Why Workers Fear Moving 50 Criminally Insane Patients

https://www.nytimes.com/2019/12/13/nyregion/Kirby-Forensic-Psychiatric-Center.html

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Kirby Forensic Psychiatric Center in New York City has long been a place of mystery, with little known about what goes on behind the razor-wire fences.

As a result, the state-run facility for the dangerously mentally ill — located on Wards Island in Manhattan — has gone all but unnoticed for decades, despite having held some of the city’s most notorious criminals, including serial killers and cannibals like Daniel Rakowitz, the so-called Butcher of Tompkins Square Park.

But recently, employees have been speaking up, painting a picture of what goes on in Kirby’s wards. State officials are planning to close Kirby and move its entire population — a decision that has created something close to panic among some of the staff, who say the new quarters are not safe for patients or employees.

Kirby is a maximum-security facility that holds mentally-ill patients who have been charged with a crime. Some have been granted an insanity plea by a judge; others are pretrial detainees accused of felony crimes but found unfit to proceed to trial.

The move will transfer the facility’s more than 200 prisoners, including 50 deemed criminally insane, from a fortresslike building with bars on the windows and cement walls and ceilings into a unit of Manhattan Psychiatric Center, a civilian hospital close by on Wards Island.

Officials say the move, planned for January, is necessary because Kirby’s building has grown outdated. They say patients will be placed in a refurbished section of the hospital, securely separated from civilian patients. But staff members are arguing that the hospital was never designed to handle a population with a criminal background, and say it presents all manner of risks.

“These are not normal mental patients,” said Catherine Mortiere, a forensic psychologist at Kirby. “They are some of the most violent inmates in the state.”

The state Office of Mental Health called Kirby’s building “antiquated.” It said it is also for the same reason rebuilding Mid-Hudson Forensic Psychiatric Center, which is north of New York, near Middletown.

“The safety and security of our staff and the people we serve are O.M.H.’s top priority,” a spokesman said in a statement. “When our facilities become outdated, we work to refurbish, rebuild and update them in order to utilize the best practices and state-of-the-art safety features to ensure the well-being of our patients and staff.”

The prospect of the move has caused upheaval at Kirby. The union representing its clinicians is filing a lawsuit in hopes of securing a temporary injunction from a judge; guards and former guards have created an online petition calling on the state’s mental health commissioner and Gov. Andrew M. Cuomo to “do the right thing and halt this move” to ensure their safety.

Stephen Harkavy, the deputy director of Mental Hygiene Legal Service, which represents the patients, said the new area will be inspected before patients are moved. “A lot of these concerns are premature, until that happens,” he said. “If they find changes need to be made, I would assume they will implement them.”

Mr. Harkavy, who said he worked at Kirby for about a decade, added: “I believe the fears about patients are overstated. I never felt unsafe.”

But several employees — who insisted that their names not be used because they said they feared reprisals — described Kirby as a singularly dangerous place to work, in the best of circumstances.

One doctor said it was not unusual for employees to be assaulted. The doctor, who said he had been assaulted twice, described “physician colleagues punched unconscious,” “staff having to fight off coordinated attacks,” “brawls,” and guards attacked with feces and, in one case, a porcelain shard from a shattered toilet.

Most patients come from city jails like the Rikers Island complex, but at Kirby, the doctor said, they can move freely. The doctor said the move will place staff and patients at greater danger because patients will be confined to smaller spaces. “The analogy is they’re packing sardines in a tin.”

Whether the move takes place or is halted, Kirby’s crisis shines a light into a dark corner of the criminal justice system and raises the question of the fate of the seriously mentally ill in New York’s custody.

In recent times, this conversation has tended to focus on Rikers Island. And with good reason. As Alisa Roth chronicles in her book “Insane: America’s Criminal Treatment of Mental Illness,” Rikers and huge jails like it have become the country’s de facto psychiatric hospitals. As officials prepare to close Rikers in 2026, advocates are asking: Where are the seriously mentally ill patients that fill many Rikers jail cells going to go?

This is a good moment to look also at how the mentally ill are shuffled among city jails like Rikers and state-run forensic facilities such as Kirby.

Kirby is generally mentioned in connection with the lurid crimes of its “criminally insane” patients. But its other patients, those who have been found “incompetent to stand trial,” make up the bulk of the population these days, according to staff.

These patients stay at Kirby — or its sister facility, Mid-Hudson — until they can be “restored to competency” and then stand trial. They watch videos and attend counseling sessions to understand the nature of the charges they are facing; some receive medication under court order. But they can remain there for months or even years before they are able to pass the required test and appear in court. In some cases, they go back to jail but mentally decline before their trial date, landing back at Kirby for another stint.

The dust-up over the planned move is a call to examine this piece of a broken system. The mentally-ill inmates who often travel between city jails and state-run forensic centers are subjected to a process that is plagued by delays and dysfunction. The patients may also face the threat of violence at Kirby, just as the staff does.

This threat could grow worse if the move takes place, Kirby employees said. In addition to the disruption of the move itself, employees warn the new unit has unaddressed structural issues: nooks where patients can hide, and low ceilings with metal frames that can be torn out and weaponized.

While they acknowledged that only a small percentage of patients presented a serious threat, several employees expressed concern about the new unit’s bedrooms. At Kirby, most patients sleep in large areas, with beds separated by partitions, where they can be easily monitored. In their new quarters, most will be in pairs in small hospital-style rooms, with no windows on the doors. This could endanger patients’ lives, I was told.

“You need a third as a witness,” said the doctor. “Not two. One could smother the other.” (This is not far-fetched: at Mid-Hudson, a patient has murdered his roommate more than once.)

Another doctor at Kirby told me: “Everyone is here for a reason, usually a serious felony — rape, murder; you don’t have people here for stealing a car. I would not call them docile. But we need to protect the people who are simply taking their medication and trying to get through.” The doctor added, “We have to protect the more manageable patients.”

Mr. Harkavy, of Mental Hygiene Legal Service, said he believed the new unit would be equipped with more cameras.

Employees who oppose the move say Kirby’s building is solid and only needs repairs. They see the move as part of a broader effort to consolidate inpatient facilities across the state to lower spending. “We are a big money sucker,” said Dr. Mortiere, the psychologist, who is providing an affidavit in her union’s lawsuit. “But this is not the place to cut costs.”

Mr. Cuomo’s office declined to comment on the move. Benjamin Kallos, a city councilman from Manhattan, said he asked the governor to address the issue after learning about it from a Kirby employee. Mr. Kallos said he got involved because he believes the responsibility for the mentally ill at Kirby — and beyond — ultimately falls to elected officials.

“These people are not violent for violence’s sake; they are mentally ill. If we put them in a situation in which we are told they could harm someone, and then they harm someone,” he said, “that’s on us.”