NYC’s Unique Approach to Assisting Individuals with Severe Mental IllnessNovember 30, 2023
It’s been a year since Mayor Adams committed to a more proactive strategy for getting help to the desperate and sometimes unstable ill New Yorkers who languish on sidewalks and subways. New data suggests progress is slower than we’d prefer but substantial, which seems about right given that the very nature of the complex challenge resists quick fixes.
Though this population is colloquially called “the homeless,” they are in fact a small and distinct subset of those who typically don’t just lack housing, but struggle with deep-seated maladies, including addiction and serious mental illness. That said, it is dangerously simplistic to assume that all such individuals are what police used to call “emotionally disturbed persons,” or that they present any risk to others. Indeed, just a small fraction of the mentally ill homeless population is prone to violence.
Still, New York has seen too many erratic actions by unstable people, too many threatening encounters, too many subway pushings, too many people who are stepped over rather than assisted in any meaningful way. While human beings should not simply be swept away — contrary to what San Francisco may have done when China’s Xi Jinping visited — it is wholly humanitarian for city government to uproot sleepers from subway cars, which are for transit, and to clear away encampments on public property.
It is wholly humanitarian to empower street teams of social workers and psychologists, sometimes with the support of police, to direct individuals in crisis toward hospitals with additional psychiatric beds and potentially compulsory treatment rather than having them cycle endlessly from ER to street to subway to ER to street to subway.
That cycle, which has persisted for many decades out of supposed respect for people’s civil liberties, in fact was cruelly neglectful of people in crying need — because people who need psychiatric help the most often know the least that they need it.
And it is wholly humanitarian to create more flexible spaces where such people can rest and recharge and find community, some of which are called Safe Havens, others clubhouses. Traditional shelters are necessary. Alternate models responsive to people’s real-world needs are complementary and essential.
Wednesday, Adams touted positive results one year into the new effort, including that the new investments and approaches have helped stabilize the lives of 54 of those considered among the 100 “hardest to reach” New Yorkers — unstable individuals who’ve repeatedly refused help — by steering them into hospitals or other caring environments.
In the equivalent 13 months before the robust new strategy, that could be said of just 22 among the 100. Meantime, more than 6,100 subway sleepers have been placed in shelters in the last year.
Though the numbers might seem small in a city this large, they add up to serious achievements of which he and his top advisor in this realm, Brian Stettin, should be proud. Individuals who’ve spent years resisting help are stubborn, sometimes for rational reasons, sometimes for irrational ones, so every new leaf turned over matters.
Last and not least, a not-so-small point about how progress is measured: Rather than getting occasional good-news updates on how many people have been helped, New Yorkers ought to see a real-time dashboard that enables them to see what’s going on in this realm, warts and all. It’s our city, after all.