New York City’s emergency responders have been directed to involuntarily hospitalise mentally ill New Yorkers, allowing police officers to remove people from the city’s streets and subways regardless of whether they are believed to pose any danger to themselves or others.
A directive from New York City Mayor Eric Adams follows several high-profile incidents involving homeless New Yorkers and crimes involving people with a history of mental illness, as officials across the US mull controversial responses to parallel crises of homelessness and mental illness.
The mayor’s order allows emergency personnel to transport people they judge to be too mentally ill to be able to care for themselves to a city-run hospital, where doctors will determine whether that person should be admitted or connected to other services.
But advocates for the city’s homeless population and other civil rights groups and city officials have roundly criticised the mandate, warning against increased law enforcement interaction with vulnerable populations that are more likely to be victims of crime than perpetrators.
The policy also has faced scrutiny from disability advocates who argued that it could be grounds for unconstitutional discrimination.
State law allows emergency responders to involuntarily hospitalise people “if such person 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 mayor argues that the law is overly burdensome, leading to assistance that only is provided in cases where a person is considered “violent, suicidal or presenting a risk of imminent harm.”
“The common misunderstanding persists that we cannot provide involuntary assistance unless the person is violent,” Mr Adams said in an address at City Hall on 29 November. “Going forward, we will make every effort to assist those who are suffering from mental illness.”
The new directive allows involuntary hospitalisation if a person cannot meet their “basic human needs” and adds that “unawareness or delusional misapprehension of surroundings” or “delusional misapprehension of physical condition or health” could be grounds for removal from public space.
Brendan McGuire, chief counsel to the mayor, said on Tuesday that emergency workers would determine whether to hospitalise New Yorkers on a “case by case” basis.
Police and other emergency responders would then call for medical support to transport that person, even if a mental health worker is not present at the scene.
New York’s elected public advocate Jumaane Williams told CNN on Wednesday that New Yorkers “don’t want police to be arresting people for having a mental health crisis” but instead want people to “get assistance and a continuum of care.”
“The main crux of this is we have to divorce a law enforcement response from a medical response,” he said. “The problem with the plans we’re putting out – we’re putting law enforcement first and not … the care and continuum of care that’s needed.”
New York City councilmember Tiffany Caban called the plan “deeply problematic” and argued that the city should instead prioritise voluntary consent with involvement from mental health responders, along with a wide array of services to support homeless New Yorkers.
“I’ve visited trained, dedicated professional mental health first responders across the US. They consistently point out a couple of truths. Often the wrong responder [and] response is what creates a deadly situation, not the mental health crisis itself,” she wrote.
Jacquelyn Simone, policy director for advocacy group Coalition for the Homeless, said in a statement that the mayor “continues to get it wrong when it comes to his reliance on ineffective surveillance, policing, and involuntary transport and treatment of people with mental illness.”
“The administration should focus on expanding access to voluntary inpatient and outpatient psychiatric care, offering individual hotel rooms to all unsheltered people, and cutting through red tape that has left far too many permanent supportive housing units sitting vacant,” she added. “Mayor Adams needs to focus on repairing our broken mental health system and prioritize bringing access to quality voluntary care and affordable, permanent housing with support services to New Yorkers who need it the most.”
Joe Rappaport, executive director of the Brooklyn Center for Independence of the Disabled, argued that the policy “directly violates” constitutional protections for disabled people and constitutes discrimination under the Americans with Disabilities Act.
“Mayor Adams’ assertion that people caught in the City’s dragnet will be released only when they have a proper discharge plan will likely result in weeks-long or months-long institutionalizations,” he said in a statement. “People with psychiatric disabilities deserve to live in their own homes and communities with the proper support, not to be locked away until medical professionals decide to grant them freedom.”
Norman Siegel – the former head of the New York Civil Liberties Union and co-founder of a volunteer outreach program the Street Homeless Advocacy Project, which the mayor has supported along with other city agencies – also believes that the order will be challenged in court.
“Just because someone smells, because they haven’t had a shower for weeks, because they’re mumbling, because their clothes are disheveled, that doesn’t mean they’re a danger to themselves or others,” he told The New York Times. “And they’re going to have the cops, of all people, make those decisions?”
A joint statement from a coalition of New York City public defender groups did not publicly support the policy but agreed with Mayor Adams’s acknowledgement of the mental health crisis and the importance of healthcare, treatment and housing to treat homeless New Yorkers.
Brooklyn Defender Services added that “involuntary commitment and an expansion of Kendra’s Law” – which allows courts to mandate outpatient treatment for people deemed a danger to themselves or others – “are not the answer.”
“Houselessness [and] mental illness must not be criminalized. Community-based and voluntary solutions need investment,” the group said in a statement.
Public defender groups have urged support for the Treatment Not Jail Act, statewide legislation that would connect mentally ill people enmeshed in the criminal legal system to treatment and other services rather than place them in jail.
“Rather than jailing people with underlying mental illnesses and similar disorders, and then abandoning them to a chaotic and unsupported transition process when they are released into the community, mental health and drug treatment courts along with the accompanying robust community services they provide, lead to greater public health and public safety,” the groups added.
