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| Report Faults City on Health Care for Mentally Ill |
| By New York Times |
| Published: 12/23/2003 |
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Nearly a year after signing a court settlement to provide a post-jail health care plan to mentally ill inmates scheduled for release, New York City health officials have failed to fulfill many of its most basic requirements, like scheduling doctor appointments and completing Medicaid applications, according to a report by court-appointed monitors. The settlement, signed on Jan. 8, requires the city to connect eligible inmates to clinics, prescription drugs, treatment centers, housing and government benefits. About one in four jail inmates suffer from a mental illness, experts estimate. Ensuring that these inmates return to their communities with treatment options and access to mood-stabilizing medicines is simply good public policy, inmate advocates and city health officials say. But in their report, investigators designated by the State Supreme Court to oversee the city's compliance with the January agreement describe several areas of the "discharge planning" process where the Department of Health and Mental Hygiene, which coordinates the city's inmate health care system, has substantially fallen short of its legal obligations. Among their findings: -A third of mentally ill inmates eligible for discharge planning services refuse to accept them, the monitors' report said, a reflection of "inadequate attempts" by mental health staff members to communicate the program's benefits, according to the report, dated Dec. 16. -Only 4 percent of inmates who did participate in post-jail planning had a scheduled appointment on the day of release, as required by the court settlement. -Mental health staff performed Medicaid prescreenings on only 42 percent of the 5,416 eligible inmates released between June 3 and Nov. 15, a rate the report's two authors called unacceptable. The report highlighted a lack of coordination between the discharge planning staff at Rikers Island and the majority of the program's other employees, who work away from the jail complex. It also noted staffing levels that heaped 200 or more inmates on individual discharge planners, and questioned whether some mental health workers were adequately trained and motivated. The city began its discharge planning in June, two months after Judge Richard F. Braun of State Supreme Court approved amended terms of the settlement. Last week's was the second report by two court-appointed monitors, Henry A. Dlugacz, a former administrator of jail mental health care services at St. Vincent's Manhattan Hospital, and Dr. Erik Roskes, a psychiatrist who has worked in Maryland state prisons. They are required to evaluate the city's discharge planning system every quarter during the first year of the settlement. Despite their failures so far, the monitors noted, the city agencies involved in comprehensive discharge planning, including the Departments of Health, Correction and Homeless Services and the Human Resources Administration, deserved credit for "good faith efforts." Still, the report noted, inmate records were often "chaotic and disorganized," and "poor communication among the many individuals" coordinating discharge plans left too many inmates facing release without community-based help for their illnesses. |
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