Gregory Seifert’s story represents everything wrong with New York’s mental-health system.
Police arrested him in 2012 for cutting down three wooden power poles with a chainsaw, terminating power to 6,800 homes in suburban Buffalo in the dead of winter.
When the police questioned him, Seifert denied everything. “I know this sounds weird,” he said, “but my cloned twin did it.”
Seifert suffers from paranoid schizophrenia. His stay in the Buffalo jail was a difficult experience for him and everyone else there.
I observed him quietly hallucinating in his cell, probably communicating with his superiors at the CIA, where he claimed to work.
Because of his illness, he broke jail rules, trashed his cell and set fire to pillow stuffing that he had jammed into an air vent, which brought additional felony charges of second-degree arson.
Yet Seifert would not have been in jail at all if his schizophrenia had received appropriate treatment. Tragically, his family’s efforts to get him medical help ran up against New York’s laws, which make the involuntary commitment of adults exceedingly difficult.
Once a leader in public psychiatric services, New York state now shows how not to treat the mentally ill. Over the last several decades, New York has downsized its state mental hospitals, which went from having 96,664 beds in 1955 to just 3,300 today — and the number keeps dropping.
When New York’s mentally ill do manage to get care, it’s often in the psychiatric units of community hospitals, where federal Medicaid and Medicare cover most of the costs, saving the state money — an incentive to further reductions.
Most such hospitals aren’t set up to look after the most difficult patients and tend to discharge them as quickly as they can.
There are many Gregory Seiferts in New York’s jails and prisons. A study done between 2002 and 2006, covering inmates in three New York county jails, reported that 15 percent of the males and 31 percent of the females suffered from a serious mental illness.
Since then, most agree, the number of mentally ill in jails has only increased. There are approximately 5,800 mentally ill people currently incarcerated in New York City jails, and 8,200 in our state prisons.
These figures represent a big step backward in how we deal with mental illness.
In the 19th century, Americans considered it inhumane to lock up mentally ill individuals in jails and poorhouses, which had long been the common practice.
Social activists such as Dorothea Dix succeeded in building the first state psychiatric hospitals and in getting mentally ill prisoners transferred en masse to the new institutions.
That the mentally ill deserved treatment, not jail, continued to be the prevailing view for
most of the next century. Then, during the ’60s, effective medications for treating mental illness became available, and the deinstitutionalization of mental patients got under way.
In 1970, the New York Civil Liberties Union, under human-rights activist Aryeh Neier, won a series of lawsuits making involuntary hospitalizations virtually impossible.
The tragedy that ensued was captured by infamous cases like that of “Billie Boggs” (real name: Joyce Brown), a mentally ill homeless woman living on East 65th Street.
Despite Brown’s defecating on the sidewalk and on herself, tearing up money given to her by passersby, running unpredictably into traffic and wearing little clothing even in cold weather, the NYCLU successfully blocked multiple attempts by the city to have her psychiatrically hospitalized.
Since individuals like Brown could no longer be forced to receive care as a condition of remaining free, many wound up getting charged with misdemeanor crimes and sent to jail.
Even Neier would acknowledge the ruinous consequences. In his 2003 memoir, “Taking Liberties,” he wrote: “Unhappily, I concede that deinstitutionalization of the mentally ill was a civil liberties success but, for many of those released and for their urban neighbors, a social policy failure.”
Putting people like Gregory Seifert in jails causes many problems. In the Rikers Island jail, the average inmate stay is 42 days, but for those with a serious mental illness, it is 215 days.
The mentally ill are less likely to make bail and more likely to break jail rules. They also usually cost more to incarcerate than other prisoners, especially if one includes the price of medications.
For New York to show such leadership on this issue again, the state will need to roughly triple the number of public psychiatric beds, from 3,300 to 9,750. New York also needs an inpatient commitment law that allows for the forced hospitalization of seriously mentally ill individuals — before they end up in jail or prison.
New York already has a great tool for mental health leadership — an assisted outpatient treatment law — but officials must be willing to use it. Finally, the state must devise an effective way to treat the seriously mentally ill who do wind up in jail or prison
Sadly, New York has had no political leaders willing to speak for the mentally ill in recent years. Gov. Cuomo has shown zero interest in this issue — indeed, he has proposed to close six more state psychiatric hospitals, virtually assuring there will be more Gregory Seiferts.
E. Fuller Torrey, MD, is the founder of the Treatment Advocacy Center and the author of several books. Adapted from the fall 2014 issue of City Journal.