How to effectively treat those with mental illness recently made the news when New York City Mayor Eric Adams announced a new directive to move those with mental illness from the streets to inpatient psychiatric wards. 

This directive encourages first responders to involuntarily hospitalize anyone who had a mental illness and was homeless, a very different approach from the high bar of homicidal or suicidal intention that has been previously required by law and used as standard practice.

In November 2022, Mayor Eric Adams – a retired police captain with 20+ years of experience in the New York City police department – announced his new plan to empower first responders to take homeless, mentally ill individuals to the hospital: 

“Job one is to make it universally understood by our outreach workers, hospital staff and police officers that New York law already allows us to intervene when mental illness prevents a person from meeting their basic human needs, causing them to be a danger to themselves.” – Mayor Adams, Daily News

Some see this as destroying the autonomy of those with mental illness, while others hail it as a much-needed solution to New York City’s rampant homeless population and growing crime. 

The best way to support and encourage recovery among those with mental illness has long relied on the community-based model of treatment. Studies show that integration in the community improves recovery, but the new directive throws that into question. 

VOCAL-NY Organizing Director Jawanza Williams fears that the new directive is regressive and takes us back to the days of forced institutionalization: “The lives of people dealing with mental health crises won’t be improved by forcing them into treatment, especially if it’s coming from law enforcement. All this directive will do is disappear them.”

Not only does this directive affect the 3,400 homeless in New York City, but it could have ripple effects throughout the behavioral health world, potentially broadening the requirements for involuntary hospitalizations and emergency petitions. 

Proponents of the directive point out that it’s in the individuals’ best interest by preventing passersby and first responders from looking the other way when someone is in crisis. The Mayor also noted that once an individual is taken to the hospital, they’ll undergo an evaluation by a behavioral health professional. 

“ ‘The doctor may disagree,’ said Brendan McGuire, Mayor Adams’ chief counsel. ‘Then you’re out. You may be out with some medication. You may be out with a treatment plan that maybe this time you decide to do. It’s really engagement more than anything — and forcing that engagement.’ “

So what do you think? Should this “engagement” be forced? Is it a necessary step to helping New York City’s homeless? Or should the high standard for involuntary commitment be maintained, preserving individual autonomy and one’s right to choose the life they want?

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