“NYC Will Hospitalize Mentally Ill People Involuntarily” blared one headline about Mayor Adams’ new directive to fulfill what he called a “moral obligation” to forcibly bring those New Yorkers who appear severely mentally ill and unable to care for themselves into hospitals for evaluations by a doctor, usually a psychiatrist.
But this isn’t something NYC will do. It’s what cops have already been doing.
People wrestling with their own demons and often unaware of their mental conditions are legally, though often violently, taken without their consent by armed agents of the state and dumped at hospitals where they’re supposed to be released under New York State law after no more than 72 hours if they’ve been stabilized.
That person might also be assessed by a psychiatrist for assisted outpatient treatment or AOT, a court order requiring them to take medication under 1999′s Kendra’s Law, named after a young journalist who was shoved into the path of a train in Chelsea by a young man who’d sought treatment but been turned away.
There are two things that are more or less new in Adams’ approach.
First, he’s putting his name behind what some cops (many of whom have yet to be trained in dealing with emotionally disturbed people, and almost all of whom dread EDP calls) are already doing, much as he put his voice behind the cruel homeless encampment sweeps that the city had been conducting regularly under the preceding administration with nary a peep from Mayor de Blasio.
(Notably, both those moves appear to be much more popular with the public than they are with headline writers, with 60% of New York City voters in a June poll in favor of encampment sweeps and a staggering 89% in favor of “making it easier to admit those who are dangerous to the public, or themselves, to mental health facilities.”
The two positions overlap, of course, given how tricky it can be for cops, advocates or the public at large to distinguish between overlapping populations of severely mentally ill people, drug abusers and the homeless, and given how both moves involve forcing vulnerable people off the streets even in the absence of supportive rooms or beds to put them into.)
The other thing that’s fairly new is the mayor trumpeting a memo the state Office of Mental Hygiene put out in February to “authorize the removal of a person who appears to be mentally ill and displays an inability to meet basic living needs, even when no recent dangerous act has been observed.”
That was a fairly quiet attempt to stretch or test what the relevant section of state law actually says: that officers “may take into custody any person who appears to be mentally ill and is conducting himself or herself in a manner which is likely to result in serious harm to the person or others.”
The Daily News Flash
Catch up on the day’s top five stories every weekday afternoon.
It goes on to explicitly define that “manner” as threats of or attempts at suicide, homicide, or serious physical harm.
In effect, the state and city are now arguing circularly (and carefully, given the legal challenges that are surely coming, and against the plain language of the law) that a severely mentally ill person’s evident inability to care for themself — someone who’s unkempt, wearing no shoes and shadowboxing, to use an example Adams provided — “is likely to result in serious harm” to themself.
And the city is arguing that it’s not in a position to wait for more state support to improve the mental health system or provide funds for expensive long-term solutions like additional psychiatric beds or supportive housing units to start doing more for — and about — severely mentally ill New Yorkers too often simply left to their own devices.
Getting more severely mentally ill people stabilized and screened in hospitals is a partial plan at best, one full of devilish details. It comes along with numerous requests for changes to state laws that will test the balance of power between, to put it crudely, Adams as a centrist offering proposals broadly popular with New Yorkers and farther-left progressives who represent the will of the Democratic caucus in Albany and who shot down many of the mayor’s priorities this year, after he’d just won election and should have had the most political leverage.
“Look, if we’re going to just leave people on the street who are in need of medical care because we don’t have the beds and we don’t have the services, then we should at least be honest enough to say that’s the reason we’re abandoning them,” Brian Stettin, City Hall’s senior adviser on severe mental illness who helped craft the new approach and who drafted Kendra’s Law as an assistant attorney general a quarter century ago, told me on the FAQ NYC podcast on Friday.
“We should not hide behind this false excuse that we can’t help them because the law doesn’t allow it.”
Siegel (firstname.lastname@example.org) is an editor at The City and a columnist for the Daily News.