Mayor Eric Adams announced Tuesday a major effort to get people with severe and untreated mental illness off the city’s streets and subways, saying New York had “a moral obligation” to address “a crisis that we see around us”.
The effort will involve hospitalize people involuntarilyeven if they do not pose an immediate risk of harm to others.
“There is a common misconception that we cannot provide involuntary assistance unless the person is violent,” Mr. Adams said. “This myth must be put to rest. In the future, we will do everything we can to help those who are mentally ill and whose illness endangers them 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 new policy directive acknowledges that “the case law does not provide extensive guidance regarding removals for mental health evaluations based on short interactions in the field.”
Homeless people with serious mental illnesses are often rushed to hospitals, only to be released a few days later when their conditions improve slightly. Mr. Adams said the city would direct hospitals to keep those patients until they are stable and release them only when there is a viable plan to connect them to continuing care.
Hospitals often cite a shortage of psychiatric beds as the reason for discharging patients, but the mayor said the city will make sure there are enough beds for people who are removed. He noted that Gov. Kathy Hochul had agreed to add 50 new psychiatric beds. “We are going to find a bed for everyone,” Adams said.
When asked about the legality of holding people involuntarily, Brendan McGuire, the mayor’s lead attorney, said Tuesday that people would be detained under a state mental hygiene law that allows for involuntary commitment if they are a threat to themselves. or for others. Mr McGuire said workers would assess people “on a case by case” basis, including whether they could meet basic needs such as food, shelter and medical care.
The effort will also see increased use of the Kendra Law, which allows courts to order treatment of those who are a danger to themselves or others.
Since the pandemic, a series of high-profile random attacks on the streets and subways has left many New Yorkers with the feeling that the city has become more unpredictable and dangerous. Many of the defendants in the attacks have been people battling mental illness and the homeless, leading to demands from many quarters that elected officials take action to address these issues.
Crime has risen sharply in the subways this year, and the mayor said last month that mental illness was the main cause: “When you do an analysis of subway crimes, you are seeing that it is being driven by people with mental health problems.”
In January, days after the mayor took office, a woman was pushed to death in front of a subway train by a man with schizophrenia who had cycled in and out of hospitals, prisons and city streets for decades. . The man, Martial Simon, became an emblem of a broken system and prompted hearings by the state attorney general and a scramble between the city’s public health and emergency response systems to address a problem that seemed intractable.
Mr. Adams stressed Tuesday the importance of hospitalizing and treating people with serious mental illnesses, even if they don’t threaten anyone.
“The man standing all day on the street in front of the building he was evicted from 25 years ago waiting to be let in; the shadow boxer on the corner of Midtown, muttering to himself as he punches an unseen adversary; The unresponsive man who can’t 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 need treatment urgently and often refuse it when offered.” said the mayor.
He added: “The very nature of their illnesses prevents them from realizing that they need intervention and support. Without that intervention, they remain lost and isolated from society, tormented by delusions and disordered thoughts.
Earlier this month, the city’s public defender, Jumaane Williams, published a report criticizing the mayor’s efforts to help New Yorkers with severe mental illness, saying that Mr. Adams relied too much 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 the police, rather than behavioral health professionals, remained the primary option for the city to respond to mental health emergencies despite the fact that police officers were undertrained, and that the mayor had cut funding for a program that sent mental health professionals, instead of police, to certain emergencies.
An advocate for people with mental illness said the measures announced by the mayor went too far and would backfire.
“The mayor talked about a ‘trauma-informed approach,’ but coercion itself is traumatic,” said Harvey Rosenthal, executive director of the New York Association for Psychiatric Rehabilitation Services and a longtime critic of involuntary commitment.
He added: “This work is all about relationship and commitment and trust and reliability and implementing this continuity of service – that’s what’s going to get us out of this, no more hospital beds and more Orders of the Law of Kendra”. He said the mayor’s approach was based on “the same broken system that is overloaded and can’t address the people they already have now.”
Mr. Adams cautioned that implementation of the new policy would take time. “No one should think that decades of dysfunction can be changed overnight,” he said. “The longest journey begins with a single step.”