Public Advocate Pushes For Clarity, Compassion In City's Mental Health Crisis Response Strategies

February 6th, 2023

Press Release

In a City Council oversight hearing today, New York City Public Advocate Jumaane D. Williams pushed for clarity on the administration's mental health strategy and raised several questions about the city's plan for involuntary hospitalization of New Yorkers perceived as being unable to take care of themselves. The tactic has been controversial, and the Public Advocate sought specifics to answer the concerns of many New Yorkers about its intention and implementation.

"Mayor Adams says that the city has a 'moral obligation' to help those who have acute psychiatric disabilities, and I agree," said Public Advocate Williams. "However, merely holding a person in a hospital before releasing them into the same environment does not help anybody and in fact may make people distrustful of and less likely to seek behavioral health services...If the city truly wants to fulfill its moral obligation to New Yorkers with psychiatric disabilities, it must invest in a continuum of care that everyone needs... Any continuum of care has to include affordable and supportive housing; affordable, community-based health services; accessible education; non-police responses to mental health crises; and employment. It should fund mental health support and services, not weaponize it."

Mental health has been a key focus of the Public Advocate, who released an assessment of the city's mental health crisis response strategies in 2019 and an updated review in November of 2022. He presented many questions and requests for clarification about the administration's latest plan in a letter shortly after its announcement, and as he noted in the hearing, many of these questions have not been addressed.

He expressed great concern about the level of law enforcement involvement in the city's mental health crisis response, saying that, "Involving the police as the primary people to respond, or having them be present without being called, when responding to a person in mental health crisis is extremely dangerous and has had historically deadly results. The number of NYPD officers who have received crisis intervention training has dropped over the last two years, to the point where two-thirds of active-duty officers remain untrained, and the NYPD has no way to ensure that those officers who have been trained are the ones responding to 911 calls reporting mental health crises."

The Public Advocate's full statement as delivered is available below. His previous, unanswered questions to the administration on the plan can be downloaded here, and the office's mental health report is here.

STATEMENT OF PUBLIC ADVOCATE JUMAANE D. WILLIAMS

TO THE NEW YORK CITY COUNCIL COMMITTEES ON PUBLIC SAFETY; MENTAL HEALTH, DISABILITIES, AND ADDICTION; HOSPITALS, AND FIRE AND EMERGENCY MANAGEMENT

FEBRUARY 6, 2023

Good morning,

My name is Jumaane D. Williams, and I am the Public Advocate for the City of New York. I would like to thank the Chairs and the members of the Committees for holding this important hearing.

In a given year, one in five New Yorkers experiences psychiatric illness, and hundreds of thousands of those are not connected to care or support. Those who are not receiving treatment or services for their psychiatric disabilities are more likely to be low-income people of more color. In addition to a shortage of inpatient psychiatric beds, our city is also experiencing an affordable housing crisis, forcing more and more people into the shelter system and the streets, making people experiencing homelessness and/or symptoms of psychiatric disabilities even more visible.

In response to a rise in crime rates in the subway, including two tragic and high-profile incidents where people experiencing symptoms of psychiatric disabilities pushed commuters in front of trains, Mayor Adams announced in November of last year that NYPD and FDNY would be allowed to involuntarily take people perceived as being unable to take care of themselves to hospitals. Many received this to mean they would be removed regardless of whether they pose any threat of harm to themselves or others. It also seemed that this was simply the announcement of a tactic, much less an entire plan. First, we have to make sure we are clear that mental health is not a crime, and that most people who are experiencing mental illness will not commit crimes.   

Until that announcement, people experiencing mental health crises could be involuntarily detained only if they were deemed to be an immediate risk to themselves or others. Now, it was assumed based on the announcement that those perceived to be “mentally ill” and unable to care for their basic needs can be detained and forced into a hospital, even if they pose no risk of harm to themselves or others. If this is the case, it could not only be dangerous but also a waste of resources.  

It is important to point out there is no evidence that court-ordered involuntary treatment in hospitals is more effective than community-based treatment. In fact, Martial Simon, the man who fatally pushed Michelle Alyssa Go in front of a train while experiencing symptoms of schizophrenia, had been hospitalized at least 20 times and reportedly was upset that hospitals were discharging him before he believed he was well enough to live on his own. Involuntary hospitalization also has a broad negative impact on many areas of a person’s life, often leading to the loss of access to basic rights and services, including employment, parenting, education, housing, professional licenses, or even potentially the right to drive.

Involving the police as the primary people to respond, or having them be present without being called, when responding to a person in mental health crisis is extremely dangerous and has had historically deadly results. The number of NYPD officers who have received crisis intervention training has dropped over the last two years, to the point where two-thirds of active-duty officers remain untrained, and the NYPD has no way to ensure that those officers who have been trained are the ones responding to 911 calls reporting mental health crises. To name only one tragic story: In 2019, two police officers were dispatched to the home of Kawaski Trawick, a 32-year-old Black man experiencing a mental health crisis. Within two minutes, the officers escalated the encounter to the point that one of the officers fired four shots, killing Mr. Trawick, who did not have a gun. The officer who fired the shots had attended crisis intervention training just days prior.

Mayor Adams says that the city has a “moral obligation” to help those who have acute psychiatric disabilities, and I agree. However, merely holding a person in a hospital before releasing them into the same environment does not help anybody and in fact may make people distrustful of, and less likely to seek, behavioral health services. Just before that announcement, my office released a report saying how we were doing on mental health, and what we could be doing better – I did not receive any response from the administration, and all of our reports do go to the administration.

If the city truly wants to fulfill its moral obligation to New Yorkers with psychiatric disabilities, it must invest in a continuum of care that everyone needs. I also want to mention that on December 1, my office sent a letter to the administration to get questions answered about many of the things that not only my office but many reporters and New Yorkers have asked, to try and see if we could flesh out if there was a fuller plan here. As of today, we have not received any response. Any continuum of care has to include affordable and supportive housing; affordable, community-based health services; accessible education; non-police responses to mental health crises; and employment. It should fund mental health support and services, not weaponize it.

I want to be clear that most communities that can access this continuum of care are generally white and wealthier. Most who cannot are generally poorer, Black and Brown, and unfortunately receive a response of police, forced hospitalizations, and arrest. So I always want to make sure that we can provide the continuum of care that’s actually needed, that may include hospitalizations, but it needs to be clear what that plan is, and my hope is that with this hearing today, perhaps we can get many of the questions answered that many of us have, including mine, and hopefully my letter can be responded to shortly.

Thank you.

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