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New York City Council
Oversight - Mental Health Care in New York City Jails
Read summaries and jump into the video at the segment start.
Council staff welcome attendees, ask phones to be silenced, explain appearance cards for those wishing to speak, and instruct that no one approach the chair.
Chair Selvena Brooks-Powers welcomes attendees and identifies the committee, herself as chair, and the bills being heard: Intro 809, Intro 453, and Intro 133. She notes members joining and frames the hearing around mental health care in city jails.
Brooks-Powers says about 60% of people in city jails have a documented mental health need, with one in five having serious mental illness. She outlines the continuum of care to be examined, including mental observation, PACE, and outposted therapeutic housing units.
Brooks-Powers says the committee will examine how lock-ins affect medical and mental health appointments. She stresses that continuity of care is critical for people with serious mental illness who rely on consistent treatment.
Brooks-Powers argues that closing Rikers and transitioning to borough-based jails requires reducing the jail population and meeting mental health needs. She says treatment, discharge planning, and diversion are necessities for the closure plan.
Brooks-Powers thanks committee staff by name and previews a productive discussion on strengthening jail mental health care. She then pauses to allow Council Member Cabán to give remarks on her bill.
Council Member Tiffany Cabán says Rikers is especially dangerous for trans, non-binary, gender nonconforming, and intersex people. She describes denial of gender-aligned housing, discrimination, and violence she saw as a public defender.
Cabán credits the TGNC-NBI task force for exposing conditions in DOC custody and calls for passing Intro 133 to extend its mandate. She also says Intro 134 would give incarcerated New Yorkers recourse to safe gender-aligned housing.
The chair calls administration witnesses to the dais. Council staff administer the affirmation to the panel before testimony begins.
Dr. Joseph Otonichar of Correctional Health Services introduces himself and colleague Jeanette Merrill. He says about 61% of patients receive mental health services and 22% have serious mental illness, with higher prevalence among women.
Otonichar describes comprehensive medical intake and mental health referrals. He says clinicians review history, interview patients, seek collateral information, and use records including PSYCKES to determine diagnosis, treatment, and level of care.
Otonichar explains that most patients with mental health needs are housed in general population and seen in clinics. He details specialized units including 17 mental observation units, the STEP program, 10 PACE units, and a 20-bed PACE unit at Bellevue.
Otonichar describes CHS reentry services, including Medicaid enrollment, community provider connections, medication access, and resources like CRAN, Portline, and PORT practices. He says patients with serious mental illness are offered supportive housing applications and other supports.
Otonichar says CHS provides community-standard care in a difficult environment for a marginalized population. He commits to working with the council and others to improve the system and says he is happy to take questions.
James Boyd introduces himself as Deputy Commissioner of Quality Assurance and Compliance at DOC and notes Assistant Chief Joseph Caputo. He says DOC ensures access to care through escorts, transportation, housing coordination, staff training, and modernization like the clinic production dashboard.
Boyd says DOC values the TGNC-NBI task force and wants collaboration to continue. He supports children having mental health access but says DOC is not the best agency to provide or refer those services, and he describes escorting patients during emergency lock-ins when safe.
Boyd says the administration is committed to community safety and access to vital services in custody. He says DOC is working with the Remediation Manager and Federal Monitor and welcomes questions.
Chair Brooks-Powers notes Council Member Althea Stevens has joined to speak on her legislation. Stevens says children visiting incarcerated parents experience trauma and deserve mental health referrals, citing her work with young people and a visit to Horizon.
Brooks-Powers says the hearing was noticed 21 days earlier and that she asked for testimony at least 24 hours in advance. She tells Boyd the administration's failure to submit timely testimony is disrespectful and hinders preparation. Boyd acknowledges the feedback and says he will take it back.
Brooks-Powers asks how people in custody are identified for mental health services upon entry. Jeanette Merrill says all new admissions can be referred to CHS mental health, evaluated for level of care, and then housed in appropriate units such as PACE, MO, or STEP.
Brooks-Powers asks for the current mental observation census. Otonichar says there are 629 patients across 17 MO units.
Brooks-Powers recounts prior testimony on CAPS and mental observation beds. Otonichar says one CAPS unit is operating, and Assistant Chief Caputo confirms 23 people are currently housed there.
Brooks-Powers asks how DOC ensures people receive medication at scheduled times. Boyd cites ongoing collaboration with CHS and medication windows or housing-unit distribution, while Otonichar says therapeutic housing units can provide medication on site.
Brooks-Powers asks how many people have transferred to Bellevue's outposted therapeutic health unit since opening. Otonichar says the current census is 81, with 18 in the PACE unit, and discusses plans for Woodhull and North Central Bronx units.
Brooks-Powers raises the August 19 death of Christopher Rodriguez at Bellevue and asks about the cause. Boyd says the cause is pending investigation and autopsy, and the chair presses on why autopsies for earlier deaths remain unresolved.
Brooks-Powers asks when Rodriguez went into distress and what policies are being reviewed. Otonichar cites patient privacy and ongoing joint assessment review, while Boyd says the State Attorney General's Office, DOI, and Board of Correction are investigating.
Chair Brooks-Powers pauses the hearing to reopen the vote so Council Member Salaam can cast his vote. Staff begin a continuation roll call.
Council staff conduct a continuation roll call on Introduction 246A. Council Member Salaam votes aye.
The chair closes the vote after the roll call records six affirmative votes, zero negative, and no abstentions. Staff reset the hearing room.
Chair Brooks-Powers resumes the hearing and yields to Council Member Mercedes Narcisse. Narcisse asks how many mental health appointments were missed due to DOC non-production. Boyd says about 10% of over 60,000 mental health appointments this year were missed for reasons including no escort, alarms, or lockdowns.
Narcisse asks what share of people leave with a discharge plan, medication supply, and community appointment, and how follow-up is tracked. Otonichar describes Medicaid enrollment, prescriptions, reentry resources, and voluntary services. Narcisse says the voluntary nature concerns her given community mental health needs.
Narcisse asks about people without medical coverage or paperwork, including TPS recipients. Otonichar says about 85% have Medicaid on release and that Health and Hospitals provides care regardless of ability to pay.
Narcisse asks whether therapy is offered in multiple languages. Otonichar says CHS adheres to community standards and uses interpreter services in person or by phone or video. Narcisse also flags future budget questions on psychiatric care.
Council Member Frank Morano asks Otonichar whether housing someone with mental illness in general population means it is clinically best or simply the best available. Otonichar says patients are continuously assessed and that PACE waitlist currently includes 24 patients needing higher care.
Morano asks whether unmet CHS recommendations for higher care are tracked and published. Boyd says placement concerns are discussed with CHS, and Caputo says CHS knows bed availability when making recommendations and that DOC does not reject higher-care placements.
Morano notes the city has thousands more people in custody than the 4,160 beds planned for borough-based jails. He worries the city may exacerbate mental health housing problems under new capacity. He yields back with time expired.
Council Member Cabán asks why transgender people are sent to gender-misaligned facilities and why nearly half of transfer requests are denied. Deputy Commissioner Nell Colon cites PREA standards and case-by-case determinations, saying DOC tries to align housing once aware of a person's preference.
Cabán asks what specific criteria accounted for 106 denials out of 231 gender-aligned housing applications. Colon lists factors including stated gender identity, security concerns, mental health, and classification, but says she does not have a breakdown of gender-based violence findings.
Cabán asks whether DOC implemented the task force recommendation for automatic independent review of housing denials within three business days. Colon says DOC has not implemented that specific recommendation but policies are under review under the remediation manager and current leadership.
Cabán says the number of people in DOC custody with serious mental illness has increased over 80% since 2022. She asks how that affects quality care, whether ACT or IMT referrals are confirmed, and how CHS collaborates with other agencies.
Otonichar says the serious mental illness rate is about 22%, up from prior years, and that CHS uses therapeutic units and clinic appointments while recognizing jail is not conducive to mental health. Ellie Epstein describes SPOA referrals and limits in tracking community placements after release.
Council Member Gale Brewer asks whether Bellevue's 104 beds are all medical and how many mentally ill patients are homeless. Otonichar explains the PACE unit at Bellevue serves comorbid psychiatric and medical needs and says 31% of homeless patients have serious mental illness.
Brewer asks about recidivism rates for people in mental health programs. Epstein says CHS does not track recidivism as a health care service, though many patients return, and Otonichar says CHS could look into available data.
Brewer cites a compliance report showing social worker staffing at 90% and asks about recruitment and discharge planning. Epstein says CHS has made recruitment and retention efforts and has only one vacancy in that area, though pretrial detention makes discharge planning difficult.
Brewer asks how long it takes between a mental health referral and initial clinical evaluation. Otonichar says in July about 1,800 intakes occurred, roughly 1,000 were referred to mental health, and 95% were seen within 72 hours; stat referrals are scheduled within 24 hours.
Council Member Yusef Salaam asks how much of the 40% unseen mental health appointment rate is refusal, officer non-production, or lock-ins, and asks about Bellevue's rate. Boyd says he lacks granular data but can follow up on missed appointments.
Salaam asks how many yearly reports the TGNC-NBI task force has issued and whether Intro 133 would extend anything beyond the fifth report. Colon says the task force issued one large report in 2022 and continues to meet quarterly even though the original local law timeframe ended.
Salaam asks who would deliver and fund mental health services for children visiting incarcerated individuals if DOC is not a healthcare provider. Colon says DOC does not provide clinical treatment and lists existing partnerships, but says the city does not yet know which agency or funding source would be best.
Salaam asks whether DOC complies with Board of Correction rules requiring tracking of how lock-ins affect care, and why seven of nine involuntary lock-ins were in mental observation units. Boyd asks for the question to be repeated, and Salaam sidelines it.
Morano relays a question from Council Member Narcisse about vacant mental health clinician positions. Otonichar says CHS has 244 FTEs in mental health and 33 vacancies, and that recruitment is challenging in carceral settings.
Morano asks Boyd what single metric shows whether access is improving. Boyd cites production data and the clinic production dashboard, an electronic system being piloted at two facilities to track scheduled, unscheduled, and walk-in appointments in real time.
Morano asks whether the dashboard distinguishes patient refusals from DOC failure to produce. Boyd says refusals are recorded on body-worn camera and about 61% of all missed appointments were related to patient refusals, while Caputo says refusals are codified separately from court or other service absences.
Brooks-Powers pivots to deadlocking and asks whether DOC can assure the council it no longer occurs. General Counsel James Conroy says DOI investigated prior allegations and did not find deadlocking as alleged, and that the administration is committed to proper documentation of lock-ins.
Brooks-Powers asks whether mental health units are regularly inspected for deadlocking and whether staff have received training or discipline. Conroy describes a tiered supervisory system, memoranda and training against unauthorized lock-ins, but says he does not know of any discipline and will follow up.
Brooks-Powers asks whether CHS disciplined employees for refusing to cooperate with the DOI investigation into deadlocking. Otonichar says he is not aware of any such discipline and will follow up, but says clinicians are expected to report barriers to patient access to supervisors.
Brooks-Powers asks how many people in custody receive active mental health treatment, psychiatric medication, individual psychotherapy, and group therapy. Otonichar says about 4,018 people are under active mental health care, about 3,000 receive psychiatric medication, and about 1,100 are in therapeutic housing units.
Brooks-Powers asks how CHS staff interface with mental observation units and how PACE units are staffed. Otonichar says MO units receive on-site services, regular rounding, groups, and medication, while PACE units have multidisciplinary teams including psychiatric providers, clinicians, nurses, treatment aides, and social workers.
Brooks-Powers asks whether CHS has hired more social workers since the last compliance report and why it has never been in full compliance with court-ordered discharge planning staffing. Epstein says CHS has only one vacancy, has improved salaries and recruitment, and faces challenges including difficult commutes.
Brooks-Powers turns to her bill, Intro 809, and asks how many lock-ins occurred in 2026, their reasons, average duration, and how many lasted over four hours. Boyd and Caputo say they do not have that data and will follow up, prompting the chair to criticize DOC for opposing the bill without lock-in data.
Boyd says DOC data show 0.1% of scheduled medical appointments were rescheduled due to lock-ins from January through August 2026. He defends safety-driven lockdowns and says DOC tries to produce people the same day when possible.
Brooks-Powers asks how DOC notifies CHS when a lock-in begins and how CHS prioritizes missed appointments. Boyd describes daily facility-level communication and huddles, while Merrill and Otonichar say CHS is not notified in advance of emergency lock-ins but triages based on acuity, medication adherence, and stability.
Chair Brooks-Powers thanks the administration panel and calls up Arden Armbruster and Claire Salant from the Independent Budget Office. Council staff administer the affirmation to the IBO panelists.
Arden Armbruster introduces herself and Claire Salant from the Independent Budget Office. She says IBO is monitoring the jail population in light of Rikers closure and will share preliminary analysis on people in DOC custody with mental illness and or homelessness.
Armbruster says IBO analyzed DOC jail stay data through June 2026 and identified two groups: people with co-occurring mental illness and homelessness and people with mental illness alone. She notes data limitations, including lack of markers for serious mental illness, substance use disorder, and domestic violence.
Armbruster says TGNC and non-binary people are a small share of the jail population but 93% had a history of mental illness and 67% also had homelessness. Cisgender women also had higher rates than cisgender men, and people with homelessness histories tended to be older.
Armbruster says people with both mental illness and homelessness histories typically faced less severe charges, with petty larceny most common, while those with mental illness alone had assault charges at rates similar to people with neither history. She reports longer lengths of stay for the same charges and lower bail payment rates.
Brooks-Powers asks how IBO performed the analysis. Armbruster says IBO uses charter-mandated DOC data from fiscal years 2008 through 2026, identifies Brad H. class members and competency restoration discharges, and matches address data to shelter and homeless keywords.
Brooks-Powers asks IBO to expand on data constraints. Armbruster says IBO cannot identify serious mental illness specifically in its data, nor substance use disorder or domestic violence histories, though those factors matter for programs and diversion.
Brooks-Powers asks if IBO has recommendations and how much the city spends on mental health care in custody. Armbruster says IBO does not make recommendations but hopes its report informs policymakers, and says she can follow up on spending and how it is split between DOC and CHS.
Brooks-Powers opens public testimony and reminds attendees that decorum must be observed. She explains appearance cards, a two-minute speaking limit, and how to submit written testimony, then calls the first panel.
Barbara Hamilton of the Legal Aid Society says her office sees people in acute mental health crisis being met with isolation and punitive measures. She describes clients allegedly deadlocked for long periods on Rikers, including in the PACE unit, and urges oversight of DOC and CHS.
Brooks-Powers asks Hamilton to confirm that her clients were allegedly deadlocked by DOC and when those instances occurred. Hamilton says the cases are from 2026 and that Legal Aid is in contempt proceedings over two court orders. Brooks-Powers asks her to provide documentation to committee staff.
Raji Deyat Mangalam, a clinical social worker with New York County Defender Services, shares success stories of clients diverted to community treatment. He argues community recovery is possible and asks the council to support the Treatment Court Expansion Act on its Albany agenda.
Ethan Lowe of the Legal Aid Society and the TGNC-NBI task force says conditions remain urgent for trans and gender nonconforming people in DOC custody. He supports Intro 133 with advocate amendments and urges a hearing on Intro 134 for enforceable gender-aligned housing protections.
Maya Zellkind, a legal intern at Brooklyn Defender Services, reads an account from a formerly incarcerated trans woman. The account describes sexual assault, violence, denial of transfer to a women's facility, and lack of medical care at Rikers.
Camila, a paralegal at the Legal Aid Society and task force member, reads testimony from a formerly incarcerated trans woman. The testimony describes repeated sexual assault, harassment, threats by officers, and the suicide of another trans woman, and urges passage of Intro 133 and hearing Intro 134.
Council Member Cabán states for the record that she is a co-sponsor of Intro 134 and requested it be part of the hearing. She says she hopes the committee will hear the bill at some point.
Lucas Marquez of Brooklyn Defender Services and the task force supports Intro 133 but says amendments are needed. He describes structural problems including lack of administrative support, uneven agency participation, and DOC opacity, and proposes Board of Correction administration, qualified representatives, reporting, and consultation requirements.
Rachel Golden, a psychologist and task force member, says the 2022 task force report made detailed recommendations on intake, housing, mental health, reentry, staffing, and accountability. She says virtually none have been implemented and urges Intro 133 with amendments and a prompt hearing on Intro 134.
Darren Mack, co-director of Freedom Agenda and a Rikers survivor, says many members struggle to get mental health services and face crisis before jail. He cites rising serious mental illness and recidivism, and asks for budget investments in low-barrier housing, dual diagnosis treatment, competency restoration, and community mental health teams.
Victor Herrera, a formerly directly impacted Rikers survivor, says behavioral health emergencies need clinical responses and community-based support. He supports closing Rikers and the Treatment Court Expansion Act and criticizes CHS and DOC approaches to mental health crises.
Zachary Katznelson of the Independent Rikers Commission says DOC's response to deadlocking appears to have been only telling staff to stop, with no new training or inspections. He also criticizes fragmented discharge and housing coordination, saying no agency is overseeing whether people get connected to care.
Dr. Gisele Castro of Exalt says young people affected by the criminal legal system carry untreated trauma and grief. She supports Intros 133, 453, and 809 but says laws do not deliver care, and recommends multi-year flexible contracts for frontline organizations and a formal community role in implementation.
Tarini Garamella of the Osborne Association testifies for the Rikers Visiting Workgroup on Intro 453. She says the bill is well-intentioned but too vague and would inappropriately expand DOC into assessing and referring children for mental health services, urging community-based services instead.
Miriam Goodman of the Women's Prison Association supports the intent of Intro 453 but says care should be provided by trained mental health professionals in trusted community organizations, not by DOC. She argues the system causing harm should not be the system families must trust for healing.
Nadia Chait of CASES says DOC and CHS described a world that does not match her clients' experiences. She recounts a client with a known release date who missed a long-acting injectable and faced Medicaid and pharmacy failures, causing a 24-hour delay. CASES opposes Intro 453 as written.
Jeannette Bocanegra of Justice for Families says Intro 453 is misguided and should be rewritten. She says children visiting incarcerated loved ones are not in DOC custody and should not face additional screening or risk of ACS involvement; she urges community-based support instead.
Jennifer Parish of the Urban Justice Center Mental Health Project says the city remains out of compliance with longstanding court-ordered discharge planning requirements. She says monitors found quality discharge planning in only slightly over half of cases and connects this to community service gaps.
Marco Barrios of the Urban Justice Center Mental Health Project and Treatment Not Jail Coalition says a punitive setting cannot be therapeutic. He describes limited treatment modalities at Rikers and says psychiatric medication management often ignores patients' needs and histories.
Mateo Guerrero of Make the Road New York says trans and queer immigrants are consistently criminalized, citing Operation Restore Roosevelt. He supports Intros 133 and 134, saying gender-aligned housing is necessary to prevent harassment, violence, and fear of seeking basic services.
Maxima Rodas of Make the Road New York's Trans Immigrant Project says avoiding incarceration is ideal but trans and gender-diverse people face heightened vulnerability. Rodas says housing decisions should consider gender identity and safety, and urges passage of Intros 133 and 134.
Chaplain Dr. Victoria Phillips supports Council Member Cabán's bill with amendments and says strong communities make police obsolete. She opposes DOC involvement in children's care, suggests amendments to Intro 809, and asks the council to call facility medical directors to testify and to investigate payroll during investigations.
Jenny Stover says people with mental illness in jails suffer trauma, isolation, and lack of care, and that punishment is prioritized over treatment. She supports the Treatment Court Expansion Act and describes the impact of a loved one's incarceration on families.
Danielle Regis of Brooklyn Defender Services says people often encounter police in crisis because appropriate care was inaccessible. She calls for individualized bail decisions and stronger access to low- and no-cost mental health and substance use treatment, saying jails are not therapeutic environments.
Chris Payton of Exodus Transitional Community says children of incarcerated parents experience grief, loss, confusion, shame, and trauma. He says referrals to community mental health should be available for children visiting incarcerated parents and cites CDC research on adverse childhood experiences.
Sharon Content, founder of Children of Promise NYC, says when a parent is incarcerated, the child serves a sentence too. She supports Intro 453 and urges that mental health support begin before a visit and continue after, addressing children's fear and confusion about correctional settings.
Mar Henriquez of the Legal Aid Society LGBTQ Law and Policy Unit says DOC's testimony ignored the harms trans people face. Henriquez cites high rates of abuse, homelessness, and foster care among LGBTQ people and urges passage of Intros 133 and 134 to protect trans and gender nonconforming people in custody.
Chair Brooks-Powers says written testimony may be submitted to the record up to 72 hours after the hearing. She thanks everyone who participated and adjourns the hearing.