For and Against: Two Reactions to the Article: “New York City to Begin Hospitalizing Mentally Ill People Involuntarily,” by Herb Scribner, “Axios,” November 28, 2022.
by Thomas Hansen and Stephen Wilson
These two reactions represent just two different perspectives—among a field of many—in reaction to the plan proposed in New York City to “hospitalize mentally ill people involuntarily.” What started out as a simple solution may be one that is much more complicated indeed. See article, below at *
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FOR: THIS IS A GOOD IDEA
(by Thomas Hansen, Editor of StreetSense)
At the end of November, New York City Mayor Eric Adams proposed this idea—out of frustration with the homeless situation perhaps—and has stirred up a lot of opinions on the solution indeed. Involuntarily hospitalizing people who may or may not be mentally ill is an extreme step.
Some states allow the homeless to walk free after a hospitalization for most illnesses and injuries. Illinois is an example. Other states demand that the homeless person be placed into some sort of facility or have an advocate, guardian, or group who can answer for the person and advocate for them, not just walk freely out the hospital door. Wisconsin is an example.
What possible good could come from “capturing” this individual, taking them to a hospital, and holding them there against their will?
Safety. It is potentially much safer for everyone involved if the person who seems to be mentally ill is kept long enough for a professional evaluation. If the police officers can calmly move the homeless (or seemingly homeless) person to a facility for a thorough evaluation, this could be a win-win or even a win-win-win situation.
How so? Well, the innocent public could be spared attack and injury if the person is moved to another location for assistance and possible psychological or medical treatment. Passersby do not get kicked, stabbed, chased, beaten, robbed or harmed in other ways. Buildings could escape damage. Windows would not get broken. Walls would not be defaced.
Workers out in public—and I think of bus drivers, train conductors, and shopkeepers—would be spared injury and insult, and would be free to continue doing their jobs without interruption. Not being put on the spot to be counselors and advisors to the homeless who may be suffering from mental illness lets them do their thing while other people handle the difficulties arising from the flare ups and the chaos out on the sidewalk.
The police officers and security guards would also be safer—and freer from being struck with fists or bottles or sticks—and other dangerous acts they face daily because of the violence of the persons on the streets.
In addition, if the person is in a facility, the person cannot harm themselves if they are monitored and evaluated. Their own safety is important also.
If done correctly, with a guarantee there will be professionals available on site and in the facilities on call—and not just to be reached by text or fax machine—then there are some aspects of this proposed law—again centering on safety—that could just work.
If this law takes effect, it could mean—and should mean—that a huge amount of financial support should be brought into play. Dollars will have to flow in a sudden and well-coordinated way to “get the word out” and bring about a huge change in the culture of the police, city, public, business, education, and park structures facing communication issues with homeless persons.
Following up the determination of who is (and who is NOT) mentally ill will need to be the millions of dollars for intervention and treatment. New York City is a big place, with a lot of money, a lot of professionals, and a lot of colleges and universities currently training a wide variety of mental health professionals. Safety is the main thing!
It is with an eye on safety, perhaps, that a group of informed and reasonable professionals could help make this idea from the mayor’s office actually work. Safety, and a concern for all, could make this good idea one with enough safeguards and support that it could actually work well for New York City.
The mayor may be onto something good! This solution is do-able for a mega-system like New York City. They could develop for themselves a great model for the Big Apple!
It might even be a model for other cities, like Chicago, which has preferred to close many of its facilities and hope that the homeless persons who are facing the challenges of mental illness will somehow magically just get help on their own accord.
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AGAINST: THIS IS A BAD IDEA
(by Stephen Wilson, one of our reporters abroad)
"It is not acceptable for us to see someone who clearly needs help and walk past..." declared with gusto New York's mayor in a speech outlining a radical reformulation of intervention to allow police extra powers to remove involuntary and send to hospitals the mentally ill homeless in New York.
The current New York State Hygiene Law allows police to remove such people if they appear to be mentally ill and pose a danger to themselves and others.
The newly-proposed law would permit police to remove a person if they are deemed mentally ill and unable to meet their basic living needs. Whether the person is acting dangerously to him or herself and others is no longer the crux of the matter.
Mayor Eric Adams claims it is time to end callous indifference to people who urgently need treatment.
Mayor Adams claims it is important to take the bull by the horns to end a critical situation where the mentally ill go from prison, to hospital, and then go on to the streets again. He is proposing steps where psychiatrists would collaborate with the police to determine whether a person is mentally ill, improve the training of police and professionals, as well as bringing about the badly needed collaboration to avoid premature discharging of patients on the streets. {One estimate claims 60,000 homeless and 19,310 children are sleeping in New York City's mainly municipal system shelters.}
On paper, some of those proposals appear reasonable but in practice huge problems loom up. In one word, there's no infrastructure for this particular solution! There are not enough trained psychiatrists, nurses and beds available in hospitals to provide decent medical treatment.
And since 2019, the number of respite care centers has been cut by half, and the number of mobile crisis units has been reduced from 24 to 19.
Further, only two drop-in centers for adults dealing with mental health problems have been created in New York since 2019. It would be wonderful if the mayor would fund the opening of hundreds!
The state lacks the training, tools and resources to do the job!
A second point is asking the police to help assess whether a homeless person is mentally ill or not! The police are not qualified to make such judgments and suggesting they simply phone up a psychiatrist on a helpline by describing the symptoms is highly problematic.
If trained psychiatrists admit to having problems in diagnosing mental illness then it is hard to imagine whether the police can make judgments so quickly. Note that a recent survey found in the United Kingdom that some patients had to wait nine and half years to be diagnosed and then after that they did not receive the adequate treatment they required.
And what if such intervention backfires? Sending in poorly trained and armed policemen to force unwilling homeless people to be removed seems a recipe for conflict. Figures are showing that as many as 1 out of 4 victims of police shootings have had mental health problems.
Some of the police have expressed reservations about those proposals. They prefer to the phrase “Let sleeping dogs lie” when it comes to intervening in the care of the mentally ill on the streets.
The mayor's view on mental health problems seems stereotyped and over-simplistic. The main problem of homelessness is not caused by mental illness and drug abuse but by the lack of affordable housing, by real estate abuse and corruption, and by a steep rise in rent as well as the higher cost of living. Many specialists in mental illness will state that a lot of the mental distress is dramatically worsened by a society which cruelly divides people into “winners and losers,” creates a huge gulf between the rich and the poor and puts possessions, profits and status before helping and caring for others.
Why doesn't Mayor Eric Adams talk to homeless advocates? Instead, the mayor is talking to police, to cadet trainers, to healthcare providers, to hospital administrators, and to taxpayers.
Why are the uninformed proposing such solutions? Supporting them? Being forced to implement them on the street?
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* Article at the heart of the discussion: Eric Adams: New York City to begin hospitalizing mentally ill people involuntarily (axios.com)