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What would you do if you found yourself at Queens Plaza at 3 in the morning with $1.50 and a $3 Metrocard? Imagine that you had no home to go to, no family to call, no other money for food or clothes or a place to stay. Imagine that it was cold outside. Imagine that you used to survive off of Public Assistance or SSI, but now your case has been closed because you were in jail. Now imagine that you need medication to help you deal with psychiatric symptoms, and you don't have any, nor do you have Medicaid or any other insurance that will permit you to see a doctor or go to any kind of treatment program.

What would you do next? Would you panhandle for money for food, or steal? Would you go to an emergency room to get medication, or just try to do without? Would you sleep in the streets or go to a shelter? Would you freeze to death? These are the choices that face tens of thousands of New York City mental health consumers when they get out of jail each year. Anyone who's ever been to Rikers Island (the island where most of New York City's 14 jails are, and the largest penal colony in the world) knows what the discharge planning procedure is. People who have served days, weeks, months and sometimes even years in jail, when they reach their release date are driven to Queens Plaza between 2 and 7 AM, and dropped off with $1.50 in cash and a $3 Metrocard. Other people, who are sentenced to time served, are released directly from the court without even the subway fare to go retrieve their belongings that remain at Rikers Island.

In Brad H. v. City of New York, a class action lawsuit filed in August 1999, the named plaintiffs, seven mental health consumers who were also inmates of the New York City jail system, challenge the City's practice of failing to provide discharge planning to inmates with psychiatric disabilities in New York City jails. "Discharge planning," a fundamental part of all mental health services, refers to the process of planning for a consumer's transition from one setting to another and ensuring that the consumer will have ongoing access to the treatment and services s/he needs to maintain psychiatric stability.

At least 20,000 people with serious psychiatric disabilities pass through New York City jails each year. While in jail, inmates with mental health needs often receive at least basic mental health care; on any given day, thousands of city jail inmates receive medication and counseling for psychiatric disabilities. Most of these people are charged with relatively minor offenses. When their release date arrives, even inmates that have been taking powerful anti-psychotic medications such as Lithium and Haldol are released with no medication, no referral to out-patient treatment, no assistance obtaining Medicaid or other benefits, and no referral to shelter for the approximately 50% who are homeless. The results are tragic—without access to mental health services, supportive services, benefits and housing, ex-inmates/consumers find themselves in a hospital if they are lucky, back in jail if they are less lucky, or sometimes even injured or dead.

The city strenuously fought the case. In a memorandum opposing plaintiffs' motion, the city states, "Here, plaintiffs cannot demonstrate that defendants' failure to provide discharge planning will result in the requisite irreparable harm... While admittedly some mentally ill inmates may decompensate if they do not continue to receive treatment or medication, there is no evidence whatsoever that such results are certain to occur at all, let alone as immediately as necessary to sustain plaintiffs' claims." The city also argued that, because the named plaintiffs were mental health consumers, they were not competent to represent a class.

The judge took a different view. In his order, issued July 12, New York State Supreme Court Justice Richard F. Braun granted plaintiffs' motion for a preliminary injunction, and ordered the city to begin providing discharge planning services immediately. He wrote, "Defendants are not providing needed mental health services and other supportive assistance to Plaintiffs and the class. It is not only to their benefit to provide them with a discharge plan but to that of all of us if such a plan can aid at least some of Plaintiffs and the class to become healthier and thus more productive members of society who are not harmful to themselves and/or others." The City's lawyers have appealed Judge Braun's decision. The plaintiffs are represented by attorneys from the law firm of Debevoise and Plimpton, the Urban Justice Center's Mental Health Project, and New York Lawyers for the Public Interest.