How Rikers Island Became New York’s Largest Mental Institution

One night in fall 2015, an 18-year-old woman was standing on a subway platform in the Bronx when a homeless man named James Dolo came up from behind and used both hands to push her onto the tracks, the police said, injuring her.

Jailed on an attempted murder charge, Mr. Dolo, then 38, soon was seated in front of a court evaluator for a review of his competency to stand trial. Mr. Dolo smelled of urine, the evaluator noted, had described a history of psychiatric hospitalizations and did not seem to understand the gravity of what he was accused of doing.

The evaluator marked him down as unfit, citing schizophrenia, and a judge ordered Mr. Dolo committed to a state forensic psychiatric hospital — a secure facility for incarcerated people — to be restored to mental competency. He spent nearly two years there before he was shuttled to a public hospital in Manhattan, and then to the city jails on Rikers Island, and then to the forensic hospital again.

Now, eight years later, having never been convicted of a crime in the subway shoving, he is back on Rikers Island, where guards once found him sitting in his own excrement and refusing to eat or leave his cell.

Mr. Dolo’s case, which has not been previously reported, illustrates one reason Rikers Island has become a warehouse for thousands of people with psychiatric problems: Many detainees with severe mental illness have moved back and forth between the jails and state forensic psychiatric facilities for months or even years before standing trial. Some have spent more time in this cycle than they might have served in prison had they been convicted.

Records show that more than half the people in city custody — some 3,000 men and women — have been diagnosed with a mental illness, and, on any given day, hundreds of them are awaiting evaluations or in line for beds at state forensic psychiatric hospitals, with scores more being treated at those facilities.