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Q&A
Post-release care and community reintegration challenges
0:17:23
ยท
5 min
Dr. Stossel addresses the challenges of post-release care and community reintegration for individuals leaving NYC jails, particularly those with mental health needs.
- She outlines current reentry services, including medication supplies and appointments for those with serious mental illness.
- Dr. Stossel emphasizes the need for more robust community mental health services, including expanded supportive housing and day treatment programs.
- She highlights the significant gap between the level of care provided in jail settings and what's available in the community, advocating for stronger support systems to help individuals transition successfully.
Keith Powers
0:17:23
Thank you.
0:17:23
And we're joined by Council Member Salamanca here as well.
0:17:25
I actually have one more question.
0:17:27
We've heard stories and we've seen high profile incidents over the last couple of years, certainly in this past year, one of those in my district, where individuals leaving custody are, you know, essentially sent with, I believe is today, I don't, you would know, probably have more clarity here, but my recollection is folks leaving with like a need for continued care, very few places are getting it, no man, they're sort of released without any sort of plan for care, some are getting I think a fourteen day prescription and no continued plan to go beyond that.
0:18:04
It seems like there's just like a major gap between in care and custody.
0:18:09
Talk about the PACE units, you talk about other units, they're getting higher staff ratios, they're getting adherence to prescriptions or other treatment that they need.
0:18:18
It's an environment where there is a sort of structure and support even inside the sort of environment we're talking about and then they are released released without any of that or very little of that and sent in some cases to the next address which might be the Bellevue Men's Shelter on Thirtieth Street or another facility where no prescriptions, no treatment, no continued care, no really nothing, it feels like nothing.
0:18:51
And maybe predictably we've seen some high profile acts where individuals have caused serious, inflicted serious pain and violence on people, have caused major incidents without intensity.
0:19:08
But even beyond those incidents, there's individuals who are suffering and aren't getting care, and streets, subways, shelters become the de facto place for them to to go.
0:19:20
Feels that that gap is a major challenge for us facing the city but not being discussed enough.
0:19:29
What recommendations do you have to help close that gap?
Dr. Lauren Stossel
0:19:32
Yeah, so I mean I think the housing and security piece is really huge and I think, you know, in terms of the reentry services available at Rikers currently, my understanding is that people who have serious mental illness are given a fourteen day medication supply and an appointment.
0:19:49
So my understanding is that they do actually leave with an appointment within those two weeks where they can get engaged into community care.
0:19:56
Many of them also have case management services with CRAN, which is a really excellent organization that helps with formerly incarcerated individuals and helps sort of connect them to services.
0:20:10
And then, you know, people who do not have serious mental illness I think get more like a referral and a seven day supply of medication.
0:20:18
There's always a refill at a pharmacy, so technically it's a full month of medication.
0:20:24
But and you know I think recently we also started giving people cell phones to help make sure that they can get connected with those case managers.
0:20:31
So I think there have been sort of incremental improvements to try to make sure that people have the support that they need.
0:20:39
But I think what's missing is is more robust community mental health services where the support can really be wraparound, where you know people don't get you know a SPOA application that recommends them for supportive housing then they get on a wait list where it could be two years, you know, while they're waiting for a place to live.
0:21:00
It's really challenging to do strong, you know, care navigation from a shelter.
0:21:07
And I think, you know, expanding supportive housing, expanding not only mental health care, but also programming.
0:21:16
There are so few day treatment programs where people with serious mental illness have a place that they can go.
0:21:23
You know, Fountain House is the one that is really popular, and I do clinical care at Kings County now.
0:21:31
Everybody gets referred to Fountain House, but it's the only place.
0:21:34
You know, I think people need not just a place to live and medication, but they need a way to fill their time and a sense that they're connected to people who care about what happens to them so that they can care about what happens to them also.
0:21:46
And I think that's, you know, really important for people who don't have strong family connections.
0:21:52
So I think, you know, there's been a real sort of pruning away of the inpatient beds.
0:21:59
Inpatient stays are very short.
0:22:02
And the drop off, you know, similarly from PACE unit in a jail setting to, you know, referral to a psychiatrist or a therapist in the community is huge.
0:22:14
Similarly, after a two week stay where you're being treated for an acute exacerbation schizophrenia in a hospital, and then you leave and you're going to a community mental health clinic where you get to see a therapist once every three weeks and a psychiatrist once every two months, it's not enough.
0:22:26
And so, you know, I think creating more robust community mental health services, residential treatment, things like that in the city would be the right sort of direction to go, if that makes sense.
Keith Powers
0:22:40
Got it.
0:22:41
Appreciate it.
0:22:42
Thanks for answering those questions.
0:22:43
Do colleagues have questions?
0:22:45
Yeah.
0:22:46
Councilor oh, councilor O'Sullivan, go ahead.
Rafael Salamanca, Jr.
0:22:47
Good morning.