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How to Help the Mentally Ill

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"Homeless and cold" by Ed Yourdon, taken January 25, 2010 in Verdi Square, 72nd Street and Broadway, New York

CITY JOURNAL
July 21, 2014

How to help the Mentally Ill?
by James Panero

A New York City task force could repeat the mistakes of deinstitutionalization.

Early last February, Jerome Murdough, homeless and seeking shelter from freezing temperatures, was arrested for trespassing in the stairwell of an East Harlem housing project. Unable to post his $2,500 bail, the 56-year-old Marine veteran with a history of mental illness remained in police custody. A week later, on the evening of February 14, he was transferred to a solitary cell in the mental-observation unit of New York City’s Rikers Island jail complex. Guards were supposed to check on Murdough every 15 minutes, but he was not fully observed until early the next morning, when it became apparent that a malfunction in the prison’s climate-control system had heated his 6-by-10-foot cinder-block room into the triple digits. When discovered slumped over his bed, Murdough’s lifeless body registered a core temperature of more than 100 degrees.Headlines blared that Murdough had been “Baked to Death on Rikers Island.”

Murdough’s gruesome death prompted New York City mayor Bill de Blasio to announce his first major law-enforcement initiative, the Task Force on Behavioral Health and the Criminal Justice System. Set to issue findings this September, it will seek recommendations from city police, judges, district attorneys, and mental-health workers on “innovative strategies to transform, reform and update this city’s criminal justice system.” In a statement, de Blasio said that the task force will allow the city to “provide real, lasting mental health and addiction treatment” for the city’s mentally ill. “For far too long,” he continued, “our city’s jails have acted as de facto mental health facilities.”

The mayor is right that the criminal-justice system dedicates inordinate resources to policing mental illness, often with disgraceful results. In this regard, New York’s experience mirrors that of much of the country. A 2010study by the Treatment Advocacy Center (TAC) found that there were “three times more seriously mentally ill persons in jails and prisons than in hospitals.” Sheriffs’ associations estimate that the mentally ill make up over a quarter of inmates in their jails. According to E. Fuller Torrey, the founder of TAC, the Los Angeles County Jail has become the largest de facto inpatient psychiatric facility in the United States. Rikers Island is the second-largest.

It shouldn’t require a task force to understand why. The vast incarceration of the mentally ill is a consequence of the 50-year-old policy of deinstitutionalization—the closing of state mental asylums and the reduction of hospital beds set aside for the mentally ill. Lacking both the medical resources and legal framework to care properly for the severely mentally ill, the community-based system meant to replace it was never equipped to give true “asylum” to those patients unable to cope in regular society. As a result, those most in need of help often wind up revolving among outpatient facilities, homeless shelters, and the streets. Arrest and prosecution offered the only remaining method of sequestering the violent and delusional and preventing them from harming themselves and others.

Unfortunately, early indications suggest that the city’s new task force could actually make things worse. Just as government planning failed to account for the catastrophe of deinstitutionalization, a new decriminalization initiative could lead to the mentally ill being pushed back into the subway system and the open-air asylums of Broadway and Central Park. This would represent a shameful return to the status quo of the early 1990s, before quality-of-life policing began under Mayor Rudolph Giuliani.

Each year, the NYPD receives 100,000 calls concerning “emotionally disturbed persons.” Elizabeth Glazer, the mayor’s criminal-justice coordinator and a leader of the task force, asks, “If someone picks up the phone and calls 911 because they see someone acting out on the street, then what does the police officer do?” Of all possible answers to this question, “leave them on the streets” seems to be the worst. Yet civil libertarians may use the task force cops to do just that, undermining proactive policing and the right of New Yorkers to live without the terror of unstable people undergoing psychotic breakdowns in public.

Instead, the task force should strengthen the state’s ability to compel the mentally ill to pursue proper treatment—for instance, by widening the use of Kendra’s Law, named after Kendra Webdale. In 1999, Andrew Goldstein, a schizophrenic who had stopped taking his medications, pushed Webdale to her death beneath a subway train. Kendra’s Law, which the ACLU opposed, gave New York courts the power to compel the mentally ill to accept treatment as a condition of living in society. According to D.J. Jaffe of Mental Illness Policy Org., Kendra’s Law reduces incarceration by 87 percent. By applying it to all prison inmates upon their release, the law would reduce reincarceration as well.

Another constructive measure would be to improve the mental-health services offered within the prison system, while revisiting the idea of asylums. Since prisons have become makeshift mental institutions, such an effort would have immediate results. But incarceration will always be an inefficient and inhumane method of caring for the mentally ill compared with purpose-built institutions. “The simple claims of a common humanity,” wrote Thomas Story Kirkbride, the progressive architect of the nineteenth-century asylums, “should induce every State to make a liberal provision for all its insane, and it will be found that it is no less its interest to do so, as a mere matter of economy.” Until New York comes to terms with the failure of deinstitutionalization, the criminalization of mental illness will never be cured.

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Backstage Breakdown

CITY JOURNAL
July 6, 2014

Backstage Breakdown
by James Panero

The Met’s labor impasse penalizes opera lovers and supporters.

Labor troubles in the performing arts have often reached operatic proportions. In 1904, President Theodore Roosevelt stepped into the middle of a dispute over foreign musicians at New York’s Metropolitan Opera, and he wasn’t the last head of state to intervene in a backstage conflagration. The loss of a performance season due to a strike or lockout is rightly regarded as damaging and even deadly to an arts house, posing a threat to the culture of art itself.

Considering the intensity of the discord surrounding ongoing negotiations at the Met, it would take more than a president to solve this year’s crisis at the 131-year-old opera house (its other crisis, if you consider the eruptionover its decision to stage The Death of Klinghoffer). With contracts for 15 of the Met’s 16 different unions set to expire on July 31, the rancorous talks now underway between management and labor could result in a lockout of part, if not all, of the upcoming season.

Who is at fault? On one side is Peter Gelb, the Met’s general manager. In an era of escalating expenses and dwindling ticket sales, Gelb says he is justified in seeking 16 percent cuts in pay and benefits from labor in an attempt to rebalance the books. But Gelb has spent lavishly: during his tenure, which began in 2006, the Met’s annual operating budget has increased from $222 million to $327 million. Gelb has paid for some of this increase through drawdowns on the Met’s endowment, which now contains less than a year’s worth of reserve funding.

Alan S. Gordon, the executive director of the American Guild of Musical Artists and the representative for the Met’s unionized chorus singers, has been Gelb’s most vocal opponent, accusing the Met manager of waging “nothing short of economic warfare.” Gelb, he wrote in one of many publicly circulated emails, “has, in essence, declared war on [the Met’s] performing artists, instrumentalists, stagehands and on the unions representing them and on all of the Met’s other represented employees, in an effort to deflect focus from the waste, excess, extravagance and out-of-control spending that has been the hallmark of Gelb’s administration.”

While each side in the imbroglio lambasts the other as unrealistic, both the Met’s management and its unions are out of touch with today’s realities. On June 16, the Met released its latest tax filings. Gelb earned $1.8 million in pay and benefits in 2012. Granted, Gelb has since taken a modest pay cut, and his 2012 salary represented some one-time payouts. Yet a salary in excess of $1 million a year underscores the unreality of Gelb’s leadership. And Gordon claims that Gelb plans to keep his full-time Met chauffeur.

Even Gelb’s purported success, the much-touted “Live in HD” broadcasts beamed to a couple thousand movie theaters, has not covered the budget shortfall. Meanwhile the HD initiative has further eroded the primacy of the Met’s live audience and eaten into its main donor base, with everyone from singers to seamstresses now forced to play to the cameras rather than the live ticketgoers. Gelb earned his reputation through music television, arranging the broadcasts of Vladimir Horowitz’s 1986 return concerts in the USSR. Yet at a time when even our phones can record in HD, his vision of lavish live broadcasts has quickly dated. For greater accessibility, today the Met could simply post a handful of full-length recordings free to YouTube every year, with opera by iPad serving as an invitation to rather than a replacement for the live event.

But similar profligacy reigns on the union side. The Met’s tax filings reveal that three of the house’s five top-paid employees are members of Local 1 of the International Alliance of Theatrical Stage Employees—stagehands whocommand pay and benefits in excess of $450,000 a year. Even Gordon’s beloved choristers, the 80 or so full-time employees who perform many nights behind the headline stars, take home an estimated $300,000 in annual pay and benefits. These are hardly proletarian sums, and the numbers are hard to justify to a millennial generation still suffering the job-market fallout of the financial crisis.

To move forward, both sides need to stop comparing their pay packages and begin proving their worth to a new opera public. Met management should pursue greater transparency in its nonprofit filings; the public deserves to see a line-by-line itemization of expenses for each new production and each star singer, as well as an explanation of where the money will come from to pay for it all. At the same time, the unions should explain why their meters click for everything from rehearsal time to costume changes, and open the door for workers of similar talents willing to do some jobs for less.

In the last few years, major arts organizations such as the New York City Opera have gone bankrupt; others, like the San Diego Opera, have verged on the brink of insolvency, and labor walkouts have silenced performances from Minnesota to Carnegie Hall. In most of these cases, management and labor have both been part of the problem. The losers are opera lovers and a future generation of supporters, increasingly treated with contempt. Joseph Volpe, Gelb’s predecessor and a seasoned negotiator whom management has kept out of current talks, pointed this out years ago, during an earlier round of strife at the opera house. “The most serious side effect” of a breakdown backstage is the crucial financial support of rank-and-file donors, Volpe wrote in his 2006 memoir, The Toughest Show on Earth: My Rise and Reign at the Metropolitan Opera. “[They were] turned off by all the bloodletting,” he added. “Opera is habit forming, but once the habit is broken, it’s easily kicked.”

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