Patterico's Pontifications


NYC Mayor’s Directive: Involuntarily Hospitalize Mentally Ill Homeless People

Filed under: General — Dana @ 10:13 am

[guest post by Dana]

New York City Mayor Adams announced a new directive yesterday, and it’s a controversial one:

The move could allow non-medical professionals, such as police officers, to request such removals from streets and subways based on their judgment of a person’s inability to meet basic needs for health and safety, the mayor’s office said. This can happen whether or not the person poses an overt danger to themselves or others.

After removal and transportation to a city-run hospital, doctors can then decide if the person needs to be admitted.

Adams also proposed an 11-point series of reforms in state law to govern the care of mentally ill New Yorkers.

“For too long there has been a gray area where policy, law and accountability have not been clear,” Adams said during an address at City Hall. “And this has allowed people in need to slip through the cracks.”

Adams offered this as an illustration of the problem he is trying to address through his directive:

“The man standing on the street all day across from the building he was evicted from 25 years ago waiting to be let in. The shadow boxer on the street corner in midtown mumbling to himself as he jabs at an invisible adversary,” Adams said Tuesday. “The unresponsive man unable to get off the train at the end of the line without assistance from our mobile crisis team. These New Yorkers, and hundreds of others like them, are in urgent need of treatment, yet often refuse it when offered.”

“The very nature of their illnesses keeps them from realizing they need intervention and support,” the mayor added. “Without that intervention, they remain lost and isolated from society, tormented by delusions and disordered thinking. They cycle in and out of hospitals and jails. But New Yorkers rightly expect our city to help them.”

Clearly, there are potentials for abuse:

Deputy Mayor Anne Williams-Isom said ideally that this judgment would come from specialized teams composed of mental health professionals and first responders such as the police.

“We want the specialized teams to come to that site, and then do that work and wait for the EMS to come so that we can transport them to the hospital,” Williams-Isom said.

But the policy, as written, allows the police alone to call on EMS to make a removal, even if a mental health clinician isn’t present on the scene. The NYPD is not permitted to transport an individual.

Note: [T]he mayor’s directive acknowledges that “case law does not provide extensive guidance regarding removals for mental health evaluations based on short interactions in the field.”

Civil liberty advocates concerned about the new directive say that the police are not the answer.

Gov. Kathy Hochul has indicated that she will support the Mayor’s proposal.


12 Responses to “NYC Mayor’s Directive: Involuntarily Hospitalize Mentally Ill Homeless People”

  1. Hello.

    Dana (1225fc)

  2. Will they be hospitalized? Unless they are sent to a mental health facility, they probably wont be admitted unless someone credibly claims they are an imminent danger to themselves or others. The hospital will probably never admit them and simply release them.

    This is more like involuntary relocation to a hospital parking lot.

    DRJ (82077e)

  3. This is more like involuntary relocation to a hospital parking lot.

    Astute observation. The intentions are good, but it’s hard to see this passing muster for a variety of reasons.

    Life in large densely-populated cities can be exciting, with residents never running out of interesting things to do. But urban dwellers do give up the idea of peaceful solitude and are forced to accept the fact that there will be completely crazy people in their midst.

    JVW (37f1d8)

  4. The parking lot indeed, not enough beds:

    Adams said that hospital infrastructure and the availability of beds would need to be bolstered to be ready for his plan and that Hochul had agreed to add 50 psychiatric beds to open up space.

    Adding 50 beds, however, would not be enough if hospitals require longer stays, as Adams’ plan proposes, said Taina Laing, the CEO of Baltic Street AEH Inc., a peer-led mental health organization based in Brooklyn.

    “He’s looking for longer-term hospital stays until the person has stabilized, but hospitals do not have the capacity for that kind of long-term stay in a forced setting,” Laing said.

    Dana (1225fc)

  5. This was a sudden decision on the part of the mayor – and it’s a big nthing He wants ti train police. But there’s nothing for them to do.

    Sammy Finkelman (5a21a3)

  6. This is what used to be done. Many state mental hospital patients were released during the 1970s — by people advocating liberty — with the promise that local mental health outpatient facilities would provide support. That didn’t happen much.

    So, what to do with those mentally ill who cannot provide for themselves and who resist/ignore/misplace all efforts to help them? We are not just talking homeless, but deranged and helpless. Unlike fictional zombies, you can’t just shoot them.

    I’m thinking that this is a fairly sane policy. It also allows one to help those homeless that will participate in the help. There is some danger that too many people will be incarcerated, of course. Particularly those whose resistance to do-gooding is willful and not due to mental illness.

    Kevin M (1ea396)

  7. Start at Gracie Mansion.

    DCSCA (af98ea)

  8. What, for example, do they do with the Skid Row alcoholic? He’s only mentally ill if you have a broad definition of that — he may be lucid and able to make rational judgements about things other than alcohol. Similarly the crack addict or junkie. Forcing them into rehab just wastes a bed and everyone’s time.

    Then again, AA warns those that seek its help that the end result of alcoholism is “jails, institutions or death.”

    Kevin M (1ea396)

  9. Note that these hospitals do not have to be ANYWHERE near NYC. Some of the people who were released in the 1970s should never have been dumped on the streets. Many did poorly. We do need to reconsider this kind of policy as there are people who would benefit from institutionalization. This is both for public safety, public health and compassion for those who really need supervision.

    Kevin M (1ea396)

  10. I’m for tough love. We have to try something different. The status quo is unacceptable.

    norcal (862cdb)

  11. What, for example, do they do with the Skid Row alcoholic?


    DCSCA (af98ea)

  12. The Port Authority Bus Terminal was once the ‘warm and cozy ‘hospital’ w/benches and floors and restrooms littered w/NYC’s nut bags.

    If you can make it through there, you can make it anywhere. 😉

    DCSCA (af98ea)

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