NYC has found a way to balance mental illness and criminal justice, but it’s a path closed to most

In the years before the NYPD arrested Reza Mashayekhi for hurling rocks through embassy windows in Midtown in 2020, he’d been tortured in Iran under suspicion of spying for the CIA, walked across America, and lost his father at a time when he needed him more than ever.

He had no money, work, or community when he arrived in New York after a cross-country voyage and more than a year without access to health care critical to his mental stability.

“I threw rocks through the consulate with no reason,” Mashayekhi, 37, told the Daily News. “The paranoia was bothering me.”

Then, he got lucky.

Mashayekhi’s lawyers succeeded where many have not, convincing prosecutors to refer his case to a special mental health court in NYC that connects participants with community-based clinical care and supervision, housing, employment, and educational opportunities.

After months of sitting on Rikers and in Bellevue’s prison ward, Mashayekhi was released from custody in February masha once his court-mandated treatment plan was ready. Now, three years after his arrest, he’s in control of his mental health and working in a job he loves.

Mashayekhi’s case points to an important but not widely discussed reality: New York City has actually figured out a model to better balance law enforcement and mental health treatment, a problem that has long vexed the criminal justice system, according to both experts and data.

But access to this program, despite its successes, is highly limited, with most defendants who need psychiatric help stuck in a nightmare loop that has turned Rikers into what many have described as the city’s largest de facto mental health facility.

Mashayekhi shares the ongoing medical needs of many in New York City’s jails. The city has estimated that over 50% of the Rikers population had a diagnosed mental health disorder, with 16% classified as severe.

But few of Mashayekhi’s counterparts get access to a third lane that’s working for many.

Funding and case outcomes in the mental health courts are difficult to pin down, but some of the available data paints a clear picture. In fiscal year 2022, Brooklyn’s felony mental health court handled around 250 cases, Manhattan handled around 75, and Queens had 41. Staten Island took on 44 new cases.

The numbers don’t capture everyone with a mental health issue receiving specialized care through the courts, but they do represent a small fraction of everyone in jail who the city says has a diagnosed mental health condition. Mayor Adams’ office said more than 50% of people in city jails had mental health issues in fiscal year 2022, around 2,779 people.

The program is hard to get into because resources are in short supply — both in the courtroom and the community. The mental health courts aren’t codified into law so they are forced to rely on whatever funding the city and state are willing to commit to, which isn’t much. Despite signs the program works, the support has not followed.

That has created a patchwork, with vast disparities across the five boroughs; where someone gets arrested plays an outsize role in whether they’ll succeed in getting their case referred.

Brooklynites are most likely to succeed. Judge Matthew D’Emic has presided over the borough’s mental health court for 21 years and stretches resources to accommodate 300 participants at a time.

“If anything, they turn us down,” D’Emic told The News. “We look for reasons to help people.”

On top of people with severe mental health issues like schizophrenia and bipolar disorder, D’Emic started accepting people with intellectual and neurodevelopmental disorders, such as autism and ADHD, after getting a federal Bureau of Justice Assistance grant in 2019 for more than $700,000 to be paid over three years.

“We’ve expanded to accept that population as well, which of course, allows us to do some things that can help people who I don’t believe belong in the system in the first place,” D’Emic said.

Manhattan’s funding is supposed to cover around 50 defendants at a time, but Manhattan Supreme Court Justice Juan Merchan and his resource coordinator, Amber Petitt-Cifarelli, typically stretch resources to accommodate 75 to 80. The city-funded agency that handles their contract, Education and Assistance Corporation, had $500,000 last year to pay psychologists, psychiatrists, case managers, and everyone involved in achieving treatment plans.

Petitt-Cifarelli said Manhattan is eager to take on more cases, but more resources are needed.

“As we’ve increased, we’ve seen waiting times increase,” she said. “Even if we can double capacity, we have to have a place to send them for their treatment.”

A spokeswoman for Adams said his office supports the state expanding the courts and that the city vendor with Manhattan’s caseload has room for more participants — she attributed limitations to a lack of judges and court calendars.

Office of Court Administration spokesman Lucian Chalfen said the model could expand if the state provides an allocation to hire resource coordinators in every county and more money is directed toward service providers.

In its $3.3 billion budget for the fiscal year 2024, OCA is slated to receive $16.3 million toward operating all the various treatment courts. About $6.3 million of that will go to ones in New York City, which include the drug courts, veterans courts, domestic violence parts and DUI courts.

Ahead of budget day on April 1, there’s an effort to convince the legislature to double the treatment courts’ budget by $16 million to expand eligibility for people with mental health disorders. It would address staffing and beef up services. The budget request has bipartisan support, according to Sen. Jessica Ramos (D-Queens), who’s trying to get more co-sponsors for related legislation.

“We know there is an appetite to expand diversion courts. Now the work is to pass the Treatment Not Jail Act and equip every part of our state to connect New Yorkers with the help they need,” said Ramos.

Gov. Hochul hasn’t taken a position on expanding the mental health courts.

Another barrier to entry is the type of charges a defendant is facing.

Facing violent charges presently or in the past often makes it harder to get a case referred to mental health court, but there’s no rule against them. In Manhattan, the most common charge prosecutors refer to the court is second-degree assault.

Merchan and D’Emic said they accept violent cases when someone demonstrates commitment and the court can devise a viable plan.

“We’ve had some kind of special circumstances, like for arson or attempted kidnapping, where the DA will allow it to come into the court but require a more lengthy court mandate,” Judge D’Emic said. “The worst candidates are ones that have done long, long prison terms.”

Manhattan has opened the door to a diversity of new cases since District Attorney Alvin Bragg created the Pathways to Public Safety division, which proactively works to identify candidates rather than waiting for their lawyers to ask.

“Connecting people with treatment helps them, which by extension helps their families, which by extension helps our neighborhoods and keeps us all safer,” Bragg told The News.

But the DA said there were limitations in referring defendants with severe issues absent more resources.

“There are a number of times when someone’s got a mental health issue, and we just don’t have an appropriate treatment vehicle available to us,” Bragg said.

While there’s no hard and fast rule against taking violent cases, people with severe needs require intensive treatment plans that current budgets don’t allow on a wide scale. Merchan said bigger service providers with more resources are needed to expand the courts.

“Before we can even talk about expanding it and taking on more people, we gotta have the resources,” Merchan said, who’s presided over Manhattan’s mental health court since it was established in 2011.

“We’re not doing anybody any favors if that person is just going to get sick again; that person is just going to commit crimes again. God forbid the crimes are violent. We don’t want that.”

Advocates for expanding the mental health courts model say it promotes upward momentum and is safer than sending an unstable person into chaos on Rikers — where their issues often go unaddressed or are poorly treated — and then releasing them back into society.

Violence has skyrocketed at the decrepit jail where 19 died last year. In March, a federal monitor’s report described “persistently unsafe” conditions at the facility, squalid conditions, and detainees routinely delayed access to medical treatment.

Many included in 2022′s death toll died by suicide, including 31-year-old Michael Nieves, who had long struggled with mental illness. The News in September reported that Nieves self-advocated to move his case to mental health court in vain weeks before fatally slitting his throat with a DOC-issued razor.

To succeed in getting a case referred, participants are required to admit their guilt. The DA’s office oversees an initial clinical evaluation, and then, if they agree to refer the case, the court conducts its own, which takes about six weeks.

The judge then works with the defendant, their lawyer, prosecutors, and clinical service providers to tailor a court-mandated treatment and supervision plan that connects participants with housing, education, employment, and access to residential programs, rehab, counseling, and pharmacological services.

D’Emic said a man who appeared before him years ago for attempted murder as a hate crime opened his eyes to how the courts could aid people with mental illness charged with committing violence. The man was accused of stabbing someone and yelling slurs at them.

“I remember the defense attorney came up to the bench with the DA. And I looked at him, I said, ‘I don’t want this case,’” D’Emic said. “It was his first psychotic break; he was in his twenties. And the experts told me that’s not unusual, that that’s the age where you can develop a serious mental illness.”

D’Emic was glad his hesitations proved wrong.

“I often say that I can’t do this job afraid, but you certainly have to be careful. And so he really did quite well. Very shy young man, too,” D’Emic said. “I think it’s a good example of how the court can work optimally. He graduated several years ago, and nobody’s heard from him since — in a bad way.”

Administrators don’t track system-wide data on the mental health courts. But figures in Brooklyn, which has had 1,851 participants since 2002, shows the model that worked for Mashayekhi has for many others.

Last year, 82% of participants — facing charges like assault, robbery, drug dealing, and weapons possession — graduated after complying with all mandates. Of the current participants, 71% comply with mandates, and 30 are in jail and expected to be connected with services when released. There are 14 with outstanding warrants.

Data by the Center for Justice Innovation shows participants in Brooklyn were 46% less likely to be arrested than their peers in regular criminal court and 29% less likely to be convicted.

“The model that we have here and the model that we have throughout the state, and even throughout the country, works,” Merchan, who presided over Mashayekhi’s case, told The News. “I think the numbers prove that. It’s successful for us. Most of the people who have graduated have stayed out of trouble or have avoided serious trouble afterwards.”

When Mashayekhi completed his court-mandated treatment plan and graduated from mental health court in September, his conviction was vacated, and the charges were dismissed.

But though his case ended, his services — and follow-up care — continue. He still lives in supportive housing and meets his Assertive Community Treatment team.

“Even now, I’ve finished in court, they come and visit me twice a week,” he said.

Mashayekhi has ongoing access to counseling and psychotherapy. He lives in supportive mental health housing, which the avid home chef fills with Persian aromas from gourmet cooking recipes sent by his mom. The court’s plan helped him find work as a server at a Middle Eastern restaurant, where he’s a favorite among the regulars.

Mashayekhi’s Legal Aid Society lawyer Jeffrey Berman said he’s a prime example of what can happen when the justice system addresses mental illness’s role in a case. And how profoundly different the results can be when someone at the nexus of the criminal justice system, homelessness, and mental illness is connected with housing, employment, and community-based care.

“Incarceration is traumatizing and destabilizing. People languish inside jails and prisons with inadequate mental health treatment and medical care while exposed to violence, trauma, and rampant drug use,” Berman said.

“And then they emerge into shelters or the streets and are expected to obtain housing, treatment, jobs, and benefits while navigating the adverse consequences of their criminal conviction.”

Mashayekhi said he couldn’t imagine what his life would look like had his case proceeded the traditional way, where he couldn’t find a path to stability.

His journey to the United Nations on E. 42nd St — which he was sleeping outside the summer he was repeatedly arrested for vandalism and trespassing — was a long one.

Mashayekhi said he and his late father, Amanullah Mashayekhi, a distinguished commander in Iran’s Revolutionary Guard and a reformist, fled their native country after they were imprisoned and tortured.

He was granted political refugee status by the United States in 2011 and believed his horrific journey had ended when he landed a laboratory job at Thermo Fisher in Santa Clara, Calif. The gig earned him enough to rent a nice apartment, buy a car, and send money home to his family.

But it would all be derailed by the timing of Mashayekhi’s onset of schizophrenia and his father dying of heart troubles. Ravaged by grief and paranoia, he drifted across the U.S. for a year and a half. He landed in a New York City jail cell after shattering doors and windows on E. 49th St.

“Even in the mental hospital, one of the employees, we were talking, and I ask him, if I [am] released, where should I go? I don’t have mom. My father passed away. I don’t have family. No money. No home,” he said.

“He said a lot of people come back to jail because they release them with no support,” Mashayekhi added. “That time, I was scared a lot for how long I’d have this experience.”

Had it proceeded the traditional way, Mashayekhi’s lawyer Elizabeth Skeen said he likely would have taken a plea deal like most defendants and landed back at square one. “He just would have been repeatedly criminalized,” Skeen said. Instead, when he got out, Mashayekhi “started planning for the rest of his life instead of the next day.”

D’Emic is proud of his work he’s achieved in his storied mental health court, but he worries its future is not set in stone.

“The problem with that is that the judge decides they’re not gonna do a Mental Health Court anymore, or they retire,” D’Emic said.

“Then that’s the end of that.”