NYC will involuntarily hospitalize homeless "who appear to be mentally ill"

[BlueWaveNeverEnd]

NYC Plans to Hospitalize Homeless Who Appear to Be Mentally Ill — What to Know


New York City Mayor Eric Adams hopes to combat crime by removing people with severe mental illness from the streets and subways, noting that the City has a "moral obligation" to help.

"The common misunderstanding persists that we cannot provide involuntary assistance unless the person is violent," Adams said during a 19-minute address at City Hall on Tuesday. "This myth must be put to rest. Going forward, we will make every effort to assist those who are suffering from mental illness and whose illness is endangering them by preventing them from meeting their basic human needs."

"No more walking by or looking away," he added.

A Shortage of Psychiatric Beds

Hospital administrators in New York City say there are not enough psychiatric beds to fulfill the need, according to The New York Times, which also reported that Gov. Kathy Hochul has promised 50 additional beds.

"We are going to find a bed for everyone," Adams said Tuesday, adding that the city would order hospitals to care for patients until they are stable, and discharge them only when there is a workable plan in place to connect them to ongoing care.

However, advocates for the homeless worry there will not be enough resources.

https://www.msn.com/en-us/news/us/nyc-plans-to-hospitalize-homeless-who-appear-to-be-mentally-ill-what-to-know/ar-AA14Khve

[FakeNoose]

1. Here's an idea ... put them on a bus and send them to Florida

I'll bet DeSantis would love to get a few more voters in the Sunshine State.

[Aristus]

2. How about we do less to increase their suffering, and more to get them the treatment

they need?

Involuntary committal is not popular. It does trigger uncomfortable questions about a person's civil rights. But deinstitutionalization is the reason there are so many homeless on the streets suffering from mental illness. On top of which, they are suffering from being homeless; hunger, disease, vulnerability to assault, cold, uncomfortable sleep at night, the works.

I don't like this asshole's motives, but the concept itself could use another look. Long-term mental health care institutions don't have to be "One Flew Over The Cuckoo's Nest". We can do right by these vulnerable people.

[DaBronx]

10. Mental illness is no joke

Even a Desantis zinger on this topic is just not cool. Mental illness is awful. It brings untold unimaginable emotional trauma to its host, family and whatever friends may be left (read that to mean none)
While enforcement will be welcome to many families who have no other way to get their loved one the immediate help they need, the help is only a very short bandaid Sadly, patients will be discharged as “clinically stable” (bullshite) with no plan, to the revolving door of homelessness, hunger, victimization. It is awful. People had dreams for their children. Instead, mental illness set in. People need help. The system is broken.

[wnylib]

19. Follow up care after release from hospitals is essential.

It is where we fell short before, when so many people were released and mental health hospitals were closed.

Oversight of treatment and assignment of advocates for the patients is also essential.

[WhiskeyGrinder]

3. This is a horrifying, violent policy that is yet another way to give cops money and power, and will

end up hurting and killing people.

[marmar]

4. "Appear to be mentally ill"?

Who's removing them? Cops? .... So they all have PhDs in psychology, I take it.

[BlueWaveNeverEnd]

32. yes, cops. here is how it will work.

The city's standards currently authorize "a peace officer or police officer to take into custody, for the purpose of a psychiatric evaluation, an individual who appears to be mentally ill and is conducting themselves in a manner likely to result in serious harm to self or others," according to a Feb. 18 Office of Mental Health memorandum.

The directive to city agencies from Adams is intended to enforce the preexisting authorization.

Adams told reporters in a press conference on the initiative Tuesday that police will receive training in order to feel confident in determining who might be classified as "in need" under the current legal language. A hotline will be launched with clinicians from city hospitals to provide guidance to officers encountering individuals in crisis.

https://www.msn.com/en-us/news/us/how-the-forced-hospitalization-of-mentally-ill-people-in-need-will-work-in-nyc/ar-AA14KWQL

The NYPD has long been accused of mistreatment and criminalization of citizens experiencing mental illness or in a crisis, according to past reports from the Urban Justice Center, New York University and more.

With police on the frontlines of the effort to get unhoused citizens off the streets, the initiative has been criticized by civil rights, mental health and disability rights advocates.

[jimfields33]

9. And somehow, in 40 years, nobody put the money back in to the system?

I always scratch my head when Reagan is brought up. He was not the end all be all. he hasn’t been governor of California in 50 years and president for 40. why in the world to be let him be the end of the line?

[BlueWaveNeverEnd]

15. was this doc. set in America?

[Midnight Writer]

17. Yes, New York. A young Geraldo Rivera snuck in with a camera crew and it was sickening.

The place was then closed down, but some of the patients drifted back to the facility to squat and camp there.

Staten Island in the 70s.

Willowbrook Hospital.

[Solly Mack]

6. No. Damn. No. That's beyond wrong.

[Tetrachloride]

7. A relative of a friend died from inadequate food and medicine

The relative had severe schizophrenia or something to render communication a problem.

The NYC plan probably would have saved that person from a wretched lonely death. ( I omit some aspects for reasons of privacy, accuracy and law.)

[Sky Jewels]

30. Yes, this is not a black-and-white issue.

When people are not well enough to seek help or to even recognize they need help or to stick with treatment, the answer is not "well, let's just leave them alone out on the streets out in the elements where they're a danger to themselves and possibly to others."

[Tetrachloride]

8. I had 2 jobs where I was involved in the paperwork trail

of social work and later psychological evaluations to be used in courtroom proceedings.

Some cases were getting people out of institutions.

I believe a few were the opposite goal.

[thucythucy]

11. One of the factors driving homelessness that rarely gets mentioned

is the elimination of SROs--Single Room Occupancies.

These were common well into the 1950s, when zoning laws began to change, more or less eliminating them as an option.

Used to be for a couple of dollars a week you could rent a room. The bathrooms would be down the hall and shared by the people on that floor. You might have a small frig and single burner stove, or a common kitchen shared with the other residents. Or you could opt for a double with a roommate.

Try finding an arrangement like that now.

As a society we've made being poor more and more difficult, ironically more and more expensive.

Need to make a phone-call? Buy a cell phone and pay some mega-corporation a monthly fee. Phone booths are a thing of the past.

Need to get from point A to point B? Buy a car, pay for gas and insurance and maintenance. Mass transit: only in the major cities.

Need a place to live? Only if you can afford hundreds of dollars a month, or more.

And once you're homeless it becomes nearly impossible to claw your way back. Public baths? No way, we prefer you stink so we have an excuse to avoid and belittle you. And it goes on and on.

Lots of times it isn't mental illness that leads to homelessness, but rather the other way around. Try living on the street for a couple of months and see if your own mental health doesn't decline.

Don't blame homelessness on deinstitutionalization. It's a pathetic culture indeed, cruel and unforgiving, that offers people in crisis only a choice between homelessness or incarceration.

[BlueWaveNeverEnd]

13. ...boarding houses, a business mostly run by women

new to town, find a boarding house. now housing is high stakes... first, last and rent, plus good credit and proof of income.

[RobinA]

26. Unfortunately

boarding houses tend to be yet another way of separating poor people from what little money they have.

[MerryBlooms]

20. RecRecRec! Spot on!! Thank you for this truth. 😭

There are folks I know paying $1,000 a month for a room rental. When you're only getting $850 a month and food assistance, many folks are left with temporary housing in motels during cold weather snaps and inadequate warming centers. It's very bad right now.

[XanaDUer2]

25. Thank you

I was talking about SROs the other day. And how they helped in the past with homelessness. When I was a kid. There were hotels that were SROs and we never saw homeless

[yonder]

27. Thank you for your very valuable perspective in this and your post no. 23.

[Phoenix61]

12. Those homeless individuals didn't walk out of a

decent facility. They are on the street because there isn’t any other place for them to be.

[WarGamer]

14. Who gets to decide WHO gets locked up?

[BlueWaveNeverEnd]

16. if it it's cops, expect a large percentage of the locked up to be black and brown males

[Takket]

18. This could be helpful if people actually got help they needed

But I’m getting a “stuff them in a room so they are out sight” fear in my gut.

I’d like to know more details.

[nini]

21. They do 72 hour hold here in L.A.

For evaluation and immediate help.

Back in the day there were state hospitals that would care for the extremely ill if they needed longer care. One of the many reasons I hate Reagan after he dismantled that system. Those folks are incapable of caring for themselves 😢

[former9thward]

29. Why has no one restored "that system"?

Reagan has been gone from CA for a half century.

[EX500rider]

22. I thought everybody here was against Reagan's closing of the mental hospitals

This sounds like them be reopened, were people under the impression people were all there of their own will in the past?

[thucythucy]

23. Reagan didn't close the institutions.

They were closed after disability rights activists brought federal lawsuits and advocated for their closing, because the conditions were almost uniformly appalling. Forced drugging, beatings, rapes, even murders weren't uncommon. The back wards of Willowbrook, for example, were statistically the most dangerous "neighborhood" in New York City.

Among other outrages, residents at such facilities were often subject to medical experiments and procedures performed without their consent. As just one example, the vasectomy was "perfected" by using institutionalized teen-aged boys for "practice." Castration was not uncommon as a way to control boys once they reached puberty. At Fernald in Massachusetts children were fed radioactive isotopes to see what the long term effects of constant exposure to radiation would be. The people running the experiment called it "the Science Club."

What Reagan did was to ax funding for community services meant to provide supports for people newly de-institutionalized. Disability advocates had laid out plans for shifting state and federal funding from the institutions into these community settings. By 1980 many programs were just getting started when Reagan was elected and enacted budget cuts to provide his famous tax breaks.

State governments, now free of federal oversight, followed suit.

The fact that people blame de-institutionalization for homelessness is a triumph of right wing messaging. The institutions themselves were largely to blame for much of the helplessness of the people imprisoned there. People who had been incarcerated all their lives, in many instances since they were infants, were suddenly forced to fend for themselves in a society that is brutal to people who are deemed to be "different" and "defective." Had those "State Schools" actually provided an education for their residents the outlook for many of those residents would have been entirely different.

It's infuriating to see how this history has been wiped from our collective consciousness. Yet another triumph for the right.

[H2O Man]

31. +1

While there were other factors, Reagan did indeed force long-term care hospitals to close. I'll add that not all of those people became homeless -- a large number became the growing prison population.

[thucythucy]

33. Many also were able to move into group homes

and become a part of their communities.

To get into the weeds on this a bit, when we say "de-institutionalization" we're basically talking about two separate developments that were related and happened at about the same time, but even so were distinct. Even the legal underpinnings of the two prongs were different, which made a difference in the outcomes.

People with cognitive and developmental disabilities who were freed from places like Willowbrook and Fernald and Pennhurst--people generally labeled "mentally retarded"--were able to avail themselves of programs developed by the Parents' Movement that started in the 1940s and grew into organizations like the Arc--formerly "the Association for Retarded Children" and UCP--United Cerebral Palsy Associations. The parents in these organizations, together with attorney advocates such as the wonderful folk at PILCOP--the Public Interest Law Center of Philadelphia--were able to hit the ground running and provide the infrastructure needed to help folks from the institutions make a "soft landing" into the community. Not that there weren't problems and mistakes and some abuses, but in general this facet of de-institutionalization was successful. The legal basis of the suits were essentially 14th amendment arguments for equal protection under the law, and the idea that it wasn't constitutionally justified to lock people away simply because they were judged--often incorrectly--to be less intelligent or less capable in some aspect of daily life.

People labeled mentally ill faced an entirely different reality. There was little social infrastructure in place for them. There was a psychiatric survivor movement--particularly on the west coast and in NYC and Boston, but it was relatively small, grassroots, and didn't have anywhere near the financial resources or the political clout of the Parents' Movement. There were beginning efforts to set up peer run settings in the form of "halfway houses" and such, and some of these were successful, at least for a time. But the funding for these either was never there, or dried up once Reagan and David Stockman took their hatchets to the federal budget. The legal argument for this part of the movement was "the right to treatment"--meaning that the enormous state hospitals were uniformly failing to provide anything like "treatment" for the people locked away. It's this difference in legal underpinning that makes it easier for people to still be locked away at the whim of the police or other authorities.

The legal stuff above is somewhat simplified, but that's my synopsis, for what it's worth.

Today there continue to be efforts to provide humane alternatives to institutions and to the medical model of how we deal with people in extreme states. Mad in America is one organization I particularly like, and MindFreedom is another. And there are grassroots peer-driven groups like the Wildflower Alliance and the National Empowerment Center, both in Massachusetts, but these generally operate on shoe-string budgets and fight a constant battle against demonization.

This post went on too long, I know. But it just pisses me off that even on DU we still fall for how the right has framed the issue. It's also quite an effective distraction from talking about meaningful gun reform whenever there's a mass shooting. Instead of locking up the guns, we prefer to lock up people, the vast majority of whom are far more "sinned against than sinning."

[H2O Man]

34. I am a retired

forensic social worker, very familiar with the history being discussed here. For example, there is a distinction between what Reagan did as governor versus as president. I've always advocated for the least restrictive environment. I have/had family and friends with serious mental illnesses, and definitely helped them remain safe in their homes.

The worse misperception of the mentally ill -- at least in my opinion -- is that the media plays a role in convincing the public that, as a group, there are dangerous and prone to violence. In fact, as I'm sure you know, those with most major mental illnesses are far, far more likely to be the victim of violence.

Reagan is far from the only one who advocated for reductions in money for institutions. Nelson Rockefeller released a significant number in my state. There was not a well organized effort to determine who was likely to benefit from living in one of the too few group homes. More, group homes that are run well often lead to more independent living in an apartment, and indeed employment at either a part- or full-time job.

One of the worst things in recent years was the cutting back or ending of case management. A good program helps keep people independent, with significantly fewer hospitalizations. Law enforcement is now tasked with community response in these cases, and they get them later than a case management intervention would have. Having taught prospective local, county, and state police the proper intervention techniques at the State University, my impression was that some understood, and others didn't. Likewise, from the clinic, I saw police who were good, and some who were brutal.

When it comes to gun violence, I definitely think we need real legal reform.I also recognize other factors. I think you would like reading Dr. Jillian Peterson & Sr. James Densley's book, "The Violence Project." They focus on a number of areas, including gun laws as essential, as well as others. I will attempt to limit myself from going on and on -- for this is such an important topic, and I'm Irish! -- but two that I think important are personality disorders and substance abuse. All of my children have been employed in social work, and three of the four still are. I think the people they serve are the children and grandchildren of those I worked with. There are generations that lack basic parenting skills, and issues become entrenched.

I am one of those old men who remembers in the 1960s, when it was in style to care about others in your community/ country. We have, to a terrible extent, lost that value. I am hoping my kids' generation, and the one followig, bring it back in style.

[thucythucy]

36. It sounds like we've both been in this struggle.

I'd quite forgotten what a creep Nelson Rockefeller was.

Are you familiar with MindFreedom? It's a psychiatric survivor group that focuses on human rights and independent living.

Anyway, I pretty much agree with everything you've posted here.

Best wishes.

[eissa]

24. Long overdue

I constantly hear homeless advocates demanding that the homeless be provided with mental health treatment, and now that NYC is doing so, it's "bad." The vast majority of those in the streets suffer from serious mental/addiction issues that need treatment, and if forcing them to get that treatment to save them from themselves will help, then good. I only hope CA does the same, although our homeless enablers will likely oppose it every step of the way.

[thucythucy]

28. Mental health treatment doesn't have to be involuntary institutionalization.

And many people are homeless because of economics, not mental illness.

And much of the mental illness we see among homeless people is the result of living on the street, not the cause of it.

As a society we could easily afford humane options for eliminating or at the very least dramatically reducing homelessness, options that don't involve locking people up. But we've chosen, by and large, not to bother. Just as we've chosen as a culture to wage "a war on drugs" by throwing hundreds of thousands of people into prison rather than offering humane and effective treatment.

When all you've got is a hammer, every problem is a nail. The hammer for our society is incarceration. Old and or disabled: we'll lock you in a nursing home. Troubled youth: "boot camp" to provide some "tough love." Caught in a spiral of addiction: build more prisons at a cost per capita that exceeds the cost of actual effective treatment many times over. Homeless: we'll lock you up for "treatment" that will inevitably devolve into forced drugging and overt brutalization.

But then locking people up is so much easier and feels so much more satisfying than dealing with the absurdly inflated cost of housing, or providing a guaranteed minimum income, or opening peer run mental health clinics, or building homeless shelters that aren't dangerous pits that most sane people would prefer to have no part of.

Here's an alternate approach that might be of interest:

A study by Foundations for Social Change, a nonprofit in Vancouver, simply gave a group of homeless people the money they needed to find housing and get off the street. Guess what? It worked. And once off the street, able to shower and do their laundry, able to eat regularly, not having to spend all their time trying to avoid being beaten, raped, murdered, or freezing or starving to death, people were able to pull their lives together.

"While direct cash transfers aren’t a silver bullet in tackling homelessness, they do seem to have some positive impacts. One study found that cash transfers made to recipients were more likely than those who did not receive them to save money and move into stable housing faster. They also retained more than $1,000 more in savings over the course of a year. In addition, they made more positive social changes, such as investing in children’s well-being and boosting family support."

Then too:

"Although many homeless people are entitled to benefits, it can be difficult to claim them when they are homeless. They often have difficulty accessing a bank account and are often unable to make an appointment due to moving from one shelter to the next. Cash transfers can help them quickly move into housing, which ultimately saves shelter systems thousands of dollars each year."

But rather than even try an approach like this, or improving the social safety net to accommodate for people who are homeless, let's just lock them all up.

You see "homeless enablers." I see people struggling to find effective and humane measures that will actually work.

[David__77]

35. This doesn't provide long term care and support just arrests and persecution.

…

[thucythucy]

37. And I wonder what recourse there will be

for people who want to contest their incarceration?

[Caliman73]

38. New York doesn't have a provision for "Grave Disability"?

In California (not that our system is great) we have involuntary detention for observation and treatment for up to 72 hours based on Danger to Self (suicidality or self harm), Danger to others (Homicidal intentions or threats), and Grave Disability (As a result of psychiatric disorder you cannot provide yourself with basic necessities of life). It is under our Welfare and Institutions Code, section 5150, hence the vernacular term of "getting 5150'd".

The problem in California, as in other places, is lack of resources. Not only during crisis, but primarily in non-critical times, where a person might be backsliding into a critical period. Our funding for housing, vocational services, therapy, etc... is piss poor. We tend to leave it up to law enforcement to be "outreach" to people who are homeless and suffering mental health crisis.

I am not complaining about this, but this is just a reality as well, you cannot compel people to continue receiving treatment after a crisis either. You can put someone into the psychiatric hospital and even medicate them, but you can't make them keep taking medications or seek any other type of treatment. As I said, I am definitely not advocating for forced treatment, but I also worked in mental health for many years and remember the difficulty of seeing client's doing well for periods of time, getting off there medications (which have bad side effects), then sliding back and you could do very little until they hit the threshold for 5150 then start over again and try to help them pick up the pieces.

It is a really complicated issue that needs far more resources available to even start to address the concerns.