Restructuring Mental Health Programming for the Mentally Ill in New York City's Jail System

New York City (NYC) has the nation's second largest jail system, with over 80,000 new annual admissions, and an average daily census of 13,500 inmates, almost all of whom are housed at Rikers Island. One-third of these inmates are mentally ill, and of these, twenty percent are severely mentally ill. NYC's Departments of Health and Mental Hygiene (DOHMH) and Correction (DOC) have a unique and historic collaborative relationship within the City's jail system. The DOC oversees the security and manages all new admissions to these jails. The DOHMH is responsible for medical, mental health, substance abuse, dental, discharge planning, and transitional health care services for all inmates. In addition, DOC and DOHMH leverage the large mental health and substance abuse systems that provide support to forensic clients in the community and the court system. In November 2010, the DOC and DOHMH implemented a pilot program to provide residentially-based cognitive behavioral therapy through a highly structured incentive-based program in three mental observation units in a jail facility on Rikers Island. The treatment team consists of mental health clinicians, social workers and correction officers, all of whom play an integral part in the success of the program. Goals of the program include: increased jail safety, active participation in post-release treatment, reduced recidivism, increased length of community survival, increased medication compliance, and improved staff morale through team building and training. Process and outcomes measures have been selected and are being tracked, and preliminary results will be available for presentation at the 2011 meeting.