, arraignment, confinement or in the neighborhood. When appropriate, the criminal justice system has an important role to play, yet many people who cycle through the system could be better served – and public safety improved – if their underlying conditions were addressed effectively.

For many with behavioral health needs, the criminal justice system is a revolving door leading
to multiple costly, short stays behind bars over the course of their adult lives. In New York City,
a group of just over 400 individuals comprises the population that most frequently returns to
the City’s jails. According to a report from the NYC Department of Health and Mental Hygiene, these 400 people have been admitted to jail more than 18 times in the last five years and they show an even higher prevalence of mental illness and substance use disorder than the general jail population—67% have a mental health need; 21% have a serious mental illness; and 99.4% report substance use disorderiii. This group accounted for over 10,000 jail admissions and 300,000 days in jail during the five years examined in the report. Eighty-five percent of their charges were misdemeanors or violations, raising a question about whether criminal justice resources are best deployed with this population.

In June of 2014, Mayor de Blasio launched a robust effort to address how the criminal justice and health systems can work together better to ensure that we are reserving criminal justice resources for the appropriate cases and deploying treatment and other proven effective remedies to interrupt those needlessly cycling through the system. Under the leadership of Deputy Mayor of Health and Human Services Lilliam Barrios-Paoli and Director of the Mayor’s Office of Criminal Justice Elizabeth Glazer, the Task Force’s executive committee included commissioners from City and State agencies, experts from the private sector, representatives from law enforcement and behavioral health agencies, district attorneys, defenders, judges and other court representatives, academics and service providers. The Task Force brought together over 400 leaders and participants in this work from across the City and the nation. Over a 100- day period, this group developed a comprehensive strategy to ensure that, when appropriate, people are diverted from the criminal justice system and that justice-involved individuals with behavioral health needs are connected to care and services at every point in the criminal justice processv. At every stage, the Task Force coordinated its work with the Task Force on Juvenile Justice Educational and Mental Health Supports (Juvenile Health Task Force), chaired by Commissioner Gladys Carrion of the Administration for Children’s Services.

The Task Force recognized the interdependent and intersecting nature of the behavioral health and criminal justice systems and looked at not only every point at which individuals come into contact with the criminal justice system, but also the overlap between them. The comprehensive, system-wide review was the first in the City’s history to consider each point of contact and how each part of the system affects the other. The Task Force identified five major points of contact and identified strategies for each:

Based on these five points of contact, the Task Force convened five working groups to address the system point where each had the most expertise and, together with each of the other working groups, to see how the points fit together. In addition, the Task Force went to each borough and, with expert guidance, spent a day “mapping” how the criminal justice system worked or did notvi. This mapping exercise engaged over 200 people from City and State agencies, community providers, advocacy organizations, and consumers of behavioral health services.

The recommendations of the Task Force focus on ensuring that, when appropriate, individuals with behavioral health needs:

  • do not enter the criminal justice system in the first place;
  • if they do enter, that they are treated outside of a jail setting;
  • if they are in jail, that they receive treatment that is therapeutic rather than punitive in approach;
  • and that, upon release, they are connected to effective services.This plan sets out concrete and immediate next steps, a forward path to address those issues not yet ready for implementation, and the vehicle to ensure expeditious and effective operations and reliable assessments of what is working, at what cost, and with what benefit.The comprehensive strategy developed by the Task Force is backed by evidence and informed by widespread expertise. It will ensure that we continue to drive New York City’s crime rate even lower by reliably assessing who poses a public safety risk and ensuring that we appropriately address – not just at arrest, but well before and well after – the behavioral health issues that have led many into contact with the criminal justice system.


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