Victory for Inmates with Mental Illnesses
On January 8, 2003, New York City finally settled the Brad H.
case, agreeing to provide discharge planning services for inmates
with serious mental illnesses. Under the agreement, discharge planning
includes an individualized assessment of the person's needs for
mental health treatment, public benefits (such as Medicaid, SSI
and Food Stamps) and appropriate housing, and requires the city
to assist the released inmates with obtaining the services and resources
their assessment determines they need. The agreement must now be
submitted to members of the class for comment and is subject to
a public hearing before Justice Braun accepts it as final. Once
approved, it will cover all city jails.
Brad H. is a precedent-setting class action in which the
state trial court, in July 2000, ordered New York City to provide
discharge planning for jail inmates who have a mental illness. The
city appealed, but the initial decision was unanimously upheld on
October 31, 2000, by the Appellate Division of the New York State
Supreme Court. The plaintiffs in the case were represented by Debevoise
& Plimpton, Urban Justice Center and NY Lawyers for the Public
Interest. The city's subsequent appeal to the state's highest court
was denied.
The city had balked at providing discharge-planning services for
inmates being released from jails such as the one at Rikers Island.
Instead, the inmates were dropped off at Queens Plaza, a transportation
hub, in the middle of the night with $1.50 and a two subway tokens.
People who took medication while incarcerated were released without
a supply to carry them until they could obtain and fill a prescription.
No one ensured that they had access to public benefits—for
which applications often take months, without special intervention
and assistance. As the judge wrote in his initial decision, the
release of prisoners without needed treatment planning risks "a
return to the cycle of likely harm to themselves and/or others"
and their resulting rearrest.
People with serious mental illnesses who have been in jail or prison
are especially susceptible to rearrest when released—as they
often are—with nothing but a few bus tokens, a few pills and
a paper with the address of a mental health center. A 1991 study
reported that almost two thirds of offenders with mental illnesses
were rearrested within 18 months of release, while approximately
half were hospitalized within those first 18 months. Discharge planning,
to help them obtain public benefits and link them to community treatment,
is an important tool for breaking such a cycle of rearrest and incarceration.
A 1999 New York City study by the Vera Institute found that the
lack of Medicaid was the biggest obstacle to accessing treatment
following release. Yet nationally only one third of inmates with
mental illnesses receive any discharge-planning services. The Bazelon
Center has produced a
booklet explaining the federal rules for access by released
inmates to public benefits such as SSI and Medicaid, which they
could used to obtain housing and mental health treatment.
Discharge
planning, properly accomplished, will provide case managers
to assist inmates in qualifying for disability benefits and Medicaid
immediately upon their release. It will also link them with community
resources for housing and mental health and rehabilitation services.
Although Brad H. has been successfully settled, many jail
administrators around the country still are unaware of what is entailed
and how discharge planning can be achieved. For example, jails can
enter into pre-release agreements with the Social Security Administration
and receive assistance from their local Social Security offices
to help inmates qualify for SSI benefits immediately upon release.
Our booklet, Finding
the Key, explains these and other approaches. Its text can be
downloaded from this site. In addition, the Bazelon Center will
soon release, Building Bridges, model legislation that states can
adapt and enact to ensure that people with mental illnesses receive
the stability they need to be successful in the community when they
are released from jail or prison.
In upholding the Brad H. decision, the appeals court also
accepted an amicus brief by the Bazelon Center, the National Alliance
for the Mentally Ill (NAMI), the American Orthopsychiatric Association
and 11 New York organizations and coalitions. Attorneys with the
law firm Gibson, Dunn & Crutcher donated their time to write
the brief on behalf of these organizations. The brief extensively
documents the importance of discharge planning to assure continuity
of services and spells out how jails can implement the requirement––already
mandated by New York State law––consistent with standards
developed by the major professional organizations.
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