New York City just announced a bold but smart step forward: it will allocate $130 million over the next four years to a public health approach to criminal justice. The goal, according to The New York Times, is “to break the revolving door of arrest, incarceration and release that has trapped many troubled individuals in the system for relatively minor, quality-of-life offenses.”
Recognizing that almost 40% of those in New York City’s jails are mentally ill, and that people were cycling in and out of jail repeatedly as a result of substance abuse and mental health problems, the City will implement public health programs throughout the criminal justice system, from “tripling the size of . . . pretrial diversion programs” to increasing “the amount of resources devoted to easing the transition from jail back into society.”
“I think this is what criminal justice looks like in the 21st century,” said Elizabeth Glazer, Mayor Bill DeBlasio’s criminal justice coordinator, who was co-chair of a task force that developed the new policy.
We couldn’t agree more. New York’s shift reflects findings and recommendations of two recent HIAs we conducted – one on treatment alternatives to incarceration in Wisconsin and one on Proposition 47 in California, which reduced the penalties for drug possession and petty theft crimes. Both studies found that so-called tough-on-crime strategies have not succeeded in increasing public safety but have led to recidivism rates around the country greater than 50%. People in prison or jail are six times more likely to have a mental health disorder and 20 times more likely to have a substance abuse problem. Most importantly, we found that programs to address mental health and substance abuse issues reduce recidivism and are cost-effective.
The Vera Institute of Justice recently released an expansive report – On Life Support: Public Health in the Age of Mass Incarceration – that backs up the City’s approach by describing the myriad intersections between the justice system and public health. David Cloud, author of the report, writes:
Mass incarceration is one of a series of interrelated factors that has stretched the social and economic fabric of communities, contributing to diminished educational opportunities, fractured family structures, stagnated economic mo¬bility, limited housing options, restricted access to essential social entitlements, and reduced neighborhood cohesiveness. In turn, these collateral consequences have widened the gap in health outcomes along racial and socioeconomic gra¬dients in significant ways.
These findings parallel our own. The Vera Institute also sees an opportunity in the Affordable Care Act to address these issues. The report is part of a new initiative called Justice Reform for Healthy Communities, which fundamentally recognizes that “mass incarceration is one of the major public health challenges facing the United States.”
An amazing New York Times editorial on the day before Thanksgiving, Mass Imprisonment and Public Health, also reflects this public health approach. Citing the Vera report, the editors point out the obvious: people in prison are not healthy. People in prison also often come from impoverished communities that have serious health issues and less access to health care. The Times said: “The experience of being locked up — which often involves dangerous overcrowding and inconsistent or inadequate health care — exacerbates these problems, or creates new ones.” Solitary confinement and other prison “management” practices do additional harm. As the Times noted, this also affects future generations, with 2.7 million children nationwide having a parent in prison. The editors conclude:
If this epidemic is going to be stopped . . . public health and criminal justice systems must communicate effectively with one another. . . . Public health professionals should seize a unique opportunity to help guide criminal justice reform while they have the chance.
Again, we couldn’t agree more. It’s time for public health leaders across the nation to step up and seize this moment. Human Impact Partners is happy to support those in public health that want to move in this direction. This new direction only further affirms what we are focused on: Transforming the policies and places people need to live healthy lives by increasing the consideration of health and equity in decision-making.