Mayor Eric Adams on Tuesday announced a major effort to remove people with serious, untreated mental illnesses from the city’s streets and subways, saying New York has a “moral obligation” to address “a crisis we see all around us”.
The effort will involve the involuntary hospitalization of people, even if they pose no immediate risk of harm to others.
“The common misconception persists that we cannot provide involuntary assistance unless the person is violent,” Mr Adams said. “This myth needs to be dispelled. In the future, we will do all we can to help those who suffer from mental illness and whose illness puts them at risk by preventing them from meeting their basic human needs.
The city said it would immediately implement training for police officers, emergency medical services personnel and other medical personnel to “ensure compassionate care.” But the city’s new policy directive acknowledges that “jurisprudence does not provide detailed guidance regarding referrals for mental health assessments based on short field interactions.”
Often, homeless people with serious mental disorders are taken to hospital, only to be released a few days later when their condition improves slightly. Adams said the city would direct hospitals to hold those patients until they’re stable and only release them when a workable plan is in place to connect them to continuing care.
Hospitals often cite a lack of psychiatric beds as a reason for discharged patients, but the mayor said the city will ensure there are enough beds for those discharged. He noted that Governor Kathy Hochul had agreed to add 50 new psychiatric beds. “We’re going to find a bed for everyone,” Mr. Adams said.
Asked about the legality of involuntarily detaining people, Brendan McGuire, the mayor’s chief attorney, said Tuesday that the people would be detained under a state mental hygiene law that allows for involuntary commitment if they pose a threat to themselves or others. Mr McGuire said workers would assess people on a case-by-case basis, including whether they were able to provide for basic needs such as food, shelter and healthcare on their own.
The effort will also involve an increase in the use of Kendra’s Law, which allows courts to order the treatment of those who pose a danger to themselves or others.
Since the pandemic, a series of high-profile random attacks on streets and subways has left many New Yorkers feeling the city has become more unpredictable and dangerous. Many of those charged in the attacks were people struggling with mental health issues and homelessness, leading to demands from many elected officials for elected officials to take action to address these issues.
Crime has risen sharply in the subway this year, and the mayor said last month that mental illness was the main cause: “When you do an analysis of crimes in the subway, you find that they are motivated by people with mental health issues.”
In January, days after the mayor took office, a woman was pushed to her death in front of a subway train by a man with schizophrenia who was cycling to and from hospitals, prisons and streets of the city for decades. The man, Martial Simon, has become a symbol of a failing system and prompted hearings by the state’s Attorney General and a stampede on the city’s public health and emergency response systems to tackling a problem that seemed insoluble.
Mr Adams stressed on Tuesday the importance of hospitalizing and treating people with serious mental illness, even if they pose no threat to anyone.
“The man standing all day in the street in front of the building he was evicted from 25 years ago, waiting to be let in; the shadow boxer around the corner in Midtown, mumbling to himself as he punches an unseen opponent; the callous man unable to get off the train at the end of the line without the help of our mobile crisis team: these New Yorkers and hundreds of others like them urgently need treatment and often refuse it when they is proposed,” the mayor said.
He added: “The very nature of their illnesses prevents them from realizing that they need intervention and support. Without this intervention, they remain lost and isolated from society, plagued by delusions and disordered thinking.
Earlier this month, the city’s public attorney, Jumaane Williams, released a report criticizing the mayor’s efforts to help New Yorkers with serious mental illness, saying Mr Adams was too dependent on the police.
The report found that the number of mental health crisis centers and mobile mental crisis response teams had declined since 2019. It also found that police rather than behavioral health professionals were still the the city’s main option for responding to mental health emergencies, even though police officers weren’t receiving enough training and the mayor had cut funding for a program that sent mental health professionals, rather than police, in certain emergencies.
A mental health advocate said the measures announced by the mayor went too far and would prove counterproductive.
“The mayor spoke of a ‘trauma-informed approach,’ but the coercion itself is traumatic,” said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services and longtime critic. of involuntary isolation.
He added: “This job is about relationship and commitment and trust and reliability and building that continuity of service – that’s what’s going to get us out of this, not more beds. hospitals and more Kendra’s Law prescriptions.” He said the mayor’s approach relied on “the same broken system that’s overloaded and can’t address the people they already have now.”
Mr Adams warned that the new policy would take time to implement. “No one should think that decades of dysfunction can be changed overnight,” he said. “The longest journey begins with a single step.”
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