tomorrow. i'm ali velshi "on target," the tale of two cities - the haves, or have not in new orleans. 10 years after katrina, and why the mentally ill are more likely to land in prison than a hospital. hospital. saturday is the 10th anniversary of hurricane katrina making land fall in louisiana. while the category 3 storm brought destruction. nowhere suffered more than new orleans. that's where the levy system that the city depends on failed, bringing kat as trafy to its

residents, some 12500 die the in new orleans, or nearby as a direct result of the storm. half the population was forced to flee the area. some never came back, in many places there was nothing to come back to. that compounded the mental trauma that many contend with, even 10 years on, particularly hard hit, is the african-american community, shrunk by almost 100,000 people since hurricane katrina hit. devastated neighbourhoods have been rebuilt. they are teaming with people. many are newcomers moving into the city after the storm. the sense of community defines people's lives, it's harder to rebuild. the changes left many new orleans residents feeling disoriented or unmoored. in the 10 years, they have revamped the levies.

opening new hospitals. university medical centers. it's meant to replace the charity hospital. once the primary center for treating illness before it was damaged during katrina. critics say the city failed to expand mental health services, when the need has grown. the new hospital says some beds are dedicated to patients in need of mental health treatment, the number is not nearly enough. in that sense, the recovery of new orleans is a tail of two cities. sure, the tourists are back, the city has new schools and hospitals for its citizens, the changes that gripped the city since katrina left some on their own. david ariosto has the story. [ ♪ ]

>> reporter: when it comes to jiving, new orleans, few are better versed than this man. he still lives here since 1943. neighbourhoods, hopes and hospitals, it's not what it used to be. 10 years after hurricane katrina, new orleans is a tale of two cities. >> post katrina a lot of people moved into new orleans, transplanted nementz l themselves and -- themselves and they don't know the city. >> reporter: many fled, never to return. today a full quarter of the residents moved here, after the storm. they are younger, wider and more educated according to a new study. many come in search of the jobs and new opportunity. and yet for old timers, the change is profound. rising costs have fundamentally changed the community that he remembers, preventing many neighbours from coming back

a lot of people were forced out of new orleans, can't afford the rent. if you live in you pay 33% more in housing. the rent is high. a third renters spend half their salaries on rent, twice the average. >> people from new orleans, some don't like what they see going on. we have been shut out of jobs. economically people are struggle stins the storm. since the storm, and the change in federal aid, there has been change, different schools, policing and stronger levies. >> as we build a biomedical complex, opening a hospital, we have people coming from all

over, because there are jobs higher. whether things really got better depend who you ask. four in five white residents says louisiana has mostly recovered since dzenan catic, three in five african-americans say it's mostly not. >> it's a two-fold story, there's improvement. you have a majority saying things are good, if not better. that shouldn't be forgotten. the second half is to remember not everyone is on the same page. >> nowhere is that divided perception more apparent than here, at the university medical center, a 1.1 billion high tech hospital that city leaders tout as an example of new orleans's recovery. >> it's re-establishing health care at a higher level than what it was before. a reinvestment in the community. >> essentially it replaced the shuttered charity hospital, offering state of the art care for patients across the region, we want to design a facility to

have destination services for cancer, cardiovascular, ear, nose and throat to be a draw. >> but critics say the new focus strays from the old mission, to serve low income residents and those without insurance, and provides specialty care. >> i understand the criticism, and the criticism would be, you know, that you can't both be bright and, you know, care for your fellow man. >> dr peter w is the interim chief officer at the interim medical center, and says hospitals have to cater to low income and high income patients if they want to survive. >> having a safety net hospital, and that buying all you are about, the only thing you do is care for. >> ntogens has no pernancy and no revenue stream. >> reporter: that's not room for

the mentally ill. the old hospital has 100 psychiatric beds. today, in the wake of a traumatic event like katrina, the new medical center has less than half that number, just 38 beds. >> pardon the pun, it's insane. this is the head of the new orleans police department crisis intervention team. the job was to identify those on the streets. prior to katrina i was handling mostly drugs and alcohol. after katrina, for two years, i dealt with a population that had never had a mental health issue, that was now suicidal, helpless and hopeless. >> today, for maybe, they remain. they were at times played out on the streets of new orleans. oftentimes there's correlation

between homelessness and the mentally ill. here in new orleans, the homeless population diminished. that doesn't mean that people are not living in pockets in streets. for those mentally ill. dash >> reporter: those that live on the streets have seen what it means when there are fewer places for the mentally ill to go. >> here, on this part of the bridge, she has a mental state. they'd take her to gaol. keep her in gaol. and determines where she's standing. coming back out. picking up what and living like she was living. >> and while conditions in new orleans have improved for many

after the storm. there are more and more words about those who may be left behind. >> david joins me now. david, the opening university medical center has been a long time coming. aside from the number of beds, the shortage we are talking about, will they provide the care they are promising. >> the sense is yes. this is a $1.1 million facility. state of the art care. this is something that new orleans needed for a long time. charity dates back to the american revolution, founded in 1776. it's been upgraded, but the less meaningful. the kind of care people are receiving, prior to the storm. it was not first rate care. this is a first rate top of the line hospital. is that spread out across the city evenly. >> since katrina shut the

charity, there's a number much community smaller operations, is that going to take some of the burden off. it's not clear. a lot of the psychiatrist after dzenan catic left. right now there's 2-3 psychiatrists in the city. louisiana is not an expanded place. there's going to be a leave there. it wasn't the only health facility shut down. it put a lot of pressure on to fill the gap for the poor or mentally ill. even though it's state of the art, not everyone is up to the task. i'll have that story next. tory next.

we are 10 years after katrina, and the loss of the charity hospital. it was a state-run facility serving people without health insurance, in its place. it will devote 20% of its resources to the poor, less than

the charity hospital, some say it's not enough. dozens of the community center, provide the city's poor. with an unprecedented level of care. susan todd runs 504 health net. 22 providers. thank you for joining us. $640 million of the funds to build university medical center came from f.e.m.a. when it determined the charity hospital. it was meant to replace the charity. is it the responsibility to provide the same level of help to the poor and under served? >> it is. the spent for umc to provide care, and say 10 years later, we'll do it better, we'll have a mission of caring for the vulnerable population in our community. if they were going to provide

care for people economically diverse. >> there doesn't seem to be a problem that there'll be more service, in 2003, more than half care was provided to patients without insurance. umc is only to defeat 20% to those without insurance, is it a maths problem. >> it is and isn't. it's gone down as part of the act and getting more insured. before we were up above 20%, and now down 17%. it's about a 20%. looking at a minimum.

there, dedicated to make sure everyone walking through the door receives care. a lot of same doctors and nurses at umc. we care for the community. new orleans is a unique community, made up of neighbourhoods, caring about each other and we look about how to do it better, build back care. >> i applaud your enthusiasm, i'm an economics reporter. state funding for the hospital has been shaky. louisiana provided 113 million for the new umc than it needed to open. the hospital is open under financial stress in a community that 10 years after katrina needs ta lot of service. starting off in you hole. >> correct, i think you are looking at the numbers. my understand is the legislature fully funded umc, and so you are

looking at working with the leadership in new orleans, and on the state level to say we'll fund so we open up the capacity that we are needing in the community. >> let's talk about - david ariosto talked about new orleans not being a medicare state. you are providing community care. how does that work and deal with the fact that there's emergency care that community clinics can't deal with, right? >> yes, but we are looking at how to build a system back in a better way, recognising the need and importance of primary care, of prevention and mental health services in the community. we have a network of 60 different sites that all the patients regardless of their ability to pay. regardless of status, we can be on medicaid and medicare. we can go and receive care.

across the region, 140,000 patients. the idea is we had treatment and prevention in community health centers for a sore throat. diabetes, to do the management there, not in the hospital setting. when you have a crisis, you are connected with the services so you can get the care and intensive diagnostics et cetera that you may need. looking at how they are building the pyramid, and connecting it appropriately to the hospital. focussing on prevention, making sure people stay healthy and not needing the hospital. >> the emergency care is available, but you build a system where the emergency care is required less, because you are treating people at appropriate levels. >> that's a hope. we hope people will not need the care as much. i don't know that they'll say the emergency care is not there. >> i'll leave that point.

>> a study by new orleans department of health looked at looking at the poor neighbourhoods. they have a life expectation si of 54.5 years, lower than the expectancy in the congo, it's 25 years young than expected in new orleans, in the '80s, more in line with the average. >> i get what you are trying to do. the problem is serious. this is an experiment that you'd look to provide in a place where things are more evenly distributed. >> i think new orleans is where you need it most. we have a community of high rates of diabetes, high rates of h.i.v. mental health is an issue. we need it in the community, neighbourhoods, down the street. it is important that they were using primary care, the delivery

system in our community is where it needs to be. if you look at and move the lines and metrics, a lot starts with primary care. keeping people healthy, trying to keep them getting sick. where you see them. there's discrepancy. >> you have a lot of work ahead of you. i applaud you for it, thank you for coming on the show. >> susan todd, the executive director of 504 community health care provider. ni., new orleans is hopeful the new medical is there will take care of the mentally ill. in most cities, prisons are the newest provider. now one judge in florida is going to change that, i show you how when we come back.

we are talking about how u.s. cities like new orleans are overburdened when dealing with the mentally ill. many untreatedened up in new asil up ums. in 44 states and the district of columbia, the largest mental

health providers are gaols in prisons, not hospitals, once incarcerated people with mental illness are locked up eight times longer than people without mental illnesses, at 7-times the cost to taxpayers, a judge in florida made it his mission to change the system, doing all he can do take mental illness out of the criminal justice system and stop making america's gaols a new asylum. >> we are responding. >> there's someone hurting herself. she may go by.

depending what goes in there now. and making contact. >> serious mental illness made their homes in the streets. police officers now handle thousands of mental health related calls in a year, anything from suicide attempts to full-blown psychiatric breaks. >> the guards want to kill herself. they know how the city's mental health crisis became a criminal justice nightmare, but thanks to the vision of this man, they have become the first step of a solution. steven is a judge from the country division. >> we have a high percentage of people with mental illness. 9.1% of general population. unfortunately, combined with florida, which is either 49th or 50th per capita in mental health funding, and that resulted in all the gaols becoming the

largest psychiatric facilities in the state. >> for years, likeman watched as the failings of a system brought those suffering from mental illnesses, scrits to manic -- schizophrenia to manic depression, flooding into his courtroom. >> if you let me have treatment, i might get you out of this place. >> folks like this, a 34-year-old paranoid schizophrenia who has been arrested 33 times since 2002. left without treatment, he says he'll and others often end up living on the streets. there they self-med kate with drugs and alcohol. and land in gaol for crimes like panhandling, trespassing or petty theft. >> a lot of crimes are change of life. they are arrested every two days. numbers are not better.

2 million go to state and the local gaols. 250,000 are incarcerated. since 2008. that meant there's 10 times more people. you have to ask yourself what is wrong with a society willing to spend more money to incarcerate people that are ill, than to treat them. >> the criminal justice system is wholly ill-equipped to provide effect difficult mental health treatment. >> this is the national director of policy and legal affairs for the national alliance on mental illness. he said while slashed budgets take a toll, it's a real problem. >> the reality is it's less costly to intervene at the front

end and link people with treatment. this is no different to providing humane treatment for someone with a stroke. >> that's what people don't understand. people with mental illness have better recovery rates, you have to get to them, the earlier the better and you have to work with them to stay in treatment tired of seeing the same faces return time and again, each time sicker than the last. judge likeman began a campaign to get the mentally ill out of the criminal justice system, and into the services they really need. >> your goal is to get her to comply by using verbal and nonverbal skills. >> that started by bringing in a straining programme teaching cops to recognise those with mental illness, and keep them out of gaol. >> police officers refer a third of people to psychiatric

facilities to medical care, instead of arresting them. those that do get arrested for nonviolent offenses opt into a programme allowing charges to be dropped or reduced in exchange for treatment. >> for the most part he's staying out of the trouble. >> he has chosen the programme over sale. he is managed to stay on his meds and avoid gaol. along with success story, likeman was credited with dropping the gaoled population by 40%. so much so the city closed down a gaol, a savings of 12 million a year, and the percentage of people with mental illness arrested for misdemeanour fell from 72% down to 20. >> the vision of the building has not been done everywhere in

the united states. >> the final piece of vision, may be his biggest gamble. his plan will transform this psychiatric institution into a one-stop shop to help those at risk. >> the idea is to target the highest utilizers of criminal justice and mental health services. >> it will have its own in-house crisis stabilization and treatment center, courtroom and rehab programme. >> we have a massive kitchen here, and a kitchen to teach job skills in the food industry. it will cost taxpayers 22 million. skeptics question whether so much public money should be thrown at a high risk population. he says anything else would be a costly mistake. >> we can continue to do what we do now, costing us billions of dollars, or we can intervene for people that are sick, so they

get their lives back, so they go to work and pay taxes, and they can have an opportunity. >> and that's the show for today. i'm ali velshi, thank you for joining us. overwhelming crisis, a truck full of dozens of dead bodies highlights the desperate measures taken by a record number of refugees seeking asylum seeker in europe. >> city of hope. >> i have never been more confident that together we will get to where we need to go. >> 10 years after hurricane katrina, the president celebrates new orleans's remarkable recovery, but acknowledges more need to b