New York City set to involuntarily take the mentally ill off the streets

New York City set to involuntarily take the mentally ill off the streets

Acting to address “a crisis we see all around us” near the end of a year that has seen a string of high-profile crimes involving the homeless, Mayor Eric Adams on Tuesday announced a major effort to ward off people with serious and untreated mental illness. streets and subways of the city.

Mr Adams, who has made clearing homeless encampments a priority since taking office in January, said the effort would require involuntarily hospitalizing people who posed a danger to themselves, even if they were not posed no risk of harm to others, arguing that the city had a “moral obligation” to help them.

“The common misunderstanding persists that we cannot provide involuntary assistance unless the person is violent,” Mr Adams said in a speech at City Hall. “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 mayor’s announcement comes at a heated moment in the national debate over rising crime and the role of the police, particularly in dealing with people whose mental health is already fragile. Republicans, as well as tough-on-crime Democrats like Mr. Adams, a former police captain, have argued that the growing disorder calls for more aggressive action. On the other side, left-leaning advocates and officials who dominate New York politics argue that deploying police as auxiliary social workers may do more harm than good.

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.”

The new policy immediately raised questions about who, exactly, would be involved.

Current state laws allow both police and medical personnel to authorize the involuntary enlistment of individuals whose behavior poses a threat of “serious harm” to themselves or others. Brendan McGuire, the mayor’s chief counsel, said on Tuesday that workers would assess people in public spaces on a case-by-case basis, including whether they were able to provide for basic needs themselves such as food, shelter and health care.

The city guideline states that “unconsciousness or delusional misunderstanding of the environment” or “delusional misunderstanding of physical condition or health” could be grounds for hospitalization.

The effort will also involve an increase in the use of Kendra’s Law, which allows courts to impose outpatient treatment on those who pose a danger to themselves or others and which has been expanded by lawmakers in ‘Albany in April.

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.

It is unclear how many people could be affected by the new policy. The number of homeless people with serious mental illness who do not live in shelters fluctuates seasonally, but numbers, at the very least, in the hundreds. According to the Coalition for the Homeless, an advocacy group, studies have shown that a large majority of homeless New Yorkers have mental illness or other serious health conditions. An annual estimate often criticized as an undercount counted around 3,400 people living on streets and subways in January.

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.

Mr Adams, a Democrat, has come under fire from some progressive members of his party for cleaning up homeless encampments and for continuing to push for changes to bail reform that would make it easier to keep people in jail . The mayor defended his focus on public safety and argued that many New Yorkers do not feel safe, especially in black and Latino neighborhoods.

Mr Adams held an event at a subway station on Monday to thank police officers who helped a homeless man who fell onto the tracks.

The episode, he said, “highlights why we’ve focused on eliminating homelessness from our subway system. The subway is not a place for people who need assistance medical and psychiatric.

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.”

Councilman Tiffany Cabán said Tuesday on Twitter that the mayor’s plan was “deeply problematic” and that consent was essential to address it.

“Often the wrong responder and the wrong response is what creates a deadly situation, not the mental health crisis itself,” she said.

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