Earlier this week, New York City Mayor Eric Adams made a speech about how he refused to ignore people living on the street who appear to be struggling with mental health issues. He acknowledged the need for long-term supports, such as permanent housing with attached social services.
But the centerpiece of his announcement was a policy shift empowering police and street outreach teams to bring more New Yorkers to the hospital for psychiatric evaluation — against their will if necessary.
Pointing to state guidance released in February from the New York Office of Mental Health, on the same day he and Gov. Kathy Hochul launched a subway safety plan, the mayor said the standard for forcing someone to go to a hospital should be whether that person appears to be struggling with a mental illness and unable to meet their own basic needs — not just whether they are likely to hurt themselves or others, which was the previous standard.
But the new directive raises the question: What exactly happens when someone is taken to a New York City hospital against their will? The practice has long been in place for people considered threatening, and some in the mental health community say it often fails to leave patients better off – at times, even making things worse.
When a New Yorker arrives at a hospital emergency room, they must first be evaluated by a medical professional to determine if they should be admitted and given a bed. The goal of a psychiatric hospitalization is typically to stabilize someone in the short term — often with medication — and then connect them with long-term services in the community. But those working in mental health said both hospital psych units and community-based services in the city are already strained.
Even those who work in psychiatric hospital settings acknowledge that not everyone benefits from being hospitalized.
“The hospital isn't the place that magically fixes problems, especially a lot of these longer-term chronic issues,” said Dr. Craig Spencer, former director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center who left this summer to join Brown University as an associate professor. “It may or may not improve their underlying condition… Maybe it'll help if they're not taking their medications, maybe it won't.”
WNYC host Sean Carlson spoke with health reporter Caroline Lewis about the state of NYC's psychiatric units and what the city's new policy could mean for people forced to visit them.
Click "listen" in the player to hear their conversation, and visit Gothamist for more on the story.