Compassion First: A New Approach to Mental Healthcare in Manhattan

Janos Marton
33 min readNov 24, 2020


Foreword: To understand our failed mental healthcare system, meet Luis Reyes, a 35-year-old Manhattan resident who has been in and out of Rikers since the age of 16.¹ A few months prior to his first arrest, Reyes was held at gunpoint, which may have led to post-traumatic stress disorder triggering severe and ongoing panic attacks, nightmares, and self-harm. He self-medicated with cocaine and soon found himself at Rikers charged with second degree burglary, where he then attempted suicide. Last year Reyes was back at Rikers after picking up a new case.

Despite his public defender providing hundreds of pages of documents presenting Reyes’ history of attempted suicides, substance use disorder, and schizophrenia, along with a traumatic brain injury from a car accident, the ADA assigned to his case declined to screen Reyes for being diverted to mental health court. Reyes was released in October, after eleven months of incarceration at Rikers which included repeated admissions to Bellevue for seizures.

How do we allow such outcomes in a supposedly progressive city? What is the point of a mental health diversion program if it cannot help people like Luis Reyes?


I am running for Manhattan District Attorney because I believe we must solve society’s problems without relying on prisons. Today our criminal legal system punishes and criminalizes people with mental health struggles rather than providing them the resources to live healthy and dignified lives. We must break the cycle of incarceration, homelessness, substance use, and unemployment that afflicts so many New Yorkers struggling with mental health.

New York City is blessed with resources to properly support people: massive local budgets, renowned hospitals, universities, thousands of non-profit organizations, and enormous city and state budgets. In the midst of unprecedented need for mental health support during this pandemic and depression, however, we are failing marginalized communities. And our continued reliance on the police to handle situations involving individuals with mental health needs is an approach that only leads to tragedy, as we’ve seen in the deaths of Daniel Prude, Walter Wallace Jr., Kawaski Trawick, Eleanor Bumpers, George Zapantis and so many others.

As Manhattan District Attorney, I will end the criminalization of people with mental health needs when safety and healing can be achieved through better responses. The Manhattan DA’s office generates significant forfeitures through its investigations into illegal conduct by financial companies. Rather than waste these funds on paying for police expansion, I will use virtually all financial resources our office obtains from these forfeitures — at least $50 million per year — to fund community-based mental health programs, investing in both proven models of success and innovative peer-based approaches, moving as many cases involving mental health out of the criminal court system as possible.

This is an issue that’s personal to me. One of my relatives suffers from a severe cognitive disability, and I’ve seen the stress it puts on our family, even in a country that offers far more support than our system. Our approach to mental health challenges simply don’t work, and they don’t keep us safe. It’s time for a new approach.

Campaign Statement of Values
The values of a District Attorney’s office must be in line with the values of the community in order for justice to be served. My values are rooted in freedom, compassion, equity, and opportunity.

There is perhaps no more universal human desire than freedom. Our nation’s history has been defined by enslaved people and immigrants, such as my parents, risking everything in its pursuit.² Every time a person is locked in a cage, stripped of their freedom, we have collectively failed as a society. That is why the deprivation of liberty will always be used as a last resort in our office, especially when we respond to individuals with mental health needs.

Our office will always pursue compassion. Anyone who has felt the cold bars of a prison cell, watched a prison gate close behind them, or spoken to a loved one through plexiglass knows that sentencing a person to prison only creates more harm. Our response to those in need of mental health care must always lead with compassion, focusing on community-based treatment rather than jail. It’s shameful that Rikers Island is the biggest mental health facility in New York.

Our office will always pursue equity. Our entire criminal legal system is rooted in racism, which is why 87% of New York City jail detainees are Black or Latino.³ When we criminalize mental health, we are often punishing marginalized people who are already experiencing systemic oppression.

We believe everyone deserves an opportunity to live a healthy life in our community. Our office will support programs that not only provide treatment, but invest in people struggling with mental health issues, assisting in their pursuit of work, education, and art. By helping New Yorkers get their lives on track, we can build stronger communities and a safer city.

Mental Health in New York City

This is the moment to finally have an honest conversation about mental health. During this COVID-19 pandemic, who among us has not struggled — fueled by the fear of getting ill, watching loved ones pass away, unemployment, evictions, isolation, and general anxiety. There has been a 60% increase in calls to the National Alliance on Mental Illness of NYC since the middle of March and 53% of adults throughout the country report a negative impact on their mental health since the onset of COVID.⁴⁵ Black mental health providers also report an unprecedented rise in calls following the protests after the deaths of George Floyd and Breonna Taylor at the hands of the police.⁶

Under our current system, quality mental healthcare is out of reach for most New Yorkers and often stigmatized in communities where treatment is most needed. Mental illness was already prevalent prior to the pandemic:⁷ Approximately 4% of New Yorkers are affected by a serious mental illness, 5% experience serious psychological distress, and 9% live with depression.⁸⁹¹⁰ Many struggle with substance use disorders in addition, which have also increased during COVID.¹¹ But therapy and other mental health services are incredibly expensive, and often not covered by traditional healthcare, resulting in mental healthcare being an economic luxury.

Individuals who are unemployed, live in neighborhoods with the highest rates of poverty, have low family income, and are uninsured or insured through Medicaid or Medicare reported the highest rates of serious mental illness, serious psychological distress, and depression.¹² Those who experience racism, discrimination, or other forms of harassment were also more likely to report serious psychological distress.

Nowhere is the mental health crisis more pronounced than in our city jails.¹³ Forty-five percent of all detainees had a mental health diagnosis and 17% had a serious mental health diagnosis as of FY19,¹⁴ numbers that have steadily increased.¹⁵¹⁶ The most commonly diagnosed serious mental illnesses in New York City’s jail system are schizophrenia (which impairs daily functioning by a combination of hallucinations, delusions, and/or extremely disordered thinking and requires lifelong treatment),¹⁷ bipolar disorder (extreme mood shifts between emotional highs known as hypomania and extreme lows of major depression that can both lead to the inability to carry out daily tasks),¹⁸ and post-traumatic stress disorders (caused by a terrifying event and can cause debilitating effects on daily life through recurring flashbacks, unexpected triggers, severe anxiety, and the inability to adjust or cope).¹⁹ Antisocial personality disorder (a difficult to treat condition that leads to aggressive, exploitative, manipulative behavior lacking in remorse and typically combined with substance use) is frequently found among incarcerated men, with prison’s antisocial environment making it even harder to treat.²⁰ Although the jail population has since decreased, in November 2019, a little over 1,100 out of approximately 7,000 detainees suffered from a serious mental illness.²¹ It is unacceptable that Rikers Island is New York State’s largest mental health provider.²²

A report last year by the New York City Independent Budget Office shows that over the past decade, the cost of health services within the correctional system has increased by $150 million.²³ Despite the jail population decreasing during the same period, the number of individuals incarcerated who suffer from a mental health issue have increased in 2020.²⁴ There is absolutely no reason the city should be spending hundreds of millions of dollars to lock up people who need treatment, not incarceration, especially when we find ourselves in a desperate fiscal crisis.

Finally, those who suffer from mental illness, particularly people of color, are also disproportionately killed by police. Nearly a thousand Americans have been killed by police this year.²⁵ Nearly one in every four police shootings involves someone who struggles with a mental illness.²⁶ Over the past five years in New York City, 16 of the 18 people who suffered from a mental illness and were killed at the hands of a police officer were people of color.²⁷

Deinstitutionalization and the Decline of Public Mental Health Services

Deinstitutionalization is a federal policy that occurred through the mid 1950–60s and moved hundreds of thousands of patients out of state-run mental health facilities.²⁸ The push was thought to be well-intentioned: many institutions were inhumanely run, overcrowded, or neglectful towards patients.²⁹

But the promised community solutions to replace these hospitals never came. Many patients found themselves homeless and unable to access appropriate medications and/or other treatment programs.³⁰ Federal legislation gradually imposed more mental healthcare costs on states, who in turn encouraged the creation of private adult homes.³¹³² In New York, these facilities often proved worse than the hospitals that had been shuttered in the 60s, with little oversight. A New York Times report found nearly 1,000 patients had died in these homes between 1995 and 2001, often in appalling conditions.³³

Massive cuts to mental health programs have continued in more recent years.³⁴³⁵ Governor Cuomo’s “Transformation Plan” has placed nearly impossible pressure on local jurisdictions to supplement the lack of state-run care.³⁶³⁷ New York City opened six homeless shelters specifically for individuals with serious mental illnesses between FY2014 and 2018 at a cost of approximately $150 million, as the number of those who needed housing increased by nearly 22%. Mental health homeless shelters provide more beds in New York City than state-run psychiatric centers and psychiatric wards of city hospitals combined.³⁸

The de Blasio administration has failed to turn this crisis around. ThriveNYC, Mayor de Blasio and Chirlaine McCray’s signature mental health initiative, which aimed to close gaps in mental healthcare access, has lacked a coherent mission or transparency with respect to both spending and program efficacy. One of the program’s major shortcomings has been its focus on individuals struggling with depression and anxiety, rather than serious mental illnesses — such as schizophrenia and bipolar disorder — which play a larger role in cycles of incarceration.

Our Solutions for Addressing the Mental Health Crisis in New York City:
After consulting with mental health providers, individuals with personal experience of mental health struggles, formerly incarcerated leaders, community advocates, and attorneys, we propose the following:

Proposal #1: Use Virtually All Financial Forfeitures to Fund Community-Based Mental Health Programs

Our campaign has previously laid out a proposal to decrease our city’s jail population by 80%, which includes finding non-jail solutions for people struggling with mental health issues.³⁹ This requires resources.

In the past decade, the Manhattan District Attorney’s office has received hundreds of millions of dollars through financial institution forfeitures stemming from investigations into misconduct and corruption by those institutions.⁴⁰ I will use virtually all financial resources our office obtains from these forfeitures to fund mental health programs.⁴¹ This will be set up as an independent program to expand and create mental health centers throughout neighborhoods in Manhattan, beginning with those who are currently the most underserved and in the greatest need. The program disbursing funds will be staffed by practitioners, directly impacted people, and other people with mental health expertise, and funding decisions will be informed by community input. The DA’s office itself will not make funding decisions.⁴²

We estimate our proposal will lead to an increase of at least $50 million a year in spending on community-based mental health spending from our office and will create services for thousands of Manhattan residents.⁴³ This is a commitment based on our best understanding of what is left in the forfeiture funds, which have been opaque, and would be increased in future years based on the success of our Major Economic Crimes Bureau’s investigations. It’s estimated that Vance has spent a little over $3 million on mental health services in the past.⁴⁴ Our investment of $50 million a year would amount to a 1620% increase in funding for mental health services through the District Attorney’s office. At a time when New York City and New York State are facing years of potential budget cuts, these investments will be essential, and hopefully inspire greater government investment once this recession has passed.

When imagining the change this funding could bring, we have several impressive examples from New York and across the country to draw from. In Hell’s Kitchen where I live, Fountain House is a clubhouse community mental health service model where residents are not referred to as patients, but considered members. By combining housing, mental health support, employment opportunities, education, and a social environment, Fountain House has had tremendous success in not only reducing re-hospitalizations and improving overall wellbeing and social integration, but even more impressive is that recidivism among its residents is less than 5%.⁴⁵⁴⁶ Housing First in Vermont has been credited as being the most influential intervention for contending with the state’s chronic homelessness through their innovative approach in providing long term community-based support programs and locating permanent housing with no questions asked in terms of drug or alcohol use.

We can similarly invest in peer support programs, which are premised on shared lived experiences, with guidance coming from people who have experienced mental health struggles of their own.⁴⁷⁴⁸ Current research shows that peer support is greatly beneficial in increasing overall mental wellbeing, participation in services, and reduction in incarceration rates. A Pennsylvania peer support program reported a 23% recidivism rate, far below the 46% general population rate and the 63% rate typically associated with medium-high risk populations.⁴⁹⁵⁰ Peer support for re-entering individuals has also seen great success.⁵¹ Peer support programs could also operate in the courtroom, or through reentry providers like the Fortune Society and Doe Fund. My office will ensure that considerable funds are appropriated for programs that support peer mentorship prior to a participant’s release and allow for support in the planning of community reintegration.⁵²

Possible grant recipients could include social work programs, such as CUNY’s Masters of Social Work (MSW) and psychology programs. The Connecticut Mental Health Center, run by the state’s Department of Mental Health and Addiction Services, provides resources for over 5,000 people in the Greater New Haven area as part of a cooperative partnership with Yale University’s School of Medicine’s Department of Psychiatry.⁵³ A similar endeavor between the New York City Department of Mental Health and Hygiene and CUNY Hunter’s Silberman School of Social Work, one of the top social work graduate programs in the nation, would benefit thousands of New Yorkers.⁵⁴

Research shows that art therapy can greatly impact one’s mental well-being.⁵⁵ Our funding program would consider grants to institutions that provide creative outlets for people with mental health issues. The Living Museum in Queens, housed in the state’s Creedmoor Hospital Complex, offers relaxed conditions for outpatient artists to work amongst counselors, and produces incredible art.⁵⁶ Notably, the affirming environment there allows for people with significant past criminal histories to work productively without any on-site security presence.⁵⁷

Proposal 2: Treat Mental Health as a Public Health Issue, Not a Criminal Issue

Criminally prosecuting people for issues emanating from mental illness runs contradictory to the professed values of our legal system. If a person lacks the necessary mens rea (or “guilty mind” requisite for intent) to commit a crime, or if they clearly need an intervention that the criminal legal system cannot offer, our office will move these cases out of the criminal court system, or dismiss minor offenses entirely. More punishment and prison time will not deter people struggling with those mental health issues or change their behavior.

There is no need for someone charged with a minor issue to needlessly waste their time and our justice system’s resources. My office will either dismiss such a case or work out a non-carceral arrangement that does not involve the court.

In addition, New York City must stop relying on police to handle situations that involve individuals going through mental health crises. Rather than police, response teams should be composed of a paramedic, social worker, a psychiatric expert, and peer support who work in the triple shift model, ensuring someone is always able to respond. In order for this program to be truly effective, these units need to respond and be on scene as quickly as other emergency responders such as EMTs or fire departments, and perhaps could be housed in government spaces like the East Harlem Neighborhood Health Action Center. A successful model to follow is Toronto’s Gerstein Crisis Centre, whose non-coercive, elective approach allows individuals to make the decision on their own as to whether they feel a residential stay is something they need, and most importantly, what they want.⁵⁸ Additionally, emergency calls should be routed through a separate three-digit number so as to not trigger an unnecessary police response, as proposed by Public Advocate Jumaane Williams last year.⁵⁹

A number of jurisdictions throughout the country have created successful emergency mental health response programs, including Dallas, Texas, and Eugene, Oregon.⁶⁰⁶¹ Earlier this month, Mayor de Blasio announced a small pilot program where mental health professionals and emergency medical response teams would respond to 911 calls involving mental health crises in two yet unnamed high-need neighborhoods to begin in February 2021.⁶² While we agree that NYPD should not be responding to such calls, the program still uses “911”, and is funded at the expense of FDNY EMS.⁶³⁶⁴

When an individual experiencing a mental health crisis is arrested our office will work with organizations such as The Bridge, Exodus Transitional Community, The Osborne Association, Harlem United, and CASES to connect them to necessary resources. In addition, we will partner with any community, peer-based group that can form trusting relationships with people in crisis, whether or not they are established nonprofits. By following this practice, our office will send a clear message to the NYPD that arresting individuals experiencing a mental health crisis is not only a false solution, but is also an ineffective use of their time and resources.

Proposal 3: Expand Eligibility for Mental Health Court and Alternative to Incarceration Programs

Specialty courts like the Manhattan’s Mental Health Court are one tool for keeping people with mental health issues out of the criminal court process. But the current use of these courts is ineffective, keeping people out who need the most help.

Our current mental health court system has created a process where individuals find themselves victims of the revolving door, constantly cycling between Rikers Island and Bellevue Hospital.⁶⁵ The inhumane environment of Rikers Island is one no person should be subjected to, but is especially difficult for those with mental illness and frequently leads to heightened symptoms and/or continued deterioration in their overall mental well-being.⁶⁶⁶⁷⁶⁸

As District Attorney, I will end this revolving door by expanding eligibility for mental health courts and encourage people who want access to these courts to use them.⁶⁹ Currently, eligibility for the courts is only extended to individuals who are charged with non-violent felonies, while individuals charged with violent felonies may be considered on a case-by-case basis.⁷⁰ All defendants must plead guilty before they are able to participate and be referred to the court by a prosecutor, defense attorney, and/or at the defendant’s request, with all petitions requiring approval by the Special Litigation Bureau of the District Attorney’s Office and finalized by the presiding judge.⁷¹ I will instruct all ADAs and the Special Litigation Bureau to review applicants regardless of their charges, and eventually make broader changes to our office to simplify the process for people accessing specialty courts and diversion programs.

Manhattan Mental Health Court is not only underused, but also lacking resources. A 2015 study showed that only 29% of screened individuals were deemed ineligible for criminal justice reasons by the ADA or Special Litigation Bureau. In 2020, just three cases were referred to mental health court prior to the court shutdown caused by COVID.⁷² A recent report issued by the New York County Defender Services found from January 2016 through September 2020, the average time from arraignment to gaining entry into mental health court was 286 days, with cases averaging 18–24 months once in the mental health court system.⁷³ Even before COVID, the court was only open once a week.

Dual diagnoses of a mental illness and a substance use disorder are also very common. We acknowledge the important feedback our campaign received from directly impacted individuals and public defenders that very often a defendant is recommended for one specialty court while having issues that should be addressed by the other. My office will work with judges from mental health, drug, and Veterans courts to ensure that if someone is found to be a better fit for another program they will not have to resubmit their application and start the process over, but rather allow an ADA to make a request for the designated specialty court to be changed.

We will work with the court system to the end the requirement that defendants plead guilty to the crime they have been charged with in order to be eligible to participate in mental health court. Until such an agreement is reached, I will drop, not reduce, all criminal charges upon successful completion of the programming prescribed by the mental health court.

We will also divert cases to alternative to incarceration (ATI) programs whenever appropriate. Certain ATI programs have proven to be extremely effective at reducing recidivism and improving overall wellbeing and outcomes for participants,⁷⁴ offering people the ability to remain in the community instead of being jailed.⁷⁵ As a bonus, ATI programs save significant taxpayer money.⁷⁶

It is unacceptable that people find themselves spending months at Rikers Island despite being accepted into an ATI because there are no beds available. The Greenburger Center for Social and Criminal Justice’s Hope House, a therapeutic residential home for individuals with serious mental illness accused of felonies, is set to open in 2021, and a model for ATI’s we believe will be groundbreaking in its success. Hope House will be one of the only facilities that welcomes those diagnosed with antisocial personality disorder, who continue to fall through the cracks by not being accepted within traditional mental health programs despite being the most challenging to keep out of the criminal legal system.

Finally, no one should be kept out of mental health programs due to their costs. I will waive fees for all diversion programs and partner with local government to expand diversion eligibility and expedite processes, following a successful approach taken in Cook County, Illinois.⁷⁷⁷⁸


“The court has grown over the years in terms of expertise, obtaining treatment for participants, and the complexity of cases. I would like to see these courts no longer being separate entities. Each court would be a Mental Health Court. All courts would have access to services, psychiatrists, social workers, and for the partnership model to be expanded.”

Justice Matthew D’Emic, Acting Justice, Supreme Court, Kings County, Criminal, Presiding Kings County Mental Health Court Judge, Presiding Kings County Domestic Violence Court Judge.⁷⁹


Proposal 4: Protect the Rights of Detained and Incarcerated Individuals with Mental Health Needs

We believe that prison should only be used as a last resort and would only seek incarceration when our system lacks any other thoughtful approach to keeping the victim and other community members safe, and achieving accountability for the person who committed the harm. But when a person is incarcerated, we must take steps to make their incarceration as humane as possible.

After sentencing, our office will recommend to Corrections that any person with mental health needs who is being sentenced to serve prison time is placed in a facility that is as close to home as possible as long as there are sufficient mental health resources. Research has shown that people who stay in touch with loved ones while incarcerated have lower rates of recidivism than those who do not.⁸⁰

Many people with mental illnesses convicted of a crime are currently sent to prisons far upstate such as the Clinton Correctional Facility in Dannemora or Attica Correctional Facility.⁸¹ These facilities are hundreds of miles from Manhattan. This adds unnecessary burdens and expenses just to visit a loved one. However, there are prisons that are just outside of Manhattan that offer the same level of mental health care. For instance, Sing Sing Prison in Ossining and the Bedford Hills Correctional Facility for Women are closer to Manhattan and offer the same level of mental health care as Clinton and Attica.⁸² If we learn that a facility closer to Manhattan lacks adequate resources, we will work with the governor’s office and Department of Correction to address that deficiency. This is a policy driven by the lived experience of formerly incarcerated people advising our campaign.

Proposal 5: Support Legislation That Protects and Supports Individuals with Mental Health Needs

The Manhattan DA’s office is part of a broader political system. We will always use the bully pulpit in our office to advance legislative, executive, and administrative policies in line with our vision of a more just society. Our office will support federal, state and local legislation that improves peoples’ lives and reduce their contact with the criminal legal system. Additionally, we will support legislation that improves conditions for people who are incarcerated. We support the following legislation and programs, some of which have been discussed previously in this paper.

  • End the use of solitary confinement. Solitary confinement is torture. In a previous policy paper we stated that we would end the practice of solitary confinement for Manhattan pre-trial defendants.⁸³ We wholeheartedly oppose the use of solitary confinement and support the passage of the HALT Solitary Confinement Act.⁸⁴ We will continue to urge Mayor de Blasio, the Board of Corrections, and the City Council to eliminate the use of solitary confinement in city jails.⁸⁵
  • Enact Public Advocate Jumaane Williams’ emergency mental health response recommendations. It has been a year since the Public Advocate released his report “Improving New York City’s Response to Individuals in Mental Health Crisis” which focuses on reforming the City and NYPD’s responses when interacting with individuals suffering from mental illness.⁸⁶ As we transition to a solution that fully removes the NYPD from responding to mental health crises, we must continue training and de-escalation for police officers.⁸⁷
  • Provide Medicaid services to incarcerated people leaving prison. It is imperative to provide continuous healthcare for people coming home, which means remaining on Medicaid during and after incarceration. This would also allow for continued therapy and other health services that benefit re-entering individuals. We support Governor Cuomo’s directive for the Department of Health to apply for a waiver amendment which would allow certain individuals who are currently incarcerated to be provided Medicaid and Medicare services 30 days prior to their release so as to not avoid a lapse in health services.⁸⁸ However, as this request has been denied by the Center for Medicare & Medicaid Services,⁸⁹ we urge the New York Congressional Delegation to get behind H.R. 1329, the Medicaid Reentry Act, sponsored by Representatives Paul Tonko (D-NY) and Turner (R-OH) and push Congress to move this through committee to a full House vote.⁹⁰
  • Stop the criminalization and policing of mental health. This includes supporting legislation involving pretrial mental health and substance abuse evaluations, changing the definition of serious mental illness in corrections law to match that of the mental hygiene law in relation to inmates, and prohibiting health professionals from engaging in torture or other harmful treatment of incarcerated individuals.⁹¹⁹²⁹³
  • Medicare For All. The New York Health Act, sponsored by Senator Gustavo Rivera, covers all essential healthcare, including mental health treatment and support.⁹⁴ These services have always been imperative for all New Yorkers to have free and easy access to but have become increasingly important over the last several months.
  • Enact a Homes Guarantee. We believe in a #NYHomesGuarantee and the reforms that activists such as VOCAL’s Home for Everyone New Yorker coalition and the Housing Justice For All campaign led by the Upstate Downstate Housing Alliance are fighting for.⁹⁵⁹⁶ When people with mental health issues are detained, they frequently lose their housing while incarcerated. Additionally, housing instability is one of the largest obstacles for folks who struggle with mental health needs and there is absolutely no reason that New York State cannot find a resolution to solve this issue.


This campaign is born from the belief that the District Attorney’s office should represent the same bold, progressive values and vision we insist on in other elected officials in this city. It is a campaign that stands on the shoulders of all who have fought, and continue to fight, to build New York’s progressive tradition. Access to mental healthcare should be available for all, not just limited to those who can pay its exorbitant costs, especially during times like these.

In ending cycles of harm, the best long-term solutions will be found in investments we make outside of the criminal justice system — investments in public mental health resources, education, housing, and economic opportunity. It’s clear that the current approach to mental health has failed to protect some of our most vulnerable neighbors, and even more tragically, people with mental illness have astronomically higher rates of victimization than those without.⁹⁷ The strategy we must take to correct course is to invest in people, not policing, and in communities, not prisons. That is especially true when it comes to mental health delivery.

As with all of our policy proposals, we welcome and incorporate feedback, especially from those who have been impacted by the system or worked within it, and we will maintain this as a living document, through Election Day and our taking power at the District Attorney’s office. Together, we can build a safer and more just New York.

The Marton for District Attorney campaign believes in the principle that those closest to the problem are closest to the solution, and we will work with community partners to generate our policy agenda. If you feel something can be improved in this proposal, contact with the subject line, “Mental Health.”

You can read about all of the issues our campaign has led on at, including:

Proposal to combat wage theft, by protecting workers and holding corporations accountable. (September 8, 2020).

Proposal to implement restorative justice in Manhattan, and create accountability and healing without using jail or prison. (July 22, 2020).

Proposal to reimagine our response to intimate partner violence as part of a much broader approach to repairing the Sex Crimes Unit. (July 7, 2020).

Proposal to generate police accountability by achieving greater independence from the NYPD, holding the NYPD broadly and individually accountable for misconduct, and reducing the role of policing and prosecution. (June 26, 2020).

Proposal to eliminate solitary confinement for Manhattan defendants. (March 11, 2020).

Proposal to end the War on Drugs and refocus drug policy enforcement using a public health lens. (January 16, 2020).

Proposal to abolish the Office of the Special Narcotics Prosecutor. (January 16, 2020). The Proposal was covered here and here.

Proposal to bring humanity to prison sentencing by shortening prison sentences, fixing our oppressive plea bargain system, and parole reform. (December 13, 2019).

Proposal to commit to 80% decarceration through our many reforms to pretrial detention. (October 20, 2019).


[1] Chelsia Rose Marcius, “‘It’s a Cruel World, and I’m Better Off Dead:’ Manhattan Mental Health Court Offers Lifeline to Those with Serious Mental Illness — but They Have to Get In”, New York Daily News, November 14, 2020, (accessed November 14, 2020)

[2] In speaking of our nation’s history, and Manhattan’s, we must recognize we are on Indigenous Peoples’ land, which Manhattan was the home of the Lenape.

[3] New York City Department of Corrections, NYC Department of Corrections at a Glance: Information for 1st 6 Months FY 2019, 2019, (accessed May 27, 2020)

[4] Carson Kessler, “Black Mental Health Specialist Weathering Waves of Trauma in Community”, The City, July 16, 2020, (accessed September 25, 2020)

[5] “Mental Health and Coping During the Coronavirus Pandemic”, Eyewitness News ABC7, September 24, 2020, (accessed September 25, 2020)

[6] Carson Kessler, “Black Mental Health Specialist Weathering Waves of Trauma in Community”, The City, July 16, 2020, (accessed September 25, 2020)

[7] National Institute of Mental Health, Mental Health Information: Definitions, (accessed June 3, 2020)

[8] New York City Department of Health and Mental Hygiene, NYC Vital Signs: Serious Mental Illness Among New York City Adults, June 2015, (accessed May 27, 2020)

[9] New York City Department of Health and Mental Hygiene, Epi Data Brief: Serious Psychological Distress Among Adults in New York City, 2002–2015, May 2018, (accessed May 27, 2020)

[10] New York City Department of Health and Mental Hygiene, NYC Vital Signs: Depression Among New York City Adults, April 2018, (accessed May 27, 2020)

[11] Tony Newman, “COVID, Drugs, Jails, Racism, and…Hope? Five Takeaways From Our Current Overdose Crisis”, New York Daily News, August 28, 2020, (accessed November 19, 2020)

[12] New York City Department of Health and Mental Hygiene, Epi Data Brief: Health Equity in New York City — Social Determinants of Mental Health Among New York City Adults, August 2019, (accessed May 27, 2020)

[13] It should be noted that people with a mental illness are not more likely to commit crimes or acts of violence. In fact, people living with a mental illness are more likely to be victims of crime.
Heather Stuart, “Violence and Mental Illness: An Overview.” World Psychiatry 2, №.2 (2003): 121.

[14] The Diagnostic and Statistical Manual of Mental Disorders (DSM V) defines any mental illness as “a mental, behavioral, or emotional disorder that can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment” and a severe mental illness as “a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.”

[15] Mayor’s Office of Operations, Mayor’s Management Report: Preliminary Fiscal 2020, January 2020, (accessed May 27, 2020)

[16] Mayor’s Office of Operations, Mayor’s Management Report, September 2015, (accessed May 27, 2020)

[17] National Institute of Mental Health, Mental Health Information, Schizophrenia, (accessed November 9, 2020)

[18] National Institute of Mental Health, Mental Health Information, Bipolar Disorder, (accessed November 9, 2020)

[19] National Institute of Mental Health, Mental Health Information, Post-Traumatic Stress Disorder, (accessed November 9, 2020)

[20] Harvard Medical School, Harvard Health Publishing, Antisocial Personality Disorder, March 2019, (accessed November 9, 2020)

[21] Samar Kurshid, “How the City’s New Jail Plan Accounts for Those with Serious Mental Illness”, Gotham Gazette, November 8, 2019, (accessed November 9, 2020)

[22] The Center for Prisoner Health and Human Rights, Incarceration and Mental Health, (accessed May 27, 2020)

[23] New York City Independent Budget Office, Why Has the Cost of Correctional Health Services Increased in the Last Decade?, September 21, 2020, (accessed September 24, 2020)

[24] New York City Independent Budget Office, Why Has the Cost of Correctional Health Services Increased in the Last Decade?, September 21, 2020, (accessed September 24, 2020)

[25] “Fatal Force: Police Shootings Database, 2015–2020”, The Washington Post, updated October 15, 2020, (accessed October 15, 2020)
853 Americans were killed by police in 2020 as of November 23, 2020.

[26] “Fatal Force: Police Shootings Database, 2015–2020”, The Washington Post, updated September 28, 2020, (accessed September 30, 2020)

[27] Correct Crisis Intervention Today, “CCIT-NYC, Mental Health Advocacy Coalition, Responds to News of NYPD’s Termination of CIT Program”, News release, September 22, 2020, (accessed September 30, 2020)

[28] Molly Kaplan (Host), Gregg Bloche (Guest), “Why Are Police the Wrong Response to Mental Health Crises? (Ep. 122)”, ACLU At Liberty, Podcast transcript, October 8, 2020, (accessed October 12, 2020)

[29] “Suffering in the Streets”, The New York Times, September 16, 1984, (accessed October 7, 2020)

[30] Michael Winerip and Michael Schwirtz, “For Mentally Ill Inmates at Rikers Island, a Cycle of Jail and Hospitals”, The New York Times, April 10, 2015, (accessed October 7, 2020)

[31] Daniel Yohanna, “Deinstitutionalization of People with Mental Illness: Causes and Consequences.” AMA Journal of Ethics15, no. 10 (2013): 886–891.

[32] O’Connor v. Donaldson, 422 U.S. 563, 95 S. Ct. 2486, 45 L. Ed. 2d 396 (1975).

[33] Clifford J. Levy, “For Mentally Ill, Death and Misery”, The New York Times, April 28, 2002, (accessed October 16, 2020)

[34] Deanna Pan, “TIMELINE: Deinstitutionalization and Its Consequences”, Mother Jones, April 29, 2013, (accessed October 14, 2020)

[35] The largest decrease in funding to public mental health since deinstitutionalization was seen between 2009 and 2012 when states cut at least $4.35 billion as a consequence of the Great Recession.

[36] New York State Office of Mental Health, Statewide Comprehensive Plan 2016–2020, (accessed October 12, 2020)

[37] Joseph Spector, “Moratorium on Closing State’s Psychiatric Centers Backed in Legislature”, Democrat & Chronicle, June 18, 2014, (accessed October 12, 2020)

[38] Stephen Eide, “Systems Under Strain: Deinstitutionalization in New York State and City”, Manhattan Institute, November 2018, (accessed October 15, 2020)

[39] Janos Marton, “A Path to 80% Decarceration”, October 20, 2019, (accessed May 27, 2020)

[40] The District Attorney’s office also receives asset forfeitures from criminal cases. I have already committed to only using these funds post-conviction and to the benefit of the community that has been harmed.

[41] Upon assessing the existing community-based programs supported by forfeitures, I am open to continuing the most innovative work that would have otherwise have difficulty securing funding.

[42] Important re-entry programs that receive forfeiture funds currently will experience gradual diminutions, while ill-conceived uses for forfeiture funds such as additional police in the subway will be ended immediately.

[43] Reuven Blau, “Vance Doles Out Millions in Grants Amid Questions Over Role”, The City, February 27, 2020, (accessed November 19, 2020)

[44] Criminal Justice Investment Initiative, Reentry Innovations, Services, and Supports, April 9, 2018, (accessed November 19, 2020)

[45] Colleen McKay, Katie L. Nugent, Matthew Johnsen, William W. Eaton, and Charles W. Lidz, “A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation.” Administration and Policy in Mental Health and Mental Health Services Research 45, no. 1 (2018): 28–47.

[46] Dr. Ashwin Vasan, “Defund the Police to Protect the Mentally Ill”, New York Daily News, June 18, 2020, (accessed November 19, 2020)

[47] Substance Abuse and Mental Health Services Administration, Value of Peers, 2017, (accessed October 13, 2020)

[48] While not trained clinicians or doctors, peer supporters can add an important layer of credibility by discussing their own journeys, offering acceptance and understanding, and providing hope that may otherwise not be found in a more sterile or clinical setting.

[49] Meghan Randall and Katharine Ligon, “From Risk to Recovery: The Case for Peer Support in Texas Correctional Facilities”, Center for Public Policy Priorities, August 6, 2014, (accessed November 19, 2020)

[50] Mental Health America, Evidence for Peer Support, May 2018, (accessed October 14, 2020)

[51] Meghan Randall and Katharine Ligon, “From Risk to Recovery: The Case for Peer Support in Texas Correctional Facilities”, Center for Public Policy Priorities, August 6, 2014, (accessed November 19, 2020)

[52] In 2015, Georgia established the Forensic Peer Mentoring Project, which provides peer support from those with lived experience in the criminal justice system to re-entering individuals. As of June 2019, 850 individuals had participated in the program — only one had been rearrested since the program began four year prior. Comparatively, the Georgia Department of Corrections reports that approximately 23% of inmates who experience a mental illness are rearrested within three years.
Georgia Mental Health Consumer Network, Peer Mentoring and Forensic Peer Mentoring, (accessed October 14, 2020)
Michele Cohen Marill, “Beyond Twelve Steps, Peer-Supported Mental Health Care”, Health Affairs, June 2019, (accessed October 2, 2020)

[53] State of Connecticut, The Connecticut Mental Health Center, (accessed May 2, 2020)

[54] Enrollment in CUNY has dropped due to the hardships many students face because of COVID. Financial difficulties, struggles with online classes, health issues, and disruptions in their personal lives have forced many students to opt out of the Fall 2020 semester. A reduced fee for students entering psychology and MSW programs would ease the burden particularly on those who have taken time off due to finances. Additionally, these programs will create a greater number of mental health professionals equipped to help our city.

[55] Heather L. Stuckey and Jeremy Nobel, “The Connection Between Art, Healing, and Public Health: A Review of Current Literature.” American Journal of Public Health 100, no. 2 (2010): 254–263.

[56] Julie Besonen, “The Living Museum, on the Creedmoor Campus in Queens, Puts Patients’ Work on Display”, The New York Times, May 1, 2015, (accessed November 13, 2020)

[57] As a matter of full disclosure, the Living Museum is run by Janos Marton’s uncle, of the same name.

[58] Gerstein also has residences for youth, men and women experiencing homelessness, and those with a substance use disorder, as well as a mental health and justice initiative which houses those struggling with mental illness and find themselves involved in the criminal legal system. Admission is voluntary rather than being mandated by the courts and provides services such as court support and diversion, case management, housing, police intervention, and crisis prevention.

[59] The City of New York, Office of the Public Advocate Jumaane D. Williams, Improving New York City’s Response to Individuals in Mental Health Crisis, September 25, 2019, (accessed October 4, 2019)

[60] Lucas Manfield,” Dallas Has Been Dispatching Social Workers to Some 911 Calls. It’s Working”, Dallas Observer, December 10, 2019, (accessed November 9, 2020)

[61] Ari Shapiro, “‘CAHOOTS’: How Social Workers and Police Share Responsibilities in Eugene, Oregon”, NPR, June 10, 2020, (accessed November 9, 2020)

[62] Sydney Pereira, “NYC to Experiment With Police-Free Response to Mental Health Crisis”, Gothamist, November 10, 2020, (accessed November 11, 2020)

[63] This pilot program would be funded out of current resources from the FDNY EMS’ already declining budget, whose union president criticized the initiative due to the already minimal pay EMS receive especially amid a global health pandemic. The pilot will be coordinated by ThriveNYC, who has greater funding yet is not financially contributing, and personnel will be trained by NYC Health + Hospitals. It also lacks peer involvement and continues a coercive model advocates have long fought against.

[64] Shant Shahrigian, “Public Advocate Jumaane Williams Criticizes New de Blasio Approach to 911 Mental Crises Calls”, New York Daily News, November 11, 2020, (accessed November 12, 2020)

[65] Michael Winerip and Michael Schwirtz, “For Mentally Ill Inmates at Rikers Island, a Cycle of Jail and Hospitals”, The New York Times, April 10, 2015, (accessed October 7, 2020)

[66] When individuals are unable to cope within this environment, they find themselves at the forensic psychiatric ward at Bellevue until they are deemed stabilized to return to Rikers and the cycle continues. This instability creates a lack of care for patients that creates additional harm and continues the revolving door cycle and involvement with the criminal justice system.

[67] Stephanie H. Procell, “How to Stop the Dangerous ‘Revolving Door’ of Jailing the Mentally Ill”, Vice, January 26, 2016, (accessed October 4, 2020)

[68] Despite efforts to address clinical instability such as the creation of specializing housing units for patients, which come at a great cost to taxpayers, a jail will always be a jail and not a sufficient place for treating those with mental health needs. Similarly, Bellevue is notorious for its brutal conditions, a reason so many psychiatric survivors are opposed to approaches that force inpatient treatment and result in being moved from one institution to another, rather than addressing the systemic conditions that obstruct treatment and create further obstacles to thrive when reentering the community.

[69] I will personally lobby city and state government to provide more resources for this and other diversion courts.

[70] New York State Unified Court System, Manhattan Mental Health Court, (accessed May 18, 2020)

[71] Erin J. Farley, “A Process Evaluation of the Manhattan Mental Health Court”, Center for Court Innovation, January 2015, (accessed July 16, 2020)

[72] Chelsia Rose Marcius, “‘It’s a Cruel World, and I’m Better Off Dead:’ Manhattan Mental Health Court Offers Lifeline to Those with Serious Mental Illness — but They Have to Get In”, New York Daily News, November 14, 2020, (accessed November 14, 2020)

[73] Chelsia Rose Marcius, “‘It’s a Cruel World, and I’m Better Off Dead:’ Manhattan Mental Health Court Offers Lifeline to Those with Serious Mental Illness — but They Have to Get In”, New York Daily News, November 14, 2020, (accessed November 14, 2020)

[74] Jeremy Travis, Bruce Western, and F. Stevens Redburn, The Growth of Incarceration in the United States: Exploring Causes and Consequences, Washington, D.C.: The National Academies Press, 2014.

[75] Greg Berman and Robert V. Wolf, “Alternatives to Incarceration: The New York Story”, Center for Court Innovation, 2014, (accessed June 24, 2020)

[76] Governor’s Commission on Youth, Public Safety & Justice, Final Report of the Governor’s Commission on Youth, Public Safety & Justice: Recommendations for Juvenile Justice Reform in New York State, 2014,

[77] Shaila Dewan and Andrew W. Lehren, “After a Crime, the Price of a Second Chance”, The New York Times, December 12, 2016, (accessed June 16, 2020)

[78] Mark Kammerer, the Supervisor of Alternative Prosecution/Sentencing Unit who runs diversion programs in Cook County, reports 97% of participants had no new felony arrests and 86% had no arrests of any kind a year after completing felony diversion programs. Additionally, Kammerer reports the programs save Cook County millions of dollars, with drug schools alone saving an estimated $1.5 million per year.

[79] Bonnie Sultan, “The Intersection of Health and Justice: Views from the Bench”, PsychAlive, (accessed November 20, 2020)

[80] Alexandra H. Smith and Jennifer J. Parish, “When a Person with Mental Illness Goes to Prison”, Urban Justice Center, 2010, (accessed May 29, 2020)

[81] New York State, Sing Sing OMH Satellite Unit, (accessed May 26, 2020)

[82] Alexandra H. Smith and Jennifer J. Parish, “When a Person with Mental Illness Goes to Prison”, Urban Justice Center, 2010, (accessed May 29, 2020)

[83] Janos Marton, “Ending Solitary Confinement in Manhattan”, March 11, 2020, (accessed April 11, 2020)

[84] S.B. S1623, 2019–2020 Legislative Session (New York, 2019). (accessed April 11, 2020)

[85] “A Blueprint for Ending Solitary Confinement in NYC Jails”, The NYC Jails Action Coalition & #HALTsolitary Campaign, October 2019, (accessed April 11, 2020)

[86] The City of New York, Office of the Public Advocate Jumaane D. Williams, Improving New York City’s Response to Individuals in Mental Health Crisis, September 25, 2019, (accessed October 4, 2019)­­­

[87] Gwynne Hogan, “NYPD Abruptly Halts Training Program Meant to Help Police De-Escalate Encounters With People in Mental Health Crisis”, Gothamist, September 25, 2020, (accessed September 27, 2020)

[88] New York State Department of Health, “Governor Cuomo Directs Department of Health to Apply for Federal Waiver to Provide Medicaid Services to Incarcerated Individuals Leaving Prisons and Jails”, News release, August 14, 2019, (accessed October 16, 2020)

[89] Calder Lynch. Calder Lynch to Donna Frescatore, February 21, 2020, (accessed October 16, 2020)

[90] A proposed law (H.R. 1329, 2019), to amend title XIX of the Social Security Act to allow for medical assistance under Medicaid for inmates during the 30-day period preceding release from a public institution, (accessed October 16, 2020)

[91] S.B. S7242, 2019–2020 Legislative Session (New York, 2019). (accessed May 21, 2020)

[92] S.B. S2690, 2019–2020 Legislative Session (New York, 2019). (accessed May 24, 2020)

[93] S.B. S7242, 2019–2020 Legislative Session (New York, 2019. (accessed May 24, 2020)

[94] S.B. S3577A, 2019–2020 Legislative Session (New York, 2019. (accessed September 9, 2020)

[95] VOCAL-NY, Homelessness, (accessed September 26, 2020)

[96] Housing Justice For All, What Is a New York Homes Guarantee?, (accessed September 24, 2020)

[97] Robert Maniglio, “Severe Mental Illness and Criminal Victimization: A Systematic Review.” Acta Psychiatrica Scandinavica 119, no. 3 (2009): 180–191.



Janos Marton

Criminal justice advocate. Democratic Candidate For Manhattan District Attorney.