Beyond the Bridge: Evaluating a Novel Mental Health Program in the New York City Jail System

Objectives. We evaluated Beyond the Bridge, a novel mental health program in the New York City jail system designed to provide residentially based cognitive behavioral therapy in jail mental observation units. Methods. We used propensity score matching and a dose-response analysis. Outcome measures included reduction in violent incidents and fights, reduction in uses of force by corrections officers, reduction in time spent on suicide watch and incidents of self-injurious behavior, and increased length of community survival. Results. There were significant reductions in all outcomes when we compared program participants (n = 218) with an earlier cohort of patients residing on the mental observation unit before programming began (n = 413). However, when we compared program participants with a cohort of other patients residing on the units at the same time but who chose not to participate (n = 267), only time spent on suicide watch unit (rate ratio [RR] = 0.72; 95% confidence interval [CI] = 0.59, 0.89) and recidivism (RR = 0.70; 95% CI = 0.59,0.83) were significantly reduced. Conclusions. This evaluation and the model we piloted may provide useful information for other settings contemplating similar interventions.