New York City’s New Mental Health Plan is Dangerous

Nazish Dholakia Senior Writer
Jan 24, 2023

Late last year, New York City Mayor Eric Adams issued a directive that effectively grants police wide discretion to forcibly remove any person who “appears to be mentally ill and displays an inability to meet basic living needs” from streets and subways and transport them to the hospital. The policy is ineffective at best and dangerous at worst. It further criminalizes people with mental health conditions and people experiencing homelessness and, if implemented, will harm hundreds or thousands of people, particularly Black people and other people of color who are disproportionately impacted by homelessness and other injustices of our criminal legal system.

Here’s why the mayor should reverse this policy and what he can do instead.

When police respond to people with mental health conditions, the outcomes are often harmful and sometimes deadly

Adams’s directive gives law enforcement wide latitude to determine whether someone is able to care for themselves, a decision police are largely ill-equipped to make. Already, interactions between officers and people experiencing mental health crises too often result in arrest or jail time or, in the worst cases, death.

In fact, people with mental health conditions are 16 times more likely to be killed by police than others who are approached or stopped by officers. Police often lack the skills and the training to safely and effectively help people with mental health needs. And even if officers have completed relevant training, the presence of police vehicles and armed officers can be enough to escalate a situation—this may be particularly true given the fraught relationship between police and unhoused New Yorkers. The mayor’s action would increase law enforcement’s role in these interactions, which could endanger people with mental health conditions, people experiencing homelessness, and officers themselves.

“When people are in the throes of a crisis, they don’t need to see someone with a badge and a gun,” Matt Kudish, executive director of the National Alliance on Mental Illness of New York City, told Gothamist. “They need to see a mental health response to a mental health challenge. Not a criminal, legal response to a mental health challenge.”

The policy also puts strain on hospitals and staff that are already overextended

Adams’s new policy enables law enforcement to transport people to hospitals against their will. But, once there, only medical staff can determine whether they should be involuntarily hospitalized. If a medical evaluation determines that a patient’s symptoms are psychological, patients then have to “board” in emergency departments, waiting hours or days for one of a limited supply of inpatient psychiatric beds. If their alleged symptoms are not determined to be psychological, they are released from the hospital—often separated from their belongings miles from where they were picked up.

Forced hospitalization is unlikely to benefit anyone under this new policy. Doctors have said it “will harm all potential ER and hospital-bound New Yorkers” and exacerbate the challenges that hospitals and staff already face. It thus serves only to displace people targeted by the policy for days or weeks at a time. People in these positions and their loved ones have described these experiences as stigmatizing, unconstructive, and traumatic.

“The mayor talked about a ‘trauma-informed approach,’ but coercion is itself traumatic,” Harvey Rosenthal, chief executive of the New York Association of Psychiatric Rehabilitation Services told The New York Times.

Governor Hochul pledged a $1 billion investment into New York’s mental health system during her State of the State address this month. However, advocates have stressed that such an investment must be used to expand access to non-coercive and community-based services. They also called for legislators to pass the Treatment Not Jails Act, which would provide more opportunity for people in the court system to receive these kinds of services, rather than jail time.

What we need instead is greater access to treatment and care

“Our ambulances are simply the entrance to a broken pipeline,” Anthony Almojera, a paramedic in New York City, wrote in response to Adams’s announcement.

Instead of a policy that handcuffs people on streets and subways and shuttles them to hospitals with no real lasting solutions, we need sustained investment in mental health care. Since 2019, the number of mental health crisis centers in the city has declined by half, and the number of crisis response teams has also decreased, according to the November 2022 report by New York City Public Advocate Jumaane Williams.

Adams has also slashed funding for New York City’s crisis response program, the Behavioral Health Emergency Assistance Response Division (B-HEARD)—which sends teams of health professionals to respond to mental health calls—by $12 million.

But these are exactly the kinds of programs that reduce our overreliance on police, and they are crying out for civic investment. B-HEARD is one of many civilian crisis response programs that have launched in cities across the country. Programs such as CAHOOTS in Eugene, Oregon, and CALL in St. Petersburg, Florida, have shown that teams of unarmed first responders—which can include people with lived experience of mental health conditions—can safely and effectively respond to calls related to mental health, poverty, homelessness, and substance use. Effective implementation of civilian crisis response programs depends upon close collaboration between officials and community partners, which requires local governments to allocate time and resources for community feedback.

We need effective coordination between city agencies on matters related to public safety

The New York City Police Department was notified of Adams’s new guidance the same day it was shared with the public. Coordination between health departments, human services, safety-focused agencies, and city leaders is necessary to sufficiently address issues related to homelessness, mental health care, and public safety.

We also need deep investment in housing, health care, and supportive services

Elected officials often default to police to respond to myriad issues. But responding to social issues through policing is a policy choice. And, in most cases, it’s one we should move away from.

We also need to stop expecting that police can or should make assessments of people’s mental health. Adams’s recent policy does just the opposite, endangering people with mental health conditions and people experiencing homelessness, groups that are already incarcerated in disproportionate numbers.

Instead, Adams and other local, state, and federal authorities should invest in much-needed services and supports—including affordable housing, crisis response programs, community-based mental health services, and other solutions—which build real public safety. Until then, this policy will only lead to more people cycling through a system that isn’t working and being harmed along the way.