FLIP-FLOPS AND ZYPREXA PILLS
On July 19, 2002, three days after her arrest, Tara stood before Judge Joseph Kevin McKay in Brooklyn. She’d hardly eaten or slept in weeks. There were still hints of beauty in her appearance—in her creamy skin and soft brown eyes—but by now she bore only a passing resemblance to the 20-year-old who’d started hanging out in the East Village in the late 1980s. Five or six teeth had rotted out, casualties of a decade of drug use.
She spoke loudly and emphatically, as she always did when she hadn’t had any medication in weeks. “I didn’t do anything wrong, man,” she said. “I want to see my children. I want to see if they’re OK. That’s all I did. That’s all I did.”
“OK,” the judge said.
“I didn’t try to kidnap anybody. I just went to say hello. . . . It’s very strange to see some stranger walk around with your fucking children. Did you know that? Have you ever noticed that?”
“I can’t say I have,” he said.
Tara thought that if the judge knew she’d been trying to help the children—not harm them—then he’d realize all of this was just a big misunderstanding. The judge didn’t quite see things that way. “Forthwith to Elmhurst Hospital Prison Ward,” he said.
Most defendants go straight to jail; those who show signs of a serious mental illness are taken to a hospital. Two psychiatrists interviewed Tara, conducting an evaluation known as a “730 exam” to determine if she was mentally fit enough to understand the court proceedings and assist with her own defense. She passed this exam and was moved to the women’s jail on Rikers Island. There, she was assigned to a Mental Observation Unit.
This jail has two M.O. units, housing a total of 90 women. The mental health staff refers to the women as “patients”; the guards call them “inmates.” Virtually all have been diagnosed with schizophrenia, bipolar illness, or a depressive disorder. Shoelaces are banned, to prevent the women from hanging themselves. Everyone wears plastic flip-flops, slip-on sneakers, or regular sneakers with the tongues hanging out. Twice a day, a nurse wheels in the pill cart. Each drawer has an inmate’s name on it; the pills in Tara’s drawer were Zyprexa, an antipsychotic. Some days she refused to join the pill line. She was convinced she didn’t need medication.
Days in the M.O. Unit are incredibly dull, even more boring than in other parts of the jail. The women there don’t go to the mess hall; the food comes to them. Unlike other inmates, who can get jobs in the laundry or bakery, these women can’t work outside their housing unit. They pass the hours by drinking coffee, braiding each other’s hair, sleeping, bickering. The television blares constantly: Jerry Springer in the morning, soap operas in the afternoon, WWE SmackDown! on Thursday nights.
Jean visited Tara every week. She’d retired several years earlier, and now her efforts to help Tara had become practically a part-time job. Jean never got to see Tara’s cell block, but she imagined the worst sort of place. When Tara called home, Jean could sometimes hear women shouting in the background. Jean became especially frightened every time she read a newspaper story about another inmate suicide.
In recent years, the number of mentally ill people in the criminal justice system has soared. An estimated 20 to 25 percent of the people in New York City jails suffer from a mental illness. The number may be even higher for women: In the women’s jail on Rikers, more than one-third of the inmates receive mental health services. These individuals are considered prisoners first, patients second. The main purpose of the jail system is to confine them—not treat them.
If Tara had been born several decades earlier, she likely would have been locked up for many years in a state hospital, not a jail. In the 1950s, 90,000 New Yorkers resided in state mental hospitals; today that number is less than 5,000. Good intentions led to the disappearance of thousands of state hospital beds. With the emergence of antipsychotic drugs in the 1950s and ’60s, there was a push to move mental patients out of hospitals and into community programs.
This lofty idea never received adequate funding. Today there are not nearly enough beds in residential programs for everyone who needs them. For Tara and many other people with a serious mental illness, jails and prisons have become de facto mental institutions.
A PLAN FOR WORLD PEACE
The only time Tara left Rikers was when she had to appear at State Supreme Court in Brooklyn. Every few weeks, an officer woke her around 4 a.m. so she could get ready. She’d spend the day on the ninth floor of the courthouse, locked in a pen with several other women. Lunch consisted of two bologna sandwiches, a carton of milk, maybe an orange. The trip could take all day. Sometimes she wouldn’t get back to the M.O. Unit until evening.
After her name appeared in the newspapers following her arrest in Brooklyn Heights, several people reported to the police in Manhattan that she had done the same thing to them. At the end of 2002, the Manhattan district attorney’s office charged her with the same crime: attempted kidnapping. Now she had two criminal cases, which meant she had to go to court twice as often.
In Brooklyn, Tara’s case was transferred to Mental Health Court, a new alternative for mentally ill defendants. This court’s mission is to keep mentally ill people out of the prison system by hooking them up with mental health services in the community—residential or outpatient programs where they receive medication and therapy. For Tara, this court represented her best chance at getting out of jail.
Some days when Tara appeared in court she shouted and cried and strained against her cuffs. The two judges overseeing her cases ordered another mental-competency exam. Tara was ushered into a cramped office in the Manhattan Criminal Court building on March 20, 2003. Two psychiatrists interviewed her, asking the usual questions: What is the charge against you? Have you entered a plea? What is the function of a judge?
At first, Tara seemed coherent. She knew the name of her Manhattan lawyer (“Frank Rothman”), the function of her defense attorney (“Supposed to help me out”), the function of the district attorney (“Supposed to uphold the law”), and the function of a jury (“See if I am a criminal, a good guy or a bad guy”).
When the doctors asked her what the consequences would be if she were found guilty, her calm veneer vanished. “I am not guilty!” she said. “I got things to do—I got to get to the U.N.—I have a plan for world peace—I’ll put all the weapons in the ocean—seal them up—in every country—put them at the North Pole—I know a way to get world peace.” The doctors concluded Tara was “not fit” to be prosecuted.
Tara was transferred to Kirby Forensic Psychiatric Center, a maximum-security hospital on Wards Island. By now she’d been locked up for 256 days. Kirby holds people deemed mentally “unfit” to be prosecuted as well as people who have been found not guilty by reason of insanity. Among its most famous residents is Daniel Rakowitz, dubbed the “Butcher of Tompkins Square Park” by the tabloids 13 years earlier when he was accused of chopping up his girlfriend and cooking her body parts in a soup.
Time moves more quickly at Kirby than on Rikers. On Rikers, nobody cares if you stay in bed all day; at Kirby the staff keeps you busy. Tara went to ceramics and painting classes, bingo nights, the library. She played pool. No longer was she surrounded only by women; her unit was coed. Romantic relationships were prohibited, but she made some male friends, collecting a few names and addresses. Since Kirby is a hospital—not a jail—there was more access to psychiatrists and group therapy.
Tara refused medication at first, but eventually she permitted the staff to give her a shot of Prolixin, an antipsychotic. Tara knew she wouldn’t get out of Kirby if she did not agree to be medicated. Over the years, she’d tried numerous antipsychotics, both old and new: Haldol, Thorazine, Prolixin, Risperdal, Geodon. The Prolixin worked better for some patients because it could be given as an injection, eliminating the possibility it could be spit out.
In the fall of 2003, 447 days after her Brooklyn Heights arrest, Tara was given yet another psych exam. This time, she answered all the questions correctly. She knew the definition of a plea bargain (“when you plead to a lesser charge”); she knew the consequences of pleading not guilty (“go to trial; I can either win or lose the trial, and I can be found innocent or guilty”); and she knew the maximum prison term she was facing (“15 years”). After eight months at Kirby, the staff decided she was mentally fit enough to be prosecuted. She was sent back to Rikers Island.
Two: Flip-flops and Zyprexa pills; A plan for world peace