The Challenge

The rate of mental illness and other behavioral health needs among the daily population at Rikers Island has significantly increased in recent years, from 29% in 2010 to 42% in 2016.1 [1] If this increase continues, within a few years roughly half of those detained at Rikers will have mental illness. Already, 11 of every 100 people at Rikers have serious mental illness.2 [2] Because many jails and prisons are poorly equipped to provide quality behavioral health treatment, inmates with mental illness rarely make progress toward recovery and rehabilitation while incarcerated. On the contrary, studies indicate that many people with behavioral health needs experience a decline in their overall wellness while incarcerated, including due to the various forms of emotional and physical abuse commonly sustained by people with mental illness in correctional facilities including Rikers Island.3 [3]

Following release from jail or prison, people with behavioral health needs often struggle to successfully manage the transition back to life in the community. Treatment providers based in the community are often reluctant to serve these individuals either due to a lack of expertise or the dual stigma of criminal histories and behavioral health needs. As a result, justice-involved people with mental illness are particularly vulnerable to a revolving door of arrest, incarceration, release, re-arrest, incarceration, etc.

4 [4]

CASES adult behavioral health services include court-based alternatives to detention and to incarceration along with community programs that include intensive mobile treatment services. All of these programs incorporate the evidence-based principles of

  • Risk-need-responsivity: tailoring service intensity to an individual’s unique risks and needs as documented in validated screening and assessment
  • Motivational interviewing: helping participants to overcome ambivalence and/or resistance to change and promoting their commitment to engaging in support and treatment services
  • Trauma-informed care: delivering services within a framework that recognizes and addresses the likelihood that clients have experienced and/or are currently experiencing trauma

As detailed in the links below, CASES’ specific adult behavioral health services include:

Court-based Programs

  • Short-term alternatives to incarceration for individuals with behavioral health treatment needs and histories of chronic low-level criminal involvement
  • Gender-responsive services for women with behavioral health needs including significant histories of trauma
  • Supervised release as an alternative to monetary bail and pre-trial detention for low-risk people awaiting trail

Community Programs

  • State-licensed assertive community treatment (ACT), including an alternative to incarceration for adults with serious mental illness facing incarceration as the result of felony charges
  • Reentry services for adults with serious mental illness returning from Rikers Island
  • Intensive mobile treatment for adults with untreated serious mental illness identified by City agencies as posing a significant risk for violence

All of the above programs include psychiatric and nursing services as needed and provide seamless referrals to CASES’ Nathaniel Clinic [5], our State-licensed outpatient mental health clinic.

CASES launched its first adult behavioral health program in 2000. This program, the Nathaniel Project, provided New York City’s first alternative to incarceration for adults with serious mental illness facing prison as the result of felony charges. At the time, it was uncertain that a program could safely supervise this population in the community while helping them to engage in treatment and avoid recidivism. As documented at right, the Nathaniel Project won national recognition for its ability to achieve these goals and was subsequently converted into the first of CASES’ three State-licensed, Medicaid-reimbursable mental health treatment programs.

Over the past 15 years, we have built on the Nathaniel Project [6] approach, providing effective alternatives to incarceration for adults with a variety of behavioral health needs and a variety of criminal justice involvement. Based on the success of these programs in reducing recidivism and promoting positive life improvements among clients, CASES in recent years has begun providing reentry and intensive community treatment programs for high-risk adults with serious mental illness.

For specific program information including outcomes, please see links below.

The Challenge

Before 2020, the vast majority of people held in NYC Department of Correction facilities had not been found guilty of a crime. Many were there because they could not afford bail, spending an average of 72 days in jail when someone facing the same charges and with the resources to pay bail would have walked free while awaiting trial. Pretrial detention threatens community safety, as it may contribute to a person’s likelihood to recidivate in the future by causing them to lose their employment, housing, and/or ties to support systems in the community. It also creates challenges for their families and loved ones.

Consistent with systemic racial disparities in the criminal legal system, bail disproportionately affects people from communities of color: more than three-quarters of the Rikers population identifies as Black or Latinx, communities whose median family income is significantly less than that of their white counterparts. This racially and economically biased approach to pretrial detention means that bail amounts as low as a few hundred dollars could be the difference between a person being able to stay in their communities, homes, and jobs or sitting in jail for several months while awaiting their day in court.

In January 2020, in a moment of groundbreaking reform, the New York State legislature passed the Bail Elimination Act. The act eliminated cash bail and pretrial detention for all but the most serious crimes, meaning significantly fewer people held on Rikers Island, a critical step to advancing the City’s plan to close that facility by 2026. A key component of this reform is Pretrial Services, which provides support to individuals awaiting trial in the community to ensure they comply with all conditions of their release. This includes reminders about all required court appointments, regular check-ins in person or over the phone, and access to tailored services to address needs and goals.

Our Approach

Since 2016, CASES has provided Pretrial Services (formerly Supervised Release) in the Manhattan Criminal Court, using evidence-informed practices to address clients’ needs while they remain in the community. This means people who may otherwise have been jailed now can maintain employment, stay connected with their families, and, as needed, access support and treatment services while they await trial. This year, an estimated 4,500 people who may have been previously unable to afford bail will receive CASES Pretrial Services as an alternative to jail detention—up from 1,200 in 2019. More than 91% of all CASES Pretrial Services clients from 2016-2019 attended all court appearances, and more than 90% had no new felony arrest while in the program.

CASES Pretrial Services serves people facing eligible charges age 16 and older standing trial in New York County (Manhattan), regardless of where they live. CASES Pretrial Services team assesses participants for needs and helps them connect with targeted services in the community, including mental health, substance use treatment, employment, and/or housing services. Most Pretrial Services participants identify as Black, Latinx, or multiracial. Almost a third are currently experiencing homelessness or are unstably housed. Services include:

  • Screening and assessment
  • Court-date reminders
  • Face-to-face meetings at clients’ homes and/or in community settings including shelters
  • Group-based cognitive behavioral services
  • Access to CASES’ mental health, primary care, care coordination, education, and employment services
  • Referrals to other community providers to address individual participants’ specific needs and goals
  • Mobile services delivered directly in the community