Mayor Adams Vows Action to Hospitalize People With Serious Untreated Mental Illness

Katie Honan and Alyssa Katz, THE CITY

This article was originally published on Nov 29 4:59pm EST by THE CITY

In a scripted speech on a fraught issue, Mayor Eric Adams on Tuesday said the city’s police, mental health and other responders will step up measures to ensure people experiencing potentially dangerous episodes of serious mental illness get psychiatric evaluations and care.

“New Yorkers rightly expect our city to help them, and help them we will,” Adams said at City Hall, before making an appearance with leaders of the effort to take questions.

Focusing on the highly visible phenomenon of people behaving erratically — and sometimes violently — on city streets and subways, Adams said that months of discussions with his team and outside experts had yielded a new approach, based on a forceful interpretation of state mental health law. 

Specifically, said the mayor, his administration will instruct NYPD officers and mental health teams that people should be removed to a hospital for evaluation when showing signs that they cannot care for their own “basic needs” as a result of apparent mental illness.

“My administration is determined to do more to assist people with mental illness, especially those with severe psychotic disorders who pose a risk of harm to themselves even if they don’t threaten others,” Adams said. “For too long there has been a gray area, where policy, law and accountability have not been clear. This culture of uncertainty has led to undue suffering and deep frustration.”

Calling action a “moral obligation,” he also outlined an 11-point state legislative agenda that includes a measure that failed to advance last session, which would enable hospitals to hold individuals involuntarily if a patient had not demonstrated preparedness to adhere to outpatient treatment, potentially including medication, after release.

“It is not acceptable for us to see someone who clearly needs help and walk past,” he said. 

An Unconstitutional Move?

The proposal prompted strong reactions from civil liberties and mental health client advocates.

Donna Lieberman, executive director of the New York Civil Liberties Union, hinted that executing the mayor’s plan could prompt a lawsuit over forced hospitalization.

“The mayor is playing fast and loose with the legal rights of New Yorkers and is not dedicating the resources necessary to address the mental health crises that affect our communities,” Lieberman said in a statement shortly after the announcement. “The federal and state constitutions impose strict limits on the government’s ability to detain people experiencing mental illness — limits that the Mayor’s proposed expansion is likely to violate.”

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Adams’ speech followed a Gracie Mansion summit last month of mental health experts convened by former NYCLU director Norman Siegel, an informal advisor to Adams, as well as shocking acts of random violence allegedly perpetrated by people with serious mental illness, including the killings this year of Michelle Go, Christina Yuna Lee, Daniel Enriquez and Allison Russo-Elling.

The mayor acknowledged that success would largely depend on passage in Albany of bills to give authorities greater power and flexibility when interacting with people with mental illness.

In October, Adams and Gov. Kathy Hochul announced an initiative to address safety on the subways that included opening two 25-bed inpatient centers for treatment through the state’s Office of Mental Health. On Tuesday, Adams said those 50 beds are now ready for patients.

Meanwhile, as Gotham Gazette reported, hundreds of hospital psychiatric beds converted during the pandemic to COVID care remain offline. 

The city’s public hospitals will play a role in providing services, said NYC Health + Hospitals system CEO Mitchell Katz, standing at Adams’ side. He previewed what the removal process would look like, following the process laid out in state mental health law. 

“Once they are removed and brought to a hospital they will get the full assessment,” Katz said.

Voluntary or Involuntary

Adams did not have specifics to offer on what city government could offer people after that evaluation and hospitalization. Asked by THE CITY about how he would ensure enough supportive housing suitable to house and care for people with serious mental illness and how he would fill empty psychiatry jobs during a reported labor shortage, Adams responded: “We’re going to staff up to the needs.”

He added: “We need beds. We’re also going to use the technology available to us. It’s a powerful tool to use, Facetime… We’re going to lean into telemedicine.”

Asked about the fatal stabbing of two children allegedly by their mother in a homeless shelter in The Bronx last week, Adams encouraged New Yorkers to use the 311 system — not 911 or 988 — when they detect a neighbor unable to meet their basic needs. “We want to do a hand-off to continuous care,” he said.

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Cal Hedigan, the CEO of Community Access, Inc., a supportive housing and advocacy organization, told THE CITY that “involuntary entry and coercion are not the answer” to helping people in need.

“We need more of the low-threshold environments where people can, if needed, receive voluntary services and build relationships with providers,” Hedigan said. 

“There’s a huge crisis in staffing in the human services workforce because we have been chronically underfunded, and it makes it harder for everyone,” she said. “This work is really about building relationships with people and you need a stable workforce.”

Seeking Another Law Change

One key player in the state legislature, Sen. Diane Savino (D-Staten Island/Brooklyn), did not run for reelection following redistricting and will be joining Adams’ administration in January in a role as yet undefined. Savino tried and failed in the last legislative session to advance a bill she sponsored allowing extended hospitalizations for people with chronic severe mental illness. 

Current New York state law requires release after 72 hours of hospitalization if a patient has psychiatrically stabilized under medical care, regardless of whether they are prepared to comply with medication and other treatment prescribed.

In an interview with THE CITY, Savino also stressed the importance of another change in law that Adams says he’ll seek, which would make explicit that care is required for someone whose mental illness prevents them from following treatment on their own.

“It can simply be your inability to manage your mental health because you won’t take your medication or because you refuse treatment that will help to manage your mental health,” said Savino. “Until you fix the law, you can’t get help to people that this population needs.”

Clarissa Crader is a retired transit cop who patrolled the system at the same time Adams did as an officer decades ago, when, she recalled, MTA rules allowed police to eject disorderly customers.

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Her 41-year-old son, Justin Campbell, is now living in a safe haven shelter in Crown Heights and receiving treatment from a city mobile case management team, following a two-decade history of violent episodes fueled by his psychosis, as recently chronicled by THE CITY.

“I didn’t hear any long-term solutions,” Crader said in reaction to Adams’ speech. “Nothing was mentioned about how chronic or multiple hospitalizations for psychiatric crises will be handled.”

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