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Looking for mental health care at Rikers

The rhythm of Erick Tavira’s life was never quite so simple.

“He would ask me, ‘Mommy, what did you think about that song?’ I would say, ‘It was beautiful,’” Haydeth Tavira, Erick Tavira’s mother, said through an interpreter. Her face was damp with tears.

His family, explained sitting in his aunt’s apartment in the Bronx, that music was one of the remaining bright spots in his life.

“He loved to sing,” his mother said through an interpreter. “From a young age, he loved it and played instruments like the guitar. That caught his attention.”

The music abruptly stopped in October.

That’s when Tavira, who was 28 years old, died on Rikers Island. His death has been ruled a suicide.

It’s one of six suicides that occurred in city custody in 2022.


What You Need To Know

  • About 16% of people on Rikers Island have a serious mental illness
  • Because of staff shortages and a lack of capacity, sources say the jails mental health care system is stressed
  • Self-harm incidents have doubled since the pandemic began. In 2022, there were six deaths ruled suicides by the medical examiner’s office

Tavira is among the estimated 16% of people on Rikers Island suffering from a severe mental illness — a steady population that has turned portions of the city’s jails into dedicated mental health wings.

It was in one of those housing units where Tavira killed himself.

For months, NY1 has examined the care those on Rikers, like Tavira, have been getting. Our investigation found a once-praised mental health care system is now stressed by staff shortages and a lack of space. Self-harm is skyrocketing, and suicides are on the rise — part of a national trend taking root right here on Rikers.

In part driven by the pandemic, detainees like Tavira with a mental health diagnosis are staying much longer in city jail, only exacerbating the isolation awaiting trial. As of fall 2022, an average detainee on Rikers Island will spend 110 days in custody. But for those with a mental health diagnosis, that number practically doubles to 208 days on Rikers.

Erick Tavira was on Rikers for 494 days.

“What they did to him is not fair,” his mother told NY1 through an interpreter. “Not just to him. I feel indignant, angry, frustrated. And I ask God to not allow for any more hatred to enter my heart because it is not good for me. But what I ask for is justice.”

As Erick Tavira struggled with mental illness, music was one of the remaining bright spots in his life.  In June 2021, Tavira was arrested and sent to Rikers.  In October 2022, after 494 days at the jail, he killed himself, according to the city's Office of the Chief Medical Examiner.  (Photo courtesy of the Tavira family)

As Erick Tavira struggled with mental illness, music was one of the remaining bright spots in his life. In June 2021, Tavira was arrested and sent to Rikers. In October 2022, after 494 days at the jail, he killed himself, according to the city’s Office of the Chief Medical Examiner. (Photo courtesy of the Tavira family)

Tavira was diagnosed with schizophrenia with paranoid delusions as a teen. He ended up on the streets and in homeless shelters. While his family was close, when he was off his medication, his paranoia could make him aggressive. It could put a gulf between them.

“Sometimes when he didn’t take his meds, yes, his mood would change,” his mother said through an interpreter. “He thought he was being followed. On the train when we were together, he thought that someone was staring at his sister, and I felt a fear that something would happen to him, or something would happen to us because he would want to defend us.”

His family says he would go to the hospital for treatment.

That’s what he did in June 2021. Tavira went to Metropolitan Hospital for help.

Surveillance video obtained by NY1 shows Tavira in the emergency room in the midst of a psychotic break. He takes off his shirt.

He then gets into a fight with one of the hospital’s security officers.

He was arrested without getting treatment and was released.

But the following week, Tavira, still unmedicated, was in Upper Manhattan and he allegedly attacked a 14-year-old from behind, hitting and trying to strangle the teen. He then allegedly fought with another person who was trying to intervene.

Tavira was arrested again, and he was sent to Rikers on strangulation and assault charges. Lease was set at $20,000.

“My brother would call constantly,” says Amariliz Torres, Tavira’s sister. “Two, three times a day. We knew when he wasn’t OK. All we could do was talk to him, try to calm him down.”

A month before he died, Tavira was transferred to a mental health unit that sources tell us had about 40 detainees in it, far more than some clinicians would recommend.

In exclusive body camera video obtained by NY1 through the Freedom of Information Law, Tavira is seen protesting the move. Officers are huddled around him explaining “mental health” wants him to go. When they get him up to move him, Tavira resists. He is then sprayed with a chemical agent.

A month later, he was found in his new cell with a sheet around his neck.

In response to this video, the commissioner of the city’s Department of Correction, Louis Molina, sent NY1 a statement:

“Our deepest condolences go out to the Tavira family and we understand that this video might be difficult for them to watch as they are grieving their loss. Transferring people in custody from one facility to another is a standard occurrence, and using an approved chemical agent is a standard correctional practice if a detainee resists. The officers involved in this video were justified in their actions. However, it is unfortunate that this video was provided by the NYC Board of Correction without regard for this important context, or the feelings of the Tavira family.”

According to a preliminary investigation by the Board of Correction, which has oversight of the Department of Correction, there was only one clinician serving the unit when Tavira died and there were no “steady officers,” who are typically assigned to mental health units to provide consistency for the staff and details.

The report found Tavira had spent “three consecutive days in his cell and did not step out to eat or shower.”

At the time of Tavira’s death, there were no suicide prevention aides working and the officer on duty did not conduct 15-minute rounds in their place.

A Department of Correction spokesperson said it’s their policy to have suicide prevention aides in these units 24/7. That spokesperson said Tavira’s death is still under investigation.

On Rikers Island, correction leaders and officials from Rikers’ health care provider contend they have a system of care that works. They just need more of it.

“I’ve been on this job 27 years. The numbers of mental health have grown exceedingly, like by 10,” said Antoinette Cort, the acting warden of George R. Vierno Center, one of the jails on Rikers Island. “Because when I first came on, we didn’t have so many mental health units, and now we have the need for more than the ones that we have.”

The acting warden is referring to what’s known as a PACE unit—the highest level of care detainees with serious mental illness can get on Rikers Island. Unlike lower-level mental health units, these units have clinical staff, therapists and social workers, embedded on site. They were widely praised when they were opened in 2016.

There are now 10 of them across Rikers.

Former Mayor Bill de Blasio committed to expand that to 12 in 2016, but staff shortages put that on pause.

“There is a long wait list,” Cort said. “These guys in 17a, they are mental health patients, but they are fit for PACE. So as soon as the beds become available, they’ll evaluate them as quick as they can, and we’ll just move them when she tells us to, to get them to the care they actually need.”

Some families, like Tavira’s, are questioning whether they are getting that care.

Data from Correctional Health Services show over the course of the pandemic, the number of mental health appointments that were completed in a given month has slowly decreased. In September 2022, just 53% were done.

Chart of the percentage of mental health appointments completed according to the city's Department of Correction.

(NY1 graphic)

Health officials say there are multiple reasons why appointments are canceled, including correction officials failing to produce detainees and detainees refusing to go. Still, they acknowledge they have staff shortages.

“I think this is a really hard time for any health care system to really staff adequately,” said Lauren Stossel, chief of service for mental health at Correctional Health Services, which runs health care on Rikers. “There’s just been huge challenges in retention and hiring since COVID, when a lot of psychiatrists and psychologists have had the opportunity to work remotely. It’s not an easy time to be working in the jails.”

The numbers agree.

As the pandemic rolled on, so did the amount of self-harm in city jails. Pre-pandemic, there were fewer than 100 incidents per month. Now, that number has doubled. The majority of those incidents are happening in specialized mental health units.

Incidents of self harm bar chart in the NYC correctional system.

(NY1 graphic)

Even so, health officials argue the care detainees get on Rikers is more robust than they get in the community.

“Our patients are actually getting an enormous amount of mental health treatment in these units, comparable to what you might get in an inpatient unit, or an intensive day-treatment program or a partial hospitalization — so really a level of care that is much, much higher than what patients might get in the community if they were just seeing an outpatient provider,” Stossel said.

John Gallagher was a deputy warden in command at the Department of Correction and was one of the officials that helped start mental health units on Rikers. He retired in June 2021.

“A lot of things fell apart,” he tells us.

Gallagher said before he left, the department was no longer focused on detainees with mental illness. It was scrambling to comply with the federal monitor, as well as the movement to close Rikers and getting rid of solitary confinement.

Those with mental illness took a backseat.

“The mentally ill population are the stepchildren of the department and that always bothered me,” Gallagher said. “There wasn’t enough focus. Everyone will complain that people shouldn’t be in jail, but I see very few people want to do anything about it.”

Training, he said, fell off during the pandemic.

“You talk about suicide prevention, nobody really paid attention to that anymore,” Gallagher said. “Trainings weren’t being done, inappropriate staff. One of the big problems I had, and the chief tried to correct it, is we would train staff, but then they were never put on the unit.”

Prior to that, he said, the mental health units were getting acclaim nationally.

“It’s like Jenga. You pull out that one block and so many things are going to fall apart,” he said. “I can tell that for a fact, a lot of the really good clinical staff that I worked with over the years left, and part of that was frustration.”

That frustration is now with families like the Taviras, who just have pictures and letters to go through.

“’By that time, I’ll be here eight months and that’s a year in Rikers Island,’” Tavira’s sister said, reading one of her brother’s letters from behind bars. He was sitting about 10 months before he died.

“’I love you all more than you can imagine. I hope to see you soon.’”

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