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More NYC homeless mentally ill would be forced off streets to hospitals, treatment under Mayor Adams plan
The New York Daily News - 11/29/2022
New York City cops and mental health clinicians who engage emotionally disturbed people on streets and subways will now be armed with a much broader interpretation of state law to institutionalize those who pose a risk to themselves or others.
That broader, more defined legal reading will likely result in the city placing more mentally ill homeless people into hospitals against their will.
Mayor Adams announced Tuesday that he issued a new directive to city agencies clarifying the way first responders and other city workers should approach those exhibiting acute mental distress — and what steps city employees are permitted to take to remove those people from a public space against their will.
“Job one is to make it universally understood by our outreach workers, hospital staff and police officers that New York law already allows us to intervene when mental illness prevents a person from meeting their basic human needs, causing them to be a danger to themselves,” Adams said Tuesday.
“This policy has been confirmed in written guidance from our state Office of Mental Health. Yet the common misunderstanding says that we cannot provide involuntary assistance unless the person is violent, suicidal or presenting a risk of imminent harm. This myth must be put to rest.”
Since taking office, Adams has bemoaned what he’s described as people’s acceptance of others living in squalid conditions and ignoring them for years. He has repeatedly vowed the city would no longer engage in that kind of willful looking away and doubled down on that Tuesday.
Several violent incidents on the subways — as well as the recent murder of two young children in the Bronx, allegedly by their own mentally ill mother — have also led to a broader public debate over what should be done to address the city’s homeless crisis and mental health needs amid the collective trauma of the COVID pandemic.
The centerpiece of the new directive Adams laid out Tuesday is how the city will interpret state law when it comes to involuntarily removing people from public spaces.
The mayor’s announcement also included several other policy prescriptions, including legislative priorities he intends to seek in Albany when the state Legislature goes into session in January, as well as a hotline for NYPD officers to use when confronting emotionally disturbed people in public.
Cops will be able to call that hotline if they’re uncertain or need clarity on how to best interpret someone’s behavior — and whether it constitutes either an imminent or potential threat to the individual’s safety or to that of others.
Adams described a scenario in which a cop might initially respond to someone in mental distress and would then call in a more specialized team of officers, as well as a mental health clinician, to more accurately assess the situation.
But the mayor and other city officials stressed that the city’s approach will be “fluid” and that determinations on whether to hospitalize people would be made on a case-by-case basis.
“So if an officer is on the train at an express stop and he looks out the car as the train moves forward and he sees someone laying on the platform, he’s going to call,” Adams said. “No more days of ‘You know what, I’m going to act like I didn’t see it.’”
Removing someone from the street and taking them to a hospital doesn’t necessarily mean they’ll be committed to an institution, however. Their removal from the street will trigger another process to determine what happens next and how long they can be held legally.
“You cannot do a thorough mental health assessment when you’re in the subway system,” said Mitchell Katz, a physician who has conducted such removals and is the CEO of the city’s Health + Hospitals network. “You cannot be asking all kinds of personal questions about people’s experience of violence or what their thoughts are.”
After removing someone from a public space and after a more thorough evaluation at a hospital, a trained clinician would then determine whether the person who’s been brought in would have to remain for further treatment or could be released back into the public.
“The doctor may disagree,” said Brendan McGuire, Mayor Adams’ chief counsel. “Then you’re out. You may be out with some medication. You may be out with a treatment plan that maybe this time you decide to do. It’s really engagement more than anything — and forcing that engagement.”
Adams stressed that he would push for several new laws in Albany as well in the coming year.
One change he wants is to amend the state’s legal definition of the term “likely to result in serious harm” to include more clear language and to encompass people “whose mental illness prevents them from meeting their basic survival needs of food, clothing, shelter or medical care.”
He also wants Albany lawmakers to require that mental health clinicians not only take into account someone’s present condition when considering involuntary treatment, but also account for the “broader context” of their treatment history and their ability and willingness to adhere to an outpatient treatment program.
Adams noted that the new policies aren’t just geared at the homeless, and he urged “everyday New Yorkers” to pitch in, as he has in the recent past.
“If you’re watching or knowing of a condition on your block, we have to all get engaged in this,” he said. “There are things that are happening behind the doors, but we are aware that this person is going through some severe challenges. We need to be a community and respond as a community.”
After making his announcement, it didn’t take long for Adams to get a response.
Jawanza Williams, VOCAL-NY’s organizing director, called the new policy “draconian” and said it would only make matters worse.
“The lives of people dealing with mental health crises won’t be improved by forcing them into treatment, especially if it’s coming from law enforcement,” Williams said. “All this directive will do is disappear them.”
But the Legal Aid Society and several other groups that have criticized Adams in the past voiced support for him Tuesday.
“We must no longer be guided by fear,” they said in a joint statement. “Albany must no longer ‘punt’ and it should instead finally enact smart solutions to a human crisis.”
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