There is no need to build the Phase III jail in New Orleans, primarily to house detainees that suffer mental disabilities. The efforts of reformers in city government and the criminal justice system, judges and attorneys for plaintiffs in the jail consent decree lawsuit, and sustained action by numerous community groups, have helped reduce the population detained at Orleans Justice Center (OJC) to around 850, in a facility authorized to hold 1,438. This is real progress.
Reduction in the average daily count at the jail, from 1,552 in 2017 to current levels, is an ongoing trend that has created a fundamental change in conditions that makes the proposed expansion unnecessary. Such laudable progress in the fight against mass incarceration demands the abandonment of plans to spend over $50 million to build a new wing and spend close to $9 million per year in operating costs, and embrace instead the city’s plan to retrofit the second floor of OJC (estimated one-time cost, $9 to $10 million) to house and treat detainees with special mental health needs. From a public health perspective, the cheaper alternative here also happens to be the better one.
The planned retrofit of OJC promises to create space to improve care for special needs detainees beyond the care provided at the jail. The recent compliance report filed by jail monitors on July 27 notes improvements in mental health care provided at the jail under a contract between the Orleans Parish Sheriff’s Office (OPSO) and Tulane Medical School. The City’s retrofit plan also meets requirements for structural change at the jail required by the plaintiffs’ attorneys and U.S. District Court Judge Lance Africk, who oversees the consent decree lawsuit. More space will be made available at the jail for individual and group mental health therapy sessions, more suicide resistant cells will be built, and the mezzanine levels at the jail will be modified to prevent attempts at self-harm. These important measures further reduce the need for a new jail facility and free up money in a tight city budget for mental health crisis intervention and treatment, and other public safety investments outside the criminal justice system.
The growing presence in jails and prisons of those with mental disabilities was caused by the growth of the criminal legal system and the closing of publicly funded mental hospitals and community mental health centers. In addition, Gov. Bobby Jindal cut spending on public mental health services and presided over the closure of Charity Hospital and its 128 mental health beds and crisis intervention center, and closure of the 176 bed Southeast Louisiana State Hospital in Mandeville. Per-capita spending on mental health services in the state has risen slowly in recent years but still amounted to only a paltry $56.53 in fiscal year 2019 (less than half the national average). As a result, more people with mental disabilities end up on the streets or in jail. The National Alliance on Mental Illness (NAMI) reports that people in mental health crisis today are more likely to encounter police than get medical treatment, as two million people with mental illness are booked into jails each year. Estimates from the Department of Justice and Centers for Disease Control are that 17 to 25 percent of men and nearly 40 percent of women held in jails and prisons suffer mental disabilities.
Jail is a violent, stressful, and traumatic place, especially for those who suffer mental disabilities. Those with mental disabilities are a vulnerable population that suffers high levels of abuse and bullying in jail that often worsens existing mental health conditions. They stay longer, suffer more often in isolation, and have higher suicide rates than other detainees. Isolation of schizophrenic detainees held in jail is associated with frequent bouts of despair and disruptive outbursts. When released, too many end up homeless, unemployed and without the treatment supplied in jail. The so-called “yo-yo” effect occurs when mentally disabled individuals are released from jail into a community that lacks adequate housing and publicly funded mental health facilities. They soon end up on the street, or find themselves in the emergency room, or back in jail for minor offenses. This cycle is a burden on the individual, but it also overwhelms law enforcement, corrections, health care providers, local budgets and family structures. NAMI estimates that, on average, it costs $31,000 per year to house an inmate with mental illness in jail, while community mental health services can be delivered for about $10,000 per year. It is best for those individuals, and for public health in our community, to shrink and close jails and prisons, to eliminate imprisonment as a primary approach to problems like mental illness. The current approach makes us both sicker and less secure.
Most detainees with special needs held in OJC are from a disadvantaged socioeconomic background. They are poor, non-violent, Black, and do not belong in jail. People with special needs, arrested for serious violent offenses, who must be incarcerated will receive constitutionally adequate care on the retrofitted second tier at OJC. By scuttling plans for a new jail, the City has an opportunity to save millions of dollars, while also diverting most of those that suffer mental disabilities away from the criminal justice system and into community-based facilities that provide acute and long-term care. It is a win-win for everyone involved.
NAMI has initiated a national campaign, “Stepping Up Initiative”, that challenges counties to reduce the number of people with mental illness in jail. They also advocate expansion of crisis intervention teams composed of mental health and substance abuse professionals supported by trained police officers to intervene when a person suffers an acute mental crisis. These folks are diverted from jail into sobering houses or crisis stabilization centers for acute treatment before some are moved into either longer term treatment facilities or return to the community. These solutions are well established and have proven successful in cities such as San Antonio, Phoenix, Miami, Los Angeles, Philadelphia, and many others.
There is overwhelming opposition to Phase III and widespread support for the retrofit option at OJC. The Mayor and City Council recently expressed a clear preference to avoid construction of yet another jail complex and they deserve our support in that effort. Adding a new jail is a step backwards, because it advances an unfair and expensive system that does not make us safer or healthier. We must continue to be leaders in the movement to reduce jail population and follow the lead of other cities that have wisely diverted money from jail expansion into alternative community care. Rather than build an unnecessary jail that will require new taxes to operate and adversely impact the safety and wellbeing of New Orleanians, let’s invest instead in jobs, housing, and community-based mental health services.
A court hearing on the city of New Orleans’ request to suspend work on the Phase III jail building is scheduled to begin on Oct. 6 at 9 a.m.
This column is supported by the following public health professionals:
- Chloe Thomas, MD
- Natasha Lee, MD
- Veronique Robins-Brown, MD
- Emily Tixier, MD
- Jemimah Chen, MD
- Evan Reuter, MD
- Jordan Vaughn, MD
- Ian Gold, MD
- Theresia K. Sutherlin, MD
- Isis Smith, MD
- Larick David, MD
- Michael Caffery, MD
- Jonah Kreniske, MD
- Deborah Levy, MD, MSPH
- Catherine Jones, MD, Assistant Professor of Medicine
- Erica Tate, MD
- Anjali Niyogi, MD, Faculty Physician
- Anna Sutherland, MD
- Virginia Byron, MD
- James Deutsch, MD, PhD
- Silai Mirzoy, MD
- Gita Chadalawada, MD
- Julianna D. Padgett, Ph.D., LCSW
- Cliff Doescher, MSW, Former Executive Director, ARC of New Orleans
- Kalila Pellerin, LCSW
- Ellen Levitov, LPC, LMFT
- Joanna Dubinsky, Physician Assistant
- Michelle Timberlake, Disability Advocate – AbleD Artists Foundation and Advocacy Center
- Laura A. Jensen, M.A.
- Hannah Miller, RN
- Amanda Robertson, RN, BSN
- Nadia Eskildsen, Harm Reductionist
- Mary Kate, Case Manager
- Ashwin Shetty, Anesthesia technician
Myrline Rose Belzince, MD, is currently in her fourth year of post graduate residency at Tulane Triple Board Program (Pediatrics/Adult Psychiatry/Child and Adolescent Psychiatry). Dr. Belzince is the former President of Rose Campaign for Girls, a non profit organization that supported girls education in Haiti. She is first and foremost a mother to her handsome and brilliant son MJ.
The Opinion section is a community forum. Views expressed are not necessarily those of The Lens or its staff. To propose an idea for a column, contact Opinion Editor Amy Stelly at firstname.lastname@example.org. (Note: Martin Pedersen, chair of The Lens’ Board of Directors, served as editor for this column.)