NYC’s new policy toward homeless people: The problem of involuntary mental health treatment

Key Takeaways

  • New York City Mayor Eric Adams has created a plan to allow police officers and emergency workers to involuntarily hospitalize mentally ill homeless people.
  • As of September, the Coalition for the Homeless reported 60,252 homeless people in New York City.
  • Advocates for the rights of homeless people and those with mental illness have spoken out against the new policy as removing basic human rights.

New York City Mayor Eric Adams last week announced an expansion of the authority of police and emergency workers to voluntarily remove and hospitalize homeless people presenting with mental health conditions. Currently, New York state law allows people to be forcibly removed from the road if they are likely to cause “serious harm” to themselves or others.

Criticisms came quickly from leading civil liberties activists. “Unless we invest adequately in the long-term health and well-being of New Yorkers facing mental illness and our chronic housing shortage, the current mental health crisis will continue,” read a response from Donna Lieberman, executive director of the New York Civil Liberties Union.

“The decades-old practice of cleaning deep-seated problems out of public view may play well for politicians, but the problems will remain — for vulnerable people in desperate need of public services and for New Yorkers,” Lieberman said.

Matt Kudish, CEO of the National Alliance of Mental Illness – New York City Metro (NAMI-NYC), echoed these concerns in a statement: “The increased use of the administration’s center law or supportive outpatient treatment (AOT) for patients with SMI (serious) mental illness) who ‘ Can’t meet their basic needs’ they are out of trouble.”

Kurdish continues, “AOT is a last-resort process, not a mental health response. People living with SMI have a right to receive person-centered and recovery-oriented mental health care. Instead of using the least restrictive approach, we’re defaulting to the extreme. That’s fundamental. take away human rights.”

A complex problem is a very risky approach

On Thursday, December 8, NAMI-NYC joined organizations, including Communities United for Police Reform, Housing Works and Right Crisis Intervention Today (CCIT-NYC).

New York isn’t the only place to implement such policies, with mixed reviews and results. Recently, three hospital systems sued the state of Oregon after they kept mentally ill people in their care instead of transferring them to long-term care. These individuals were considered a danger to themselves or others at the time of admission.

“Sometimes people are truly a danger to themselves—either in terms of active risk such as suicide, or their basic survival needs such as not eating—or a danger to others, and hospitalization, with or without consent, is the only appropriate and ethical treatment,” says Dr. Irene Harford, a psychiatrist and clinical program director at One Mind As of September 2022, there were 60,252 homeless people in New York City.

Irene Harford, MD, is a psychiatrist and clinical program director at One Mind

If the mayor is serious about helping New York City’s homeless find housing, he will expand the use of an evidence-based model for providing housing and mental health services to New York City’s homeless population.

— Irene Harford, MD, a psychiatrist and clinical program director at One Mind

The policy calls for training police officers to identify who needs mental health care. Harford calls these life-altering decisions a “recipe for human rights violations” and this quick direction and power to create the potential to hurt those affected.

Dr. Zeeshan Khan, a psychiatrist at MindPath Health, points out a number of issues that can arise. People may not want to leave voluntarily, especially if they have confusion about taking or see other people being committed involuntarily.

Tensions and even violence can occur—a combination exacerbated by police officers carrying loaded guns. Since 2015, in one out of five cases where someone was shot and killed by an on-duty police officer, the victim had a mental illness, according to a database maintained by the Washington Post.

Expanded access to housing is essential

An overwhelmed hospital system and a lack of affordable housing in New York City compound the problem. Affordable apartments (or what affordable means in New York City) are rare. According to the 2021 Housing and Vacancy Survey, the vacancy rate for apartments under $900 is 0.86%. In contrast, the survey found 12.64% of apartments $2,300 and above are vacant.

Mental health professionals across New York City have spoken out about the lack of psychiatric beds and staff to care for patients.

Experts agree: Making housing and health care more accessible (both in terms of affordability and safety) is an important path forward. “By not addressing the underlying housing problem and lack of access to appropriate healthcare, we are only perpetuating the problem,” Khan said.

“Mayor Adams has advanced a Housing First model, but at this time, it will only provide housing for a small minority of homeless people in New York City,” Harford added. “If the mayor is serious about helping New York City’s homeless find housing, he will expand the use of an evidence-based model for providing housing and mental health services to New York City’s homeless population.”

What does this mean for you?

As mentioned, both people with mental health concerns and people who are homeless need help. This includes affordable and accessible housing and treatment. Experts in the field recommend taking these steps to secure long-term, beneficial changes. As an individual, you can advocate for these measures and work to create a fair, equal space for all.

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