He Was Sick, So They Sent Him to Prison

New York jails can transfer people with mental illnesses to maximum security prisons, even while they’re legally innocent.

Chris Gelardi   ·   December 21, 2023
The back of an open prison transport van
Jail officials say they're transferring people to prisons for their own safety. Those people get funneled into a system notorious for violence and medical neglect. |

Alex Mirzaoff needed help. His bipolar disorder had been getting worse. A judge from a mental health court in Rochester, where the 29-year-old had regular appearances for past shoplifting charges, decided that he had become dangerous and needed full-time care at a supportive housing facility.

The closest group home had a waitlist, so the judge sent him to the county jail. But the jail wasn’t equipped to provide Mirzaoff with the care he needed.

The sheriff found a solution in a process called “boarding out.” He sent Mirzaoff, who hadn’t been convicted of a crime, to Attica Correctional Facility, a maximum security state prison. Most boarding out occurs when officials transfer people between county jails, which hold people awaiting trial and on short sentences for minor crimes. But every year, they send dozens more to state prisons, throwing them, temporarily, into the brutalities of long-term confinement.

After over three months of incarceration, the judge ended Mirzaoff’s case and sentenced him to time served. But the damage had been done: By the time he went home, he had gotten a broken nose, his diabetes was out of control, and his mental state was worse than when he entered.

“What he’s been put through — it’s not just bipolar anymore. His brain is broken,” his mother, Robin Mirzaoff, told New York Focus. “This is not my son.”

Across New York, the majority of defendants boarded out to prisons have severe mental health problems or behavioral issues. The thinking, according to authorities, is that while jails have limited resources and offer temporary accommodations, the state prison system has the facilities and 24-hour medical and security staff required to treat and house those with significant needs.

“If we can’t do it — if they’re damaging things and we can’t handle them — it’s for the inmates’ safety that we’re getting them out of here,” Madison County Sheriff Todd Hood told New York Focus.

In reality, they get funneled into a system notorious for violence and medical neglect. Some, like Mirzaoff, end up in general population units or solitary confinement. Their conditions deteriorate. In recent years, at least one has died.

“Solitary is just not right or built for people. You can’t retake your mind from the hurt of knowing that the outside world is going on without you.”

—Alex Mirzaoff

According to records obtained by New York Focus, 23 counties sent at least 56 people in their custody to state prisons between December 2022 and mid-September. Three-quarters were for mental health or behavior reasons. At least one was imprisoned for going on a hunger strike.

They disappear into a little-known wrinkle in the carceral system. Given special prison identification numbers, people boarded out from county jails don’t show up in the prison system’s internal rosters or online portal. When asked for more data, the prison department directed New York Focus to file a public records request, which takes months to fulfill.

“I reached out to the news, I reached out to different law firms, and everybody thought I was making this story up,” said Shonday Williams. Her brother spent nine months at Attica, pretrial, in 2018 and 2019 after the Genesee County Sheriff’s Office decided it couldn’t deal with his schizophrenia and bipolar disorders. “I’m like, ‘No, he hasn’t been convicted of anything. He’s just being housed there,’” she said.

Counties could largely avoid the practice by sending people to state-run psychiatric centers — but it costs too much, said Hood. Inpatient Office of Mental Health facilities charge counties at least $1,100 per patient per day, and will up that rate to nearly $1,300 starting next month. For patients under 18, it’s more than $2,900. The prison system, on the other hand, doesn’t charge anything.

Even though they haven’t been sentenced, it’s legal to out-board people with special needs to prisons — at least for now. This month, state Senator Julia Salazar, who heads that chamber’s corrections committee, introduced a bill that would ban the practice. Senate and Assembly committees will consider the bill after the legislative session begins next month.

“People should not be transferred to state facilities because of bureaucratic barriers, like OMH billing counties an exorbitant amount for treating an incarcerated individual,” said Salazar. “Somebody who hasn’t been given a prison sentence just shouldn’t be in prison.”

Mirzaoff started going downhill near the end of 2022. He couldn’t sleep, according to his mother, and spent most of his days walking around their suburb of Rochester, talking to himself. He would quickly transition from manic episodes, laughing hysterically, to bouts of severe depression and back again.

His doctors tried switching his medicine, but that only made things worse, his mother said. He started hallucinating and expressing angry, violent thoughts, so his family made calls to a mobile crisis team, the police, and authorities who could facilitate court-ordered treatment. At first the mental health officials said they couldn’t do anything, but Mirzaoff’s episodes got bad enough that they hospitalized him twice.

In late June, Mirzaoff had an appearance at mental health court. At that point, according to his mother, he was on the upswing — the result of another medication change. But the judge saw the hospitalizations and the reports of aggression and ordered Mirzaoff committed. His family said they would have welcomed his transfer to a group home, but since the home was full, the court put him in jail.

Within hours, another incarcerated person attacked him, breaking his nose in three places, according to an affidavit his mother filed in state court. Staff immediately isolated him.

“I begged the people at Attica to please get Alex to a hospital.”

—Robin Mirzaoff

Mirzaoff spent 61 days alone in a cell, said Robin, his mother. “He could see other inmates, and I guess they could hear each other talk, but they would not even let me give him a book,” she said. “They wouldn’t even let him have a Bible.”

In a statement to New York Focus, a spokesperson for the Monroe County Sheriff’s Office denied that it had held Mirzaoff in isolation for so long.

Eventually, Robin learned about a relatively new law, the Humane Alternatives to Long-Term (HALT) Solitary Confinement Act, that placed strict limits on the amount of time prisons and jails can hold people in solitary confinement. It also banned facilities from sending people with any mental illness to solitary. As New York Focus recently reported, jails have found ways to sidestep the law: In Monroe County’s case, Robin alleges, jail staff told her, “We don’t call it solitary confinement. We call it isolation.”

Still, she told the jail that what it was doing was illegal. Then staff sent Mirzaoff to prison.

Robin blamed herself. “I caused this,” she said. “They moved him to Attica because I did that.”

“The Monroe County Jail does not engage in the practice of isolation or solitary confinement, as defined in the NYS HALT Act,” the sheriff’s office spokesperson told New York Focus.

“Solitary is just not right or built for people,” Mirzaoff said in an interview with New York Focus. “It’s so depressing on the mind. You can’t retake your mind from the hurt of knowing that the outside world is going on without you.”

While Mirzaoff was at Attica, he was technically in Monroe County custody — subject to a “substitute jail order,” which lets local jails house people elsewhere.

Jails mostly employ the maneuver when they’re overcrowded or need to separate people for security reasons, sending incarcerated people to other jails in neighboring counties. But if they deem that jail is “unfit or unsafe” — like for someone with significant mental health care needs — they can board them out to the state prison system for up to 30 days. After that, they need a state-level oversight body to sign off on the arrangement.

A spokesperson for the oversight body, the State Commission of Correction, said that it had not denied a substitute jail order in the past three years — as far back as the agency’s records go. (As New York Focus reported this week, the commission rarely uses its power to hold jails and prisons accountable.)

Asked if it has the capacity to treat people with severe mental health needs, a spokesperson for the prison department replied: “Yes.”

According to the dataset that New York Focus obtained, several people had been imprisoned pretrial for upwards of six months when the numbers were compiled. Two had been in prison for over nine months. Among those who had been released, sent back to the county jail, or sentenced to actual prison time, the average pretrial prison stay was 68 days.

Asked whether it believes it has the capacity to treat people in county custody with severe mental health needs, a spokesperson for the prison department replied: “Yes.”

Williams’s brother, Plush Dozier, was 23 years old when Genesee County sent him to Attica. The prison is designated to provide the highest level of mental health care, but he was sent to solitary confinement, where staff beat him, he and Williams alleged. Williams’s weekly visits to the prison horrified her. “He couldn’t even open his eyes,” she said.

He had tried to take his own life in jail, and in prison, he threatened to try again.

A year and a half later, in November 2020, Cattaraugus County in western New York transferred 34-year-old Andrea Jackson to Albion Correctional Facility to get 24-hour nursing care for a seizure disorder. She spent most of her prison time in isolation for “harassment” and creating “disturbances.” Her first offense, according to a State Commission of Correction report: “She placed a soiled sanitary pad against a window and stated, ‘What do you want me to do with this bloody pad?’”

Six weeks after Jackson entered the prison, an officer conducting rounds in the solitary confinement unit found her on the floor, her bed sheet tied around her neck. Staff tried to resuscitate her. She died four days later.

Robin went to Attica, roughly an hour drive from their town, as often as she could, staying the entire five hours she was allowed to visit with her son. She saw his condition worsen in real time: He was confused, talking to himself unintelligibly, she wrote in a court affidavit. He couldn’t gather himself enough to play a card game.

In addition to his mental illness, Mirzaoff suffers from diabetes, and Robin asserts that he wasn’t getting his medication — a common complaint.

“His fingernails would be blue at the back because of lack of circulating oxygen,” she said. “He would be so clammy and sweaty. I begged the people at Attica to please get him to a hospital.”

She eventually threatened to call the police. Shortly after, prison staff moved him to a special medical wing, and his condition somewhat improved, she said.

In Robin’s eyes, the most tragic part of her son’s ordeal is that it all could have been avoided. The week he entered jail, she got a call from the group home: A spot had opened up. Workers at a court-appointed clinic said they’d facilitate his transfer, but never did, she said. She tried contacting the court liaison, but couldn’t reach anybody. Mirzaoff appeared in front of the mental health court judge in early October.

“He said to him, ‘I’m so sorry this has happened,’” said Robin. “He just didn’t know how this could have taken place.”

December 21, 2023 — This story has been updated with a statement the Monroe County Sheriff’s Office sent after publication. The office declined to elaborate on Mirzaoffs case, citing HIPAA regulations.

Chris Gelardi is a reporter for New York Focus investigating the state’s criminal-legal system. His work has appeared in more than a dozen other outlets, most frequently The Nation, The Intercept, and The Appeal. He is a past recipient of awards from Columbia… more
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