I am looking for mental health care in Rikers

The rhythm of Eric Tavera’s life has never been so simple.

“He would ask me, ‘Mom, what do you think of that song?'” “It was beautiful,” Eric Tavera’s mother, Hedith Tavera, said through an interpreter. Her face was wet with tears.

Sitting in his aunt’s apartment in the Bronx, his family explained 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. This caught his attention.”

The music suddenly stopped in October.

That’s when Tavira, then 28, died on Rikers Island. His death was ruled a suicide.

It is one of six suicides in the city’s custody in 2022.

What you need to know

  • About 16% of Rikers Island’s population suffers from a serious mental illness
  • Due to staff shortages and lack of capacity, sources say the prison mental health care system is strained
  • Incidents of self-harm have doubled since the pandemic began. In 2022, there were six deaths that the medical examiner’s office ruled to be suicide

Tavira is among the 16% of Rikers Islanders who suffer from severe mental illness — a steady population that has turned parts of the city’s jails into dedicated mental health wards.

It was in one of those housing units where Tavira committed suicide.

For months, NY1 has scrutinized the care those in Rikers, like Tavira, get. Our investigation found that the once lauded mental health care system is now being strained by a shortage of staff and a lack of space. Self-harm is on the rise, suicides are on the rise—part of a national trend that is rooting here on Rikers.

Spurred in part by the pandemic, detainees like Tavera with a mental health diagnosis are spending longer in the city jail, exacerbating the isolation awaiting trial. Starting in fall 2022, the average Rikers Island detainee will spend 110 days in custody. But for those with a mental health diagnosis, that number practically doubles to 208 days on Rikers.

Eric Tavera has been at Rikers for 494 days.

“It’s not fair what they’ve done to him,” his mother told NY1 through an interpreter. “Not only him. I feel indignant, angry and frustrated. I ask God not to let any hatred enter my heart because it is not good for me. But what I ask for is justice.”

While Eric Tavera struggled with mental illness, music was one of the remaining bright spots in his life.  In June 2021, Tavira is captured and sent to the Rikers.  In October 2022, after 494 days in prison, he committed suicide, according to the city's chief medical examiner's office.  (Photo courtesy of the Tavera family)

While Eric Tavera struggled with mental illness, music was one of the remaining bright spots in his life. In June 2021, Tavira is captured and sent to the Rikers. In October 2022, after 494 days in prison, he committed suicide, according to the city’s chief medical examiner’s office. (Photo courtesy of the Tavera family)

Tavera was diagnosed with schizophrenia with paranoid delusions as a teenager. He ended up on the streets and in homeless shelters. While his family was close, when he was out of therapy, his paranoia could make him aggressive. You can put a gap between them.

“Sometimes when he’s not taking his meds, yeah, his mood changes,” his mother said through an interpreter. “He thought he was being followed. On the train when we were together, he thought someone was staring at his sister, and I got scared that something would happen to him, or that something would happen to us because he wanted to stand up for us.”

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

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

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

Then he got into a fight with one of the hospital security officers.

He was detained without treatment and then released.

But the following week, Tavira, who was still untreated, was in upper Manhattan and allegedly attacked a 14-year-old from behind, striking the teen and trying to choke him. It was alleged that he then had a fight with another person who was trying to intervene.

Tavira was arrested again, and sent to Rikers for strangulation and assault. Bail was set at $20,000.

“My brother was constantly calling you,” says Tavira’s sister, Amaryllis Torres. “Twice, three times a day. We knew when he wasn’t feeling well. All we could do was talk to him and try to calm him down.”

A month before his death, Tavira was transferred to a mental health unit that sources tell us held about 40 detainees, far more than some doctors recommend.

In an exclusive body cam video obtained by NY1 through the Freedom of Information Act, Tavera is seen protesting the move. The officers gather around him and explain that Mental Health wants him gone. When they make him move him, Tavira fights back. Then it is 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 city’s Department of Corrections commissioner, Louis Molina, sent a statement to NY1:

“Our deepest condolences go out to the Tavera family and we understand that this video may be difficult for them to watch as they grieve their loss. Transferring detained persons from one facility to another is routine, and the use of an approved chemical agent is standard correctional practice if a detainee resists. The officers involved in this were vindicated However, it is unfortunate that this video was provided by the New York City Board of Directors without regard to this important context, or the sentiments of the Tavera family.”

According to an initial investigation by the Correction Board, which oversees the Department of Corrections, there was only one doctor serving the unit when Tavera died and there were no “steady officers,” usually assigned to mental health units to provide consistency for staff and detainees.

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

At the time of Tavera’s death, there were no suicide prevention aides on duty and the officer on duty had not conducted 15-minute rounds in their place.

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

On Rikers Island, Reform Leaders and Administrators from the Rikers healthcare provider assure that they have an effective system of care. They just need more of it.

“I’ve been in this job 27 years. The mental health numbers have grown exponentially, like 10,” said Antoinette Court, acting director of the George R. Vierno Center, a prison in Rikers Island. “Because when I first came in, we didn’t have a lot of people.” of mental health units, now we need more than the ones we have.”

The acting warden refers to what is known as the PACE unit – the highest level of care that seriously mentally ill detainees can receive at Rikers Island. Unlike lower-level mental health units, these units have medical staff, therapists, and social workers on site. They were widely acclaimed when they opened in 2016.

There are now 10 of them across Rikers.

Former Mayor Bill de Blasio committed to expanding that to 12 in 2016, but a staffing shortage has paused that.

“There is a long waiting list,” Kurt said. “These guys are on 17a, they’re mentally ill, but they fit on PACE. So as soon as the beds are available, they’ll assess them as quickly as they can, and we’ll move them when you ask us to, to get them into the care they really need.”

Some families, like Tavera’s, wonder if they receive such care.

Data from Corrective Health Services shows that, over the course of the pandemic, the number of mental health appointments completed in a given month has slowly decreased. In September 2022, only 53% has been completed.

Chart of percentage of mental health appointments completed by city correctional department.

(NY1 drawing)

Health officials say there are multiple reasons for the cancellations, including failure of corrections officials to bring detainees and detainees’ refusal to go. However, they acknowledge that there is a staffing shortage.

“I think this is a really difficult time for any health care system to function really adequately,” said Lauren Stossel, chief of the Mental Health Service at Corrective Health Services, which manages health care on Rikers. “There have been significant retention and staffing challenges since COVID, when a lot of psychiatrists and psychologists had the opportunity to work remotely. Working in prisons is not an easy time.”

The numbers agree.

With the spread of the epidemic, the amount of self-harm in the city’s prisons has also increased. Pre-pandemic, there were fewer than 100 incidents a month. Now, that number has doubled. The majority of these incidents occur in specialized mental health units.

Bar chart of self-harm incidents in the New York City correctional system.

(NY1 drawing)

However, health officials argue that the care detainees receive on Rikers is stronger than what they get in the community.

“Our patients actually receive an enormous amount of mental health treatment in these units, compared to what you would get in an inpatient unit, intensive day program or partial hospitalization — so really a very high standard of care,” Stossel said. Patients in the community would have to if they were just visiting an outpatient provider.”

John Gallagher was a Deputy Sheriff in the Department of Correction and was one of the officials who helped set up mental health units at Rikers. He retired in June 2021.

He tells us: “Many things collapsed.”

Gallagher said before he left, the department no longer focused on mentally ill detainees. She was scrambling to comply with federal oversight, as well as the movement to shut down Rikers and get rid of solitary confinement.

Those who struggle with mental illness have taken a back seat.

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

He said training fell through during the pandemic.

“You’re talking about suicide prevention, nobody pays attention to that anymore,” Gallagher said. “Not doing the exercises, inadequate staff. One of the big problems I had, and the chief tried to rectify it, was that we were going to train the staff, but then they weren’t put into the unit.”

Before that, he said, mental health units had a national reputation.

“It’s like Jenga. You pull on that one block and a lot of things fall apart.” “I can say that as a matter of fact, a lot of the really good medical staff that I’ve worked with over the years stayed, and part of that was frustration.”

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

“By then, I’ll be here eight months and that’s a year on Rikers Island,” Tavira’s sister said, reading one of her brother’s letters from behind bars. It was about 10 months before his death.

“I love you more than you can imagine. Hope to see you soon.”

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