The New Yorker Radio Hour - Keeping Released Prisoners Safe and Sane

Episode Date: June 30, 2020

Starting this spring, many states began releasing some inmates from prisons and jails to try to reduce the spread of COVID-19. But a huge number of incarcerated people are mentally ill or addicted to drugs, or sometimes both. When those people are released, they may lose their only consistent access to treatment. Marianne McCune, a reporter for WNYC, spent weeks following a psychiatrist and a social worker as they tried to locate and then help some recently released patients at a time of uncertainty and chaos.  This is a collaboration between The New Yorker Radio Hour and WNYC’s “The United States of Anxiety.” New Yorker Radio Hour listeners, we want to hear from you.  We have a few questions about the show and how you listen to it. The survey takes about twenty minutes, and your feedback will help us make our podcast better.  Take the survey here.

This is The New Yorker Radio Hour, a co-production of WNYC Studios and The New Yorker. Welcome to The New Yorker Radio Hour. I'm David Remnick. This year, we've been talking on the program about mass incarceration. The fact that the United States imprisons its people at a rate unparalleled in the world. And when the coronavirus pandemic hit, we looked at a push by activists and prison officials to release some inmates as quickly as possible. In March, to take one example, the county jail in Cleveland, reduced its population by almost half. 900 inmates came out with unprecedented speed, and one of them was a 36-year-old named Germain.

They was trying to stop it from spreading, so they were letting people out. That's how I got out. Like so many incarcerated people, Germain suffers from mental illness, and he's addicted to drugs. That's true of anywhere from 20% to more than half of incarcerated people,

depending on where you are and how you calculate it. In some counties, prisons are the largest providers of mental health care. And when Germain was released, the first thing he did was to vanish. Now where it goes, so it was just messed up, for real. I mean, it just was messed up. As part of our collaboration with WNYC's United States of Anxiety, reporter Marianne McCune spent weeks following a psychiatrist and a social worker who are trying to find Germain and others like him during a time of chaos.

Here's Marianne McKeown. A lot of us have someone in the family or someone close who is addicted to drugs or has some kind of mental illness. Manic episodes or paranoia, they can't keep out of trouble, and we can't figure out how to take care of them. Those are the kind of people who end up in Dr. Testa's office. Hi, Mary Ann, it's Meg Testa psychiatrist from Cleveland. Since I can't go see her in my house.

I'm at the agency. I'm outside. Dr. Testa has been recording dispatches from her office, and it's down to every little detail. I'll be using this to call my patients. Dr. Testa is a psychiatrist for people who churn in and out of the criminal justice system. So as they come out of Ohio's prisons and jails, she tries to keep them from going back in. That is, if she can find them. Ever since the local jails started releasing inmates' rapid fire, Dr. Testa is struggling just to keep track of patients, much less treat them. I'm like in my office one day. I'm trying to call a patient. I'm trying to call a patient. I'm hanging it up. And my desk phone rings. And it's one of my patients that was my patient two years prior.

And he had just been let out of a jail with no meds, no treatment, no nothing and told to just give a promise to link up with his doctor. He did call me, but by this time, he was calling me to tell me, how. how many banks he owned and how much money he had and how great he was doing because he was fully manic. Dr. Testa has blurred some of the details of the case to protect his identity. She says there's no way a person in his state could consent to sharing his story. And she's giving him the name Bobby. He was on the bus when he was on the phone with me. He's using drugs and alcohol.

He's without treatment. He doesn't really think he needs treatment. He doesn't even know how to keep himself safe from coronavirus because he thinks the whole thing is like a trick by the government and it's martial law and it's it's a whole lot of nothing that he needs to be worried about. Dr. Testis is this call from a bus. This is not the way to get started with a patient. If you want any chance of helping someone begin a new life after prison, you need to start the minute they walk out that gate. And what's missing right now more than ever is a handoff from the jail or prison to the people who can help.

The problem is that if we don't even know that they're out, we're going to lose them. At this point, Bobby has had weeks on the street without medication, making choices that could hurt him. How are you coping? And all Dr. Testa can do is wait for his calls. Any fever or coughing, anything like that, trouble breathing? It's possible that I'm just the only person in his life that he can think of that'll pick up the phone and talk to him right now. I spend the next several weeks checking in to see how those conversations are going. Good.

Tell me about her sleep. Your sleep is good. To somehow coax him off the bus, off the streets, and enter her office for help. I know. We miss you too. We miss you too. When she was young, Dr. Testa had a close family member with mental illness who, like so many, ended up behind bars. She remembers sending letters to the prison.

Now she's part of a team of doctors and counselors and caseworkers who, whose mission is to help people with mental health problems exit the criminal justice system. Good morning. She works for recovery resources, one of a network of agencies that contract with the state and county to set up housing, health care, rehab. Ideally, the moment a prison is released. They'll pick him up. They'll try to get his income sorted out. They'll take him to family services. They'll try to get him food stamps. They'll take him shopping. They'll get him clothing. They'll help him apply for jobs.

But when COVID-19 hit, they had to pull back dramatically to comply with Ohio's shutdown order. They can't drive people, places, so much is closed anyway. Only a few people at a time are allowed to come to their office for appointments. Good morning. How are you? The normally full waiting room. There's only one person there, kind of sitting in the corner, wearing a mask. A lot of their services, from psych evaluations to group counseling, are on the phone or over computers, which is hard for everyone.

Do you guys want to say hi? Nobody's saying hi. They will. They're all muted. Oh, okay. Say hi. It's a reporter for that thing I'm doing. Radio. Annette Amistadi is a social worker

Dr. Testa works closely with. She's also been recording herself. While she spends a frustrating amount of time searching for the people she's supposed to be helping. Did you give you the address? Right now, she's trying to find Germaine. who was among the 900 inmates released from jail in Cleveland after COVID hit. Germain has schizoaffective disorder, among other things.

So it is 1148. It's Annette here. I'm trying to locate a client who was released from city jail without a plan and I wasn't aware of his release. So now I am trying to. trying to figure that out. So I'm going to send this email now. Germain was Annette's client last year when he came out of a longer stint in prison. They were making some progress, trying to treat his addiction and prescribing psych medication, but as is often the case, he got locked up again.

She was waiting for information about his court dates and release, and then she found out, oh, he's been out for a week and a half. His parole officer emailed saying she has no idea where he's. is. He is declared whereabouts unknown, but I'm hopeful that I don't even know. We can find something because he definitely needs help and this is a problem. So that's currently what I'm doing. Over the weeks to come, Annette will be part social worker, part detective. Her mission, find Germain and pull him into the fold. While down the hall, Dr. Testa is waiting for that desk phone to ring with Bobby on the other end.

She's especially worried about getting Bobby the right medication in time. He's one of those guys that, like, he has a different treatment when he's in prison than he has when he's on the street. This is something I'd never thought about, but mentally ill people are like all of us in that they behave differently in different settings. So Dr. Testa says a lot of her patients will have their prison meds and their street meds. An example of that is called xyprexa. Zyprexa is an antipsychotic medication and it's really sedating. Some of my patients, they go zyprexa, that's my jail med. They feel like they can cope with their environment. They're more calm. They're less likely to overreact to other inmates and get in trouble and get in the hole if they're like a little bit sedated while they're in jail. But as soon as they hit the streets, they say, I'm not taking zyprexa. That's jail meds. I want Abilify. It treats psychics. But Abilify doesn't usually cause sedation. And so people will tell me, like, I need to be alert.

I need to be able to watch my back. I need to be able to react. Right now, Dr. Testa knows exactly what's going to help Bobby on the street because she's treated him in the past, a strong dose of an antipsychotic drug, an injection that lasts him for a month at a time. I can say, like, we know you need your shot. Come on in and get your shot. But right now, when he's so grandiose and he's so.

amped and he's so into his delusions and it's hard to come at him that way. And every day he's out there without treatment, he's harder to reach. It's not like no one is trying to solve this problem. The medical director at the county jail says even when they released 900 inmates in March, their staff worked, quote, tirelessly to link inmates with the help they needed. Ohio and states across the country are spending hundreds of thousands of dollars on program to identify inmates with mental health problems and connect them to services.

The problem is, even in the best of times, success rides on a patchwork system. It depends on what prison or jail you're in, who evaluates you, the judge who presides over your hearing, your parole officer, your social worker. It's Annette. It is currently 202.

While she continues to look for Germain, Annette sends me updates about other cases she's working on too. And there's this one that gives you an idea of the lengths to which she can go to smooth the way for someone when she knows ahead of time they're coming out. I have an email from the institution where one of, well, one of my clients who's getting out on Friday. She's already done the hard part. She has a treatment plan and a group home in Cleveland. But now there's this minute detail of just how to get the woman from the prison three hours away to her new home.

They're not able to transport people. The parole officer tells Annette they're putting her on a Greyhound bus. So I'm like, okay, well, what times the bus is going to get back in here? Like the Cleveland? The bus isn't even getting in here until like 11.30 at night. What the hell am I supposed to do to help somebody at 1130 at night? How am I going to get her from the bus station in Cleveland to her group home, which is not close? This makes no freaking sense to send someone on the Greyhound,

who's very been identified of having mental health issues. like, let's put them on a bus and say, figure it out. Like, what? What? So Annette, who I should say is also a member of the National Guard, she did a tour in Afghanistan. She's kind of unstoppable. She keeps emailing and calling prison staff, the parole officer, trying to get an answer from the warden. And two days later, here she is.

Hey, it's Annette. It is currently 1157 in Friday. Driving to meet her client, and it's noon, not midnight, as originally, planned. She was getting transported up here by the officers. Continues straight. And stay to the left to a 77 north downtown. Which is really awesome. Thank you, GPS. And so now I'm like rushing to get there. Annette got the warden to agree to send the woman to Cleveland in one of the prison's big white cargo vans and to give Annette an ETA. So she's timed things so exactly that she thinks she sees

the van driving right behind her. Ah ha. Ha ha. I have good timing. Apparently, I am a miracle worker. Turn right on Buckeye Road. Hey, it's Annette. It is right around 11 o'clock. Annette is still trying to track down Germain, 12 days after he was released from jail. And then, out of the blue. He called me today. Yay! I'm so excited.

And I'm going to go try to see him today at the shelter. I'm really hopeful he is there. But yeah, just was really cool. excited, wanted to share that. He has found his way to a homeless shelter, managed to get a cell phone that he called her on. Okay, that's the end. And the next day... I'm going to take it off to speak your phone right now. I'm going to hand the phone.

Just Germain. We're listening to Annette Amistadi, a Cleveland area social worker and one of her clients, Germain. Our story continues in a moment. This is the New Yorker Radio Hour. This is the New Yorker Radio Hour. I'm David Remnick. We're going to continue now our story about mental illness and prison. and what it means when inmates with mental illness get released. Over the last few months, many states have tried to reduce the populations in their prisons and jails

because of COVID-19. It threatens everyone who lives and works in prison. But for some inmates, prison may also be the only place they've gotten consistent treatment for mental illness and addiction. A former inmate from Ohio named Glenn put it this way. My reaction is they're in trouble. For the guys like now that are getting kicked out of prison, basically, with this coronavirus, they can't get in no place. There's no place they can go.

WNYC's Marianne McKeown continues our story. When Annette, the social worker, finally manages to meet up with Germain, she finds out the full story of what happened. Hello? Yeah, can you hear me? Annette has known Germaine for a while. Last year, when he came out of prison the first time around, she and Dr. Testa did a lot for him. They set him up right away with an ID,

applied for Social Security. He tried living with his mom in public housing, but caused too much trouble, and she had to kick him out or risk being kicked out herself. Annette was still trying to get him into the right program, but in March, Jermaine says he broke into a liquor storm for a drink. I had caught a break in every case,

and I got locked up. and they was letting people out. With COVID hitting jails and prisons, the county was trying to move people through fast. They was trying to stop it from spreading. So they was letting people out with lower tear felonies. They were letting people out or reducing their bonds. So that's how I got out.

And when they said they were going to let you out, did they ask you, hey, do you have a, any mental illness or addiction problems or do you have a place to stay? Did they check with you about that stuff? Yeah, they know. They had records of it. The social worker come talk to me about it and ask questions and they gave me medication to leave. They gave me prescription. I got to feel it's enough for two weeks, I think, two, three weeks. And they knew you didn't have a place to stay either. Yeah. I'm supposed to go to the treatment center. But then... They just let me out. They just scrapped all that and it was just me. I had to do my own my own. So I went to 2100,

lakeside. 2100 is a shelter? Yeah, I was in there before, so that's where I knew where it was at. So they let you out of jail early because of social distancing, but then you had to go to a shelter where that was impossible? Yeah. There's no way to practice social decisions in a homeless shelter. Were you sober when you came out? And then were you able to stay that way? Yeah, for a little while, and it went back to the same thing.

What did you do? As far as drugs of alcohol, GCP, crack, alcohol. alcohol. That is how it is. If you're dealing with things, go back to what you used to. All right. Is Annette? Right around one o'clock.

At first visit with Germain, Annette checks in from her car after they see each other. Of course, he has no clothing because when you go to jail, you lose all your clothing. And before that, you was at his moms. And of course, she threw all that away because she's sick of him. and so had to look into places that he can go get clothing on his own because I can't take him to get clothing. He lost his ID. He lost all the stuff we spent the last year getting him because he did some really stupid stuff. But now I have to go figure out how I'm going to get him in to see the doctor, get his meds figured out, get all that other stuff figured out because now that I located him, I kind of have to stop. start all over.

There is one piece of good news. He told me that the shelter is putting him in a hotel tomorrow. So I did not know this, but the shelter is putting people in hotels because they can't social distance and stuff down here, which is pretty freaking awesome. So fingers crossed, he calls me tomorrow like he's supposed to. And then I guess we'll go from there. Now on to the next person. Annette is so persistently hopeful.

But the next time she tries to get in touch with Jermaine, his phone line is dead. The telephone number you have dialed is temporarily not in service. A few days later, he leaves a voicemail. He's in the hotel the shelter moved him into. Getting in the elevator here to see if I can find him. She gets to his door. Oh, I'm sorry. Is Dermaine in this room?

He's not there? He's not there? Okay. All right, thank you. Mind if I just push the down button really clear? Oh, go ahead. Excuse me? So Jermaine is missing again. Annette, his social worker, is playing catch-up.

And the array of programs and people that could potentially help Jermaine, in a lot of ways they are all part of a much bigger and longer game of catch-up. A response to choices our country has made across two centuries. I think we as a society, we have pushed mentally ill people off into certain places. So first it was asylums, they needed a therapeutic place, and we pushed them there. And then when we decided that was inhumane, we let them out. But we failed to create a nationwide network of mental health centers that was supposed to replace them. And in the decades to come, we turned increasingly to the criminal justice system to address all kinds of problems.

We criminalized addictions, and we criminalize a lot of mental illness behaviors, like nuisance behaviors, just hypercriminalized all of it, and we pushed all these people away again. And the problem is, when people get out, we don't have our arms open for them. We just simply don't. They do fall in the crack. Should we have this problem?

No, but we do. So, like, you're trying to reply for all this stuff and everything's, like, pretty much, boom, close. It's been almost a month since Dr. Testa was sitting here in her office, and that former patient she's calling Bobby. telephoned her out of the blue from a bus, high on delusions about owning several banks. I know. It's like anything you try to do right now. He called a lot after that.

And she started using what they call motivational interviewing to try to get him to come see her in person, which he finally did for a first appointment. Yeah, I would love to see pictures. Whenever you can come in the next time, it'll be like, great. She says by that time he'd already gone from that manic state to something much less happy. We call it dysphoric. It's like this irritable, paranoid state where he, whereas he had told me that coronavirus was no big deal. It was like a fake thing that the government was putting out there and it wasn't even really a harm to him. He started really like fixating on that it was still fake, but that it was sort of reflective of this like religious war that was going to happen and there was Wiccans involved. And what I said was I said, I remember that you had some of these ideas in the past. And I could be wrong, but it's my recollection that when you took Risperdall,

you started to think, like, why was I even thinking that? Like, why was I even feeling that way? And so he was willing to take, like, a light dose of the Risperdall. And so I was able to start that medication for him. Annette, the social worker. It's still so frustrated by what she's not allowed to do because of COVID. She keeps sending dispatches from her car venting about this or that challenge. Turn left on St. Clair Avenue.

Here I am debating, do I get in trouble and transport somebody when the agency says I'm not allowed to because of the six-foot rule thingy, right? Or do I do it to ensure my client's taken care of? One encouraging development, she has managed to talk to Germain again. and set up a time to meet back in that hotel room, the shelter moved him into. Put on my mask. All right, here we go. Fingers crossed. I'm hoping.

I'm truly hoping. She heads up in that same elevator. The smell of marijuana. Super potent, so this is fun. And then she's outside Germaine's room again. See how this goes. I hear something. Yay.

Germaine. She's finally found him. So you got your own room then? Yeah. Okay. Okay. Germain has a full-size bed to himself. He's got no roommate right now.

There's a TV on a stand. And when they call on Annette's phone, Germain tells us he's been turning to a channel that when you think about it, is either terrible or wonderful for someone like him. HGTV, home renovation shows. The Scott brothers, where it's property brothers or how to build the houses and how they do the houses and stuff.

Oh, like the home improvement things? Yep, I like to watch Chops. I love that show. I don't cook for shit, Germaine, but I like to watch it. Meals are delivered to Jermaine's door every day. Lunch time. It's a mishmash. There's a tub of peanut butter, piece of peach cobbler.

In the fridge, Jermaine has a big hunk of orange cheese they brought one day. What is that? A whole thing of cheese. It gave us just yesterday. Like, what are you supposed to do with that? That's like, what, a pound of cheese? I don't even know, two pounds of cheese? That's why I see it.

Well, you know what? I know it's weird, but it's food. You know? Now that Annette has found Germaine, she's lining things up for him, starting with his social security application so he can have some income. But Germain is stressed out.

He just doesn't know what's coming. The world outside is still mostly shut down. He doesn't have a phone, says someone took it. And honestly, he says life felt easier when he was locked up. Yeah, you ain't got that many worries in there. You don't have to worry about the clothes and nothing like that. So does it feel harder now than when you were inside? Yeah.

Yeah. What's better about it? You ain't got to know the pressures. You know what's coming to you and stuff like that for us. You ain't got to worry about nothing. Mm-hmm. Did, when they told you that you were going to get out early from jail, what was your feeling about that? You got to go back to struggling and stuff, so. Would you have ever told them that you wanted to stay in?

No, you can't. Yeah, I do. Try how you can't. You did try? Yeah, they ain't about to let you do that. You can't do that. When Dr. Testa first became a forensic psychiatrist, she says she used to congratulate new patients. Like they would have their first visit with me being released from jail or prison and I would be like, how awesome that you're out. Like I would just come right out of the gate with that. And for a lot of people, it is not awesome that they're out. Dr. Testa is a big advocate of prison reform.

She is definitely on the side of we should not be locking so many people up, especially people with mental health problems. But given the way the system works now, she's finding herself at odds with people saying, this is the moment for change. It feels really bad to be like, guys, I can't be with you on this one. I think it's a bad idea. I wish that COVID was this golden moment and this is the time and now we're going to decarcerate everyone. That would be really awesome. We should have already been looking at this. We should have already been decarcerating.

This is long overdue. We should already be doing this. But to want to do it at warp speed in the middle of a pandemic, that's where I get frustrated because it's hard enough when someone comes out. And right now, now is just not the time. Like many states, Ohio is beginning to open up. But there is still so much chaos. Courts are still holding video hearings.

Probation and parole are still mostly on the phone. Annette still can't drive people places. And many of the organizations like hers that serve people with mental illness and addiction are now more financially strapped than ever. I mean, I think it feels really bad as a society right now that we have all these people vulnerable. Now we have a pandemic and now we're having to look at all that. But I don't think a lot of people are looking at like, oh, this is what's best for this person. Like, let's get them out. If we were thinking about it that way, we would already done this.

back in the 60s and 70s, when states across the country were trying to shut down big mental institutions, the idea was to put the money saved toward helping people live independently, put it toward treatment and counseling, and also housing and income. But the money didn't end up following the patients. Now, if we're going to release inmates with mental health problems from prisons and jails, the question is, again, can the money we were spending, to hold them in custody, go instead toward helping them live on their own. Will the money follow the patients this time? Reporter Marianne McCune. Our story was produced in collaboration with WNYC's program, The United States of Anxiety.

I'm David Remnick, and that's the New Yorker Radio Hour for today. Thanks for joining us. See you next time. The New Yorker Radio Hour is a co-production of WNYC Studios and The New Yorker. our theme music was composed and performed by Merrill Garbus of Tune Yards, with additional music by Alexis Quadrado. This episode was produced by Alex Barron, Emily Boutin, Ave Cario, Riannon Corby, Calalia, David Krasnow, Caroline Lester, Gauphin and Putubuele, Louis Mitchell, Michelle Moses, and Stephen Valentino,

with help from Alison McAdam, Mengfei Chen, and Emily Mann. The New Yorker Radio Hour is supported in part by the Cherina Endowment Fund.