At Rikers, people with mental illness fall through the cracks over and over again

those that end up there.

Muhammad was an obvious candidate for diversion: He responds well to mental health treatment; he has a support system, namely a very supportive mother; and his prior criminal record was mostly low-level misdemeanors. Even his current crime was not very serious. The woman, his victim, was fine. Had she been younger than she was, it may well have been only a misdemeanor.

Muhammad did finally get diverted. But it took months of negotiations for his lawyer and social worker to find a placement for Muhammad — months during which he was locked up in an environment that some psychiatrists have described to me as psychotogenic, that is, psychosis-causing.

I’ve talked to numerous lawyers and social workers about the challenges of finding placement for clients in treatment programs, and again and again I hear the same thing: There aren’t enough spots, or the client is too sick or not sick enough or has a co-occurring substance use disorder or any number of other barriers.

At Rikers, Mohammed told me that he’d seen psychiatrists only occasionally and never saw the same one twice. The most consistent treatment he got was likely on the CAPS — Clinical Alternative to Punitive Segregation — unit, designed as an alternative to solitary confinement for prisoners with mental illness who repeatedly break rules.

This self-contained 25-bed unit is meant to function like a psychiatric ward in a regular hospital, with group therapy and other forms of treatment, and rewards for good behavior instead of punishment for behaving badly. When I visited, I watched an officer play ping pong with a prisoner and saw artwork on the wall of the cell-turned-therapists office.

The CAPS units, which opened in 2013, were a big improvement over both the regular mental health units and the solitary confinement ones where people were sent when they broke the rules; the irony was that a prisoner had to misbehave, and pretty badly, to end up there. So in 2014, the jail opened four units known as Program for Accelerating Clinical Effectiveness or PACE, essentially CAPS units, but for people who haven’t misbehaved.

Data suggests that they work: In their first three years, there were half as many use-of-force incidents on the PACE units as on other mental health units, half as many incidents of self-harm, and a 40% increase in patients taking their medication properly.

The trouble is, most people will never make it to a CAPS or PACE unit. Under the current plan, the city has budgeted more than $20 million to build several more units — for a total of 300 beds. But at current population levels, about 700 people at Rikers have a serious mental illness, and those who don’t win a spot on the special units will simply be sent to mental health observation units, which have far less programming than either PACE or CAPS.

Kyle Muhammad, it turns out, was one of the lucky ones in other ways, too. After nearly two years at Rikers, he was accepted into the Manhattan mental health court, an alternative program that allows participants to forgo prison if they meet certain conditions, usually taking medication, undergoing drug testing and regularly seeing a mental health clinician. Muhammad did well, graduating in near-record time.

But even here, we make things difficult for people like him: Because of strict eligibility requirements and small capacity, mental health courts currently accept only a minuscule percentage of those who could be could benefit from the program. There was some talk, for example, about whether the “violent” nature of Muhammad’s crime would disqualify him.

Even once he was accepted, there were barriers at every step. The day Muhammad was to be released from Rikers, the judge held a special session of mental health court to officially accept him into the program. Muhammad appeared in court wearing a shirt — delivered to Rikers by his mother in the days before the hearing — and tie, hands cuffed behind his back, clutching a clear plastic garbage bag that contained all of his belongings.

“How are you feeling today?” the judge asked. “I’m grateful,” Muhammad replied. “I’m thankful. God is good.” The judge set a court date for two weeks later, and wished him luck. But almost immediately, a call came from the Department of Correction, notifiying the clerk that due to a bureaucratic error, Muhammad was not, in fact, free to go.

The judge made a merciful decision to allow Muhammad to stay, handcuffed, at the defendant’s table rather than be sent back to the cells, and less than an hour later, another call came that Muhammad was free to go. But it was an inauspicious start to a new life where stability can still be elusive.

When Muhammad finally got out of jail, for example, the only way to keep his place on the waiting list for supportive housing was to be homeless. So instead of staying in the house that his mother shares with his sister, he lived in a shelter on Wards Island, which he was forced to vacate from early in the morning until late in the afternoon.

Despite the barriers, Muhammad has succeeded so far: He lives by himself in supportive housing and has found work helping people with mental illness navigate the system. But having watched him go through it — accompanying him to medical appointments, the Social Security office and other places — I attribute much of that success to his own drive and discipline, and to his mother’s unwavering support, not to the city or either the mental health or criminal justice systems.

Because of Rikers’ size and poor condition, the scale of its challenges is extreme. But it’s hardly unique in having far too many people with mental illness locked up in it, or having far too few resources to help them.

Closing Rikers is the perfect opportunity to address this crisis and turn New York from pariah into role model. But it requires finding new ways of thinking about the problem. We need to find ways to make it easier, not harder, for the Kyle Muhammads of the world to live in the community, rather than leaving them to be mistreated in jail. Roth is author of “Insane: America’s Criminal Treatment of Mental Illness.”