By Jared Chausow
By Katie Toth
By Elizabeth Flock
By Albert Samaha
By Anna Merlan
By Jon Campbell
By Jon Campbell
By Albert Samaha
For mentally ill people who commit a serious felony, there have long been just two options: Go to prison, or enter a plea of not guilty by reason of insanity. Defendants who choose the latter have been confined indefinitely at places like Kirby Forensic Psychiatric Center, the maximum-security hospital on Wards Island, where they can languish for years, maybe even the rest of their lives. Today, mentally ill people arrested in Brooklyn have a third choice: They can try to get their case heard in Mental Health Court, where the primary objective is to place people in treatment programsnot prison.
As mental hospitals across the country have been closing, replaced by a rickety network of outpatient services, mentally ill people increasingly find themselves in jails and prisons. An estimated 11 percent of inmates in New York state prisons are mentally ill; that's about 7,500 people. In state prisons nationwide, the likelihood is greater than one in six that an inmate has a serious mental illness.
There is a hefty price tag for locking up all these people, of course; it would be cheaper to treat them in their community. Mentally ill inmates are far more expensive to care for than other inmates, and they tend to stay in prison longer.
Mental health courts represent an innovative attempt to tackle this problem, and in recent years these courts have become increasingly popular. There are now 97 across the country, in places like Anchorage, Seattle, Akron, and St. Louis. The Mental Health Court in Brooklyn, which opened in 2002, was the first of its kind in New York State. Unlike many other mental health courts, the one in Brooklyn focuses primarily on people charged with feloniesdrug sales, assault, robbery, arson, kidnapping, grand larceny. For these defendants, who are facing state prison time, the offer to plead guilty and receive treatment can be a lifesaver.
The Brooklyn court is in session on Tuesday mornings in room 774, on the seventh floor of the State Supreme Courthouse, at the end of a long scuffed corridor. There is no sign outside indicating this is Mental Health Court, nothing that would suggest anything out of the ordinary occurs here. Inside, men and women fill the rows of wooden benches in the back, waiting to check in with the judge. Most of these defendants have already pleaded guilty and been assigned to a treatment program. A psychiatrist working for the court has diagnosed them with a serious mental illnessmost likely, schizophrenia, bipolar disorder, or severe depression.
Perhaps the biggest difference between this criminal court and most others is the tone set by Judge D'Emic, 51, a Bay Ridge native who was appointed to the bench by Governor George Pataki in 1996. Two years later, he was picked to preside over domestic violence court, and after receiving a year of weekly tutorials from a psychiatrist, he began overseeing Mental Health Court.
On a recent Tuesday morning, he peered down from his perch at Thomas, 39, who was dressed in a denim jacket, a pack of Pall Malls jammed in the front pocket.
"Everything all right?" the judge asked.
"Yeah, I'm all right," Thomas said.
Thomas has been coming to this court for a year, ever since he got arrested for third-degree assault.
"Do you have any cards with you today?" the judge asked.
"No," Thomas said. Instead, he pulled out a dollar bill, which he gave to his Legal Aid attorney to inspect. "This is pretty cool," he told the judge. "I'm going to turn this bill inside out."
He folded the bill several times, then unfolded it so it appeared as if it had been cut in four pieces and reconfigured with the corners in the middle. He held it up for everyone to see. Then he folded it once again. This time when he unfolded the bill, it was back to normal. A ripple of laughter spread through the room. "That's good," said the judge, grinning.
Few judges encourage defendants to show off their skills or to talk about their achievements, but D'Emic always does. Thomas usually performs a magic trick or two. Two young men regularly belt out songs; one prefers r&b, the other gospel. Some defendants show the judge artwork, poetry, or pictures of their kids. He invites most up to his bench, so he can talk to them one-on-one about their lives. This practice is unheard of in other parts of the building, where, if a defendant strode up to the judge's bench, the court officers would tackle him.
Room 774 at the Brooklyn State Supreme Courthouse: New Yorks first mental health court
photo: Cary Conover
The question pushed Jose's lips into a smile. "Good," Jose said. "She's getting big."
"How old is she?"
"Good for you."
Jose promised to bring a picture of his baby next time, then turned toward the exit. To remember personal details about each defendant, Judge D'Emic relies on a computer hidden beneath his desk. The computer contains his notes on every defendant's prior visits; to read them, he looks down at the monitor through a small window. In Jose's file, there was a mention of his daughter's birth. As Jose walked out of the courtroom, the judge tapped on the keyboard, adding a few more lines.
These private notes include all sorts of information one would never find in a standard court file. Judge D'Emic knows who just got back from a family reunion in North Carolina, who lost a construction job, whose wife recently died, who got their benefits cut off, who passed their last drug test. On a Tuesday in May, the judge saw Francisco, 51, who has been coming to this court for a year, since his arrest for a drug sale. Now he is in a program and trying to put an end to his addictions.
"D CAUGHT AN 8 PD STRIPED BASS AND CELEBRATED BY HAVING A BEER," the judge typed in his computer. "STEP BACK BUT HE KNOWS IT AND ADMITTED IT. HE WILL BRING IN A PHOTO OF FISH NEXT TIME." Three weeks later, after Francisco's next court appearance, the judge wrote: "D SHOWS ME PICTURE OF 9 LB FISH HE CAUGHT."
The judge always notes when a defendant receives a certificate. There are four "phases" in Mental Health Court, and when defendants stay out of trouble for a certain period of time, they receive a certificate from the judge. After completing a treatment programwhich lasts at least a yeara defendant "graduates" from the court, meaning that the felony is dismissed and the person is completely free. So far, the court has 19 graduates. Each received a handshake from the judge, applause from the audience, and a gift from the court's clinical directorusually an appointment book or a disposable camera or a box of chocolates.
This strategy of lavishing attention and giving regular rewards seems to work. "These are people who have been really sick their whole lives," says Lisa Schreibersdorf, executive director of Brooklyn Defender Services, who is often in the court. "Everyone's telling them how messed up they are, that they're a complete failure. They haven't had much positive response from anybody in authority their whole life, and here's a judge telling them they did a good job. They just brighten up when he pays attention to them."
Many of the defendants have been coming here for so many months that their stories are well-known. There is the pharmacist who became a pill addict and a habitual drunk driver; the woman with the spiky red hair, a former cocaine addict who pulled on a ski mask and stuck up her local bodega; the Brooklyn Law student who broke into his school to retrieve a test because he was afraid he'd failed; and the Pratt Institute student who was beaten up by other inmates after he started twirling around his Rikers jail, bumping into people, and declaring that he was Jesus and Rikers was heaven.
Helping these defendants navigate New York City's mental health system is the job of the court's clinical director, Lucille Jackson, and her staff. For each defendant, they search for the appropriate servicesa case manager, a treatment program, and if necessary, a residence too. Finding an empty bed is the hardest part. If a defendant needs a place to live, he or she could end up spending an extra six months or more on Rikers Island.
Even when the court connects a defendant with a case manager, a treatment program, and a residence, there is, of course, no guarantee he will flourish. The tall, slender 25-year-old wearing a Jason Sehorn jersey and a pair of handcuffs, standing before Judge D'Emic on a recent morning, knows this as well as anyone. Diagnosed with a paranoid personality disorder, he was assigned to Mental Health Court in early 2002, after an arrest for grand larceny. Not long before, he had left state prison after spending two years inside on an assault conviction.
Like every other defendant in the court, he pleaded guilty and was assigned to a treatment program. The judge explained that if he stayed in the program, his second felony would be erased; if not, he would receive a prison sentence of two to four years.
It was not long before the young man ran away from his residence. The court found another residential program, and the judge even gave him his cell phone number, so he could call any time he needed help. All of this effort didn't seem to work, however. He did not respond well to his medication; he looked like a zombie when he came to court. He ran away again. Over five months, he ran away at least twice from two residences. Then he disappeared altogether.
Eight months later, he ended up back on Rikers Island, arrested for carrying a substantial amount of marijuana. Today the judge was planning to sentence him to prison. Not surprisingly, the young man was hoping for one last chance. "He really does want to pursue treatment," Schreibersdorf, his lawyer, said. "I was hoping that you might consider the possibility of one more try."
"I didn't run on my own," the defendant said. "I was tricked. I was scared I was going to get sent back to jail. . . . I've got an illness. I just can't sit up north in jail with a mental illness. It's not right. . . . If anything, it's going to make me worse." Between his pleadings and those of his lawyer, they managed to persuade the judge to push back his sentencing to another day. A court officer whisked him from the room.
"Sometimes it's the mental illness that makes it impossible to succeed," Schreibersdorf said later. About her client, she added, "He doesn't really belong in prison because what he says is the truth. . . . When he gets out, he'll have learned nothing. He'll be institutionalized. And he'll have gotten no insight into how to control his own behavior. He's right about that, and we all know he's right, but there's no in-between."
For defendants who require a secure facility, who will run away if they are not in a locked building, the judge has no place to send them except to prison, which, of course, is the outcome the court was set up to avoid. Prison may be the single worst place to send mentally ill people. They are victimized by other inmates, have trouble obeying the prison's rules, and often end up in solitary confinement, where the isolation and lack of human contact can make them even sicker. Self-mutilation and suicide attempts are common.
Sitting in this court, listening to defendants tell their stories, it is easy to see that mental illness is only one of a long list of obstacles they must overcome. A young man whispered to the judge that he is very depressed because he wears the same clothes every day; he only owns one outfit. Another man, a longtime cocaine addict, not yet middle-aged, has suffered 13 heart attacks. An older woman was so sick from a recent stroke that she could barely walk into the courtroom.
Even for defendants who "succeed"who finish treatment and receive a graduation certificatethere is no certainty that they will remain free. Living with a serious mental illness is a lifelong struggle. Two of the court's 19 graduates have already returned, arrested on new charges.
So far, 108 people have participated in the court; the judge has sent seven of them to prison. That leaves 101 people who got a second chance, who received treatment instead of punishment. "If no innocent people are getting hurt and the defendant is going to treatmentor if he's not and I can cajole him into doing the right thing and staying engaged in treatmentthen I think I'm doing my job," Judge D'Emic says. "You can't base public policy on anecdotes. On the other hand, success can only be measured one case at a time."
Judge Matthew D'Emic: "In my mind, I have to always balance the needs of the defendant and their family versus public safety."