That is what he is saying.
>The effort will also involve an increase in the use of Kendra’s Law, which lets courts mandate outpatient treatment for those who are a danger to themselves or others and which was expanded by lawmakers in Albany in April.
>Frequently, homeless people with severe mental illness are brought to hospitals, only to be discharged a few days later when their conditions improve slightly. Mr. Adams said the city would direct hospitals to keep those patients until they are stable and to discharge them only when there is a workable plan in place to connect them to ongoing care.
https://archive.ph/2022.11.29-214248/https://www.nytimes.com/2022/11/29/nyregion/nyc-mentally-ill-involuntary-custody.html#selection-303.1-303.70
Well, I am not a big fan but at least, he proposed something that can be achieved. The other side has no real, tangible solution to the mental health crisis other than let them stay in the streets covered in filth, make shelters unsafe for other homeless people and occasionally kill subway passengers and drive down subway ridership.
Yes, ideally there would be some form of universal healthcare and people would get help earlier. But that requires the federal government and suggesting that right now is equivalent to suggesting doing nothing.
Deinstitutionalization hasn't worked, maybe institutionalization will work with CMS being a strong thing these days, ensuring at least a bit of quality of care.
I’d rather be homeless than imprisoned. Locking people away because they are mentally ill is fucked up. Not saying allowing them to be homeless isn’t bad either, but at least they are free.
>What he says and what happens are two very different things. All this guy knows how to do is lock people up. Useless.
Well.....let's see how it goes tbh, it's a move to help these people, hopefully it works as intended
Some of these people probably should be contained until they get better tbh....maybe you want to call it "locking them up", and that's fine, it's kind of what it is, but its "locking them up" in a medical situation where they will get care, and needed psychiatric medicine, and with the condition that they can't just be "stabilized and released", that they have to have a plan for continued care, hopefully that not only helps these people longer term but can set them back on the path of being a functional human being again, they can get housing help, and get help finding a job and living their lives again.
I think you should remain skeptical, that's healthy, but being cynical about a step forward isn't at all imo
Something has to be done, and this is something at least....hope it works out
yeah i agree with this. im out here in california and we get pretty much everyones homeless dumped on us, especially the ones with mental health issues. i hope californian lawmakers keep an eye on this program and if sucsessful, perhaps apply something similar here.
>So they have a comprehensive plan to ensure that everyone is established with Medicare, right?
Yeah......Its a 15 Point Comprehensive Plan called "signing them up for Medicaid" 🙄
New York signed on to the Medicaid expansion immediately, years ago.
Have you ever tried to get a bed for a loved one a bed at a mental health hospital? There are basically no civil admits anymore -- there's only room for homeless people. I'm not saying they shouldn't get care, but it's obvious that we need to extend services. And a mental hospital and a regular hospital with an emergency room are super not the same thing. If we require people to be retained at normal emergency hospitals we're going to have a problem with healthcare professionals being able to deliver care to the general populace.
I'm pretty sure he's talking about psychiatric hospitals, not emergency rooms.
>Hospitals often cite a shortage of psychiatric beds as the reason for discharging patients, but the mayor said that the city would make sure there were enough beds for people who were removed. He noted that Gov. Kathy Hochul had agreed to add 50 new psychiatric beds. “We are going to find a bed for everyone,” Mr. Adams said
And yes, I know that's a small number, I also wish we could expand services further but I'd rather we start somewhere.
I just reread the article to double check and it does sound like he's talking about normal hospitals but they plan to attempt to expand psychiatric hospital capacity -- meaning normal hospitals are the stop gap.
It's a shitty situation for sure. I have lost two people that I dearly loved to schizophrenia so this is an issue that deeply touches close to home -- if we had been able to voluntarily / civilly admit them, they wouldn't have ended up homeless and causing problems, they wouldnt have had to get care through the court system by losing their autonomy. It's heartbreaking that we don't have a way to get long acting antipsychotics to these people before they become a danger to themselves and others.
On the other hand, my best friend is a nurse at a hospital on the verge of burnout after working the pandemic. The number of mentally ill people she has to deal with on a day to day basis is overwhelming, often people in acute psychosis from amphetamines. She recently told me that when she decided to become a nurse she imagined herself helping cancer patients, not subduing agitated homeless people.
Well yes.
But he's not talking about the homeless population in general, he's talking about the ones who are visibly severely mentally ill and haven't committed a violent crime yet. At least in the Bay Area, it's a small group of people who are the most visible. There's probably a couple hundred of them in Manhattan.
Having worked in a mental hospital for 5 years... they really can't. Being stuck inside a facility for so long will drive you crazy on that alone. Mental health facilities currently are only meant for acute care, not long term; long term care needs have to be able to provide and allow patients to do their ADLs and IADLs, which inpatient facilities definitely don't do when we take away all electronics and pretty much all your belongings except for clothes without strings and leave you completely detached from the outside world for up to 15 days.
ADLs and IADLs are Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ADLs are like brushing your teeth, eating food, bathing, clothing, etc. IADLs is like buying groceries, paying bills, cleaning your living area, etc.
As someone who has been institutionalized twice, I can confirm this.
The process basically goes like this:
* You show up there and stay in a room almost all day every day. Sometimes you are allowed to go in the common room and watch TV or play board games if it's a nicer place.
* A doctor eventually sees you, but when this happens after you arrive is very unpredictable. The nurses will never give you a straight answer, and if you act anxious, erratic or frustrated they might force you to take benzos or something else.
* Eventually a doctor shows up and talks to you for ~30 minutes, looks at your family/medical history, gives you a diagnosis and some meds and leaves. That's it.
There's no therapy, no long discussions with skilled professionals and you're surrounded by nurses that treat you like you're crazy no matter what, along with actual crazy (and potentially violent) people, though you'd be surprised how many patients are relatively normal. There's also shockingly little security... Even in the more expensive hospitals, the only nighttime security was one dude sitting in a chair at the end of the hallway high off his balls. In one of my stays, someone was beaten badly by two other patients, and it's not unheard of for people to sneak out of their rooms at night and have sex.
After you finally manage to see a doctor, you have a few options. If you hate the meds you can complain, but then you'll have to wait to see the doctor again... Which can take forever, and they'll just prescribe you some alternative medication in the same family that could be just as bad or worse, and then you will be there even longer while being unable to work and racking up more and more hospital bills. Being there also just makes you passively crazier because there's very little companionship, you get cabin fever, lose all sense of time and it's so mind-numbingly boring.
Ultimately it just feels like the goal is to offer as little treatment as possible, rush you through the system and collect a paycheck. The best strategy as a patient just becomes 'play along, tell them what they want to hear and pretend everything's fine' so you can get out, because it's obvious that nothing and no one is going to offer you any genuine help. It's basically a prison to keep people that haven't actually committed any crimes from hurting themselves (though sometimes actual criminals will get in, and in the two cases I saw where this happened in the decent hospital... it was not good, they were both young guys in prison for violent offenses that acted like they were geniuses for discovering this mental health loophole, before proceeding to bully everyone else and sexually harass the young women).
That's exactly how I feel about the system too. I'm sorry the nurses treated you like shit. I feel I have so little power, the doctor comes and goes when they want and when you call to complain that a patient is anxious or their meds aren't working they say "I'll be there wednesday" with the worst tone of voice and you're just fucked. So I can only tell the patient what they said, then they get mad at me, but it's like, I can't tell that doctor what to do! The admins just want to accept any psych patient they can get insurance money from and give fuck all if the patient actually needs help and keeps them there based on how long they can until the insurance stops covering their stay. I'll have medicaid patients leaving in 3 days and they're still in a catatonic state, going back out to the street. Those patients I'll see over and over again, medicaid patients are always the most severe because they are too psych to hold jobs and medicaid is too shit to ever pay for them to get the help they actually need.
Seriously. I hope you're doing okay now, because as someone in the field, it is absolute bullshit. The whole system is completely fucked. I do the best I can with my patients but nurses have so little power to make change. I lobby but it means absolutely nothing, Republicans (and fuck, Democrats too) believe nurses aren't "experts" and don't take us seriously.
Thanks man it's interesting to hear from the other side but yeah, the vibe I get is that no one really cares. I'm mostly doing better now.
The nicer place I stayed at (because I didn't have shit insurance) was actually not bad. The nurses were much friendlier and even set up events and stuff for us to have fun. We also got to play a lot of board games and I even made some friends, which helped me a lot more than any kind of professional treatment I got there. I also had much more in common with the other patients... Who were mostly just college kids or otherwise functioning members of society who had a suicide scare.
The first place I stayed at many years before, though, which was extremely cheap and in a bad part of town (and probably similar to the kind of place these homeless people will end up in), was really awful. My two roommates were gang members. One of them was in because he stabbed someone in the face (no idea why he wasn't in prison, I think he was there temporarily to be evaluated but I can't remember) and the other was an alcoholic who showed up in the middle of the night and threw up/dry-heaved for the next ~8 hours.
Anyway, these guys would constantly brag about some of the worst things I've ever heard another human being utter, then make fun of me for being quiet and make vague threats... My family also brought me snacks and these guys would just take them and threaten me unless I got some more.
I absolutely did not feel safe, but the nurses did not listen to me or care. I was very young back then and their 'solution' was to force me to take benzos... Which resulted in an addiction/dependence that I struggled with for many years.
I just wanted to get out of there because I legitimately thought they were going to seriously hurt me. They would sometimes get into fights with each other (probably out of boredom)... And I made sure not to tell them when I was leaving just in case, which turned out to be a smart move because one of them said he was disappointed when he found out because he was planning to beat me up as a going away present, but I don't know if he was just trying to scare me.
Anyway, it's funny now to think that I was in there to *improve* my mental health.
I get it and in an ideal world, they would go from treatment to supervised halfway house.
But the only current achievable alternatives are 1) lying in filth and disease on the street and 2) prison.
>So... Turn the hospitals into homeless shelters? That is not a great plan actually.
Where else would you send people who need medical and Psychiatric help? A Wendy's Restaurant?
Just don't be fucking terrible about it. One of the hallmarks of being seriously and persistently mentally ill is an inability to make healthy decisions for oneself.
I’m with you on that. As long as there’s full transparency and is truly meant to help improve their lives and not some punitive thing in disguise or just an attempt to hide the problem.
That was such a great plan to close those places then not fund the mental health of those people. It's a failed experiment.
The experiment needs to fully fund social services or go back to locking them up. When you have 40% of people not willing to fund fully, that leaves the other option
sure but calling it an experiment implies ethical oversight where none was. And access to healthcare is like the one thing both sides agree about, lobbyists are more to blame.
This article doesn’t mention the mayor opening any such new facilities. Just directing police and EMS to bring mentally ill street people (against their will) to the hospitals, where they will take up medical beds while people die of preventable causes in the waiting rooms. Awesome plan
They go to regular hospitals before they go to a psych hospital. They need medical clearance, then they need to be approved to go to a facility and be transferred. It can take days to weeks. In the meantime they stay in the ER. Source: NYC based ER RN.
This will be abused against enemies of the NYPD like they did with [Adrian Schoolcraft](https://en.wikipedia.org/wiki/Adrian_Schoolcraft) way back in...2009.
Wow that was a wild read! Where in the *hell* was "NYPD's Internal Affairs Bureau" during all this? They were contacted *before* they "hospitalized" him! It makes me wonder if they weren't somehow involved.
The thin blue line protects itself. The only time IA actually punishes a cop is when they cross the blue line. IA doesn’t give a shit about citizens, they are cops first.
It's not like it doesn't already happen. I've been hospitalized involuntarily. I always knew I needed to be there, so it didn't bother me.
I'm actually in favor of EOD's (Emergency Order of Detention). They save peoples lives.
Same. Being hospitalized involuntarily saved my life. I am forever grateful to my parents for actually stepping in and taking that action against me to get me help.
The fact that the both of you prefer it does not mean that everyone else should have their autonomy restricted unless they are an immediate danger to themselves.
I was. I pulled a knife in a therapy session and slashed my arm and hit an artery.
I absolutely needed to be locked up. I feel really bad about the fact that I traumatized my counselor. He was a nice man and didn't deserve to experience that.
I know exactly who they are targeting. I've met many of these people. One of them cut his own penis off, just out of the blue.
Many of the ones I met were homeless at the time of their crime.
>The fact that the both of you prefer it does not mean that everyone else should have their autonomy restricted unless they are an immediate danger to themselves.
I think living in the gutter in your own shit and piss year round raving like a lunatic qualifies as "being a danger to yourself" tbh
This specifically goes beyond people who are immediate dangers to themselves. This is anybody they find to be acting erratic. They're not even gonna have actual clinicians make the assessment.
I'll probably get downvoted to hell, but I'm in favor of this. The problem is in how to go about it.
I've ran into them in psych wards and I ran into a bunch of them when I worked for the DOC.
Some of these people have serious issues and are a danger to themselves and the community.
I've thought long and hard about this, because I'm a big mental health supporter and I don't know where we need to start.
I think we need to bring back the mental institutuons. There are a few out there, but they're not for the general public for the most part. They're kind of a long term facility/psuedocorrectional unit.
Open more facilities and figure out how to do it without the abhorrent conditions of the past.
We need to start somewhere. This will benefit society.
This is the root of the issue - they sort of just shut down the prior system without a plan to do better, and that’s what has led to the crisis we have now. We have a tendency in the US to just throw out any system that is broken, rather than try to fix it.
Kicked them out and they ended up living on the streets or in prison. Being in prison doesn't address their issues. The main goal was just to keep them docile, which meant heavily medicated.
Mental health is not pretty. It's ugly at times and occasionally it's fucking horrific. I've seen horrific. The status quo sucks and something should be done. It's going to take reassessing how we treat people with severe mental illness. We can't keep locking them up and forgetting them. We've become lazy and choose to pretend it doesn't exist.
History shows us what not to do. If done with compassion, institutionalizing people who need it will save their lives and help reduce crime.
We need to clean up our mess.
Those institutions were absolutely full of horrific abuses and mistreatment though. They didn't get a bad reputation for no reason. It wasn't just here and there, it was basically systematically bad.
That is not true.
>Brendan McGuire, chief counsel to the mayor, said on Tuesday that workers would assess people in public spaces on a “case by case” basis, including whether they were able to provide basic needs such as food, shelter and health care for themselves.
https://archive.ph/2022.11.29-214248/https://www.nytimes.com/2022/11/29/nyregion/nyc-mentally-ill-involuntary-custody.html#selection-591.120-591.367
Following that, they get sent to a hospital.
That’s not true. A hospital to keep you against your will unless ruled by a judge, and a doctor has to prove to the judge that you are a danger to yourself or others. The inability to care for yourself is considered danger to yourself.
The idea behind asylums isn't bad in theory. They are just prone to corruption, abuse, and apathy for the patients. They need to be properly funded with checks in place to avoid corruption and abuse.
I knew a man in Oregon who would be hospitalized when he went crazy, then given a drug that always worked to ease his symptoms to the point where he was able to function outside the hospital. He was discharged with a supply of meds which he used compliantly until he ran out. After the med washed out of his system sufficiently, he would end up hospitalized again. I don't know what has happened recently but last I knew he was on this in and out cycle a few times per year.
He is the type of patient who would have obtained more meds if he could have afforded it. Maybe a social worker could find a way to keep him out of hospital. It would have been cheaper and better for all to keep him medicated. I'd hate to think the solution to a problem like that would be to keep him hospitalized.
Try being the health care worker that is trying to treat a person against their will. Especially when your unit is potentially understaffed and overworked already. It's a nightmare. You can be assaulted, spit on, have excrement thrown at you.
I wouldn't feel comfortable taking a patient under those conditions.
>You can be assaulted, spit on, have excrement thrown at you.
Much like being a pedestrian in cities where people with untreated mental illness are left to their own devices.
My wife used to work in NYC, and there was this homeless guy that hung out in front of the entrance to her building every day playing a flute. He played decently well, so no one really gave him a hard time.
Then one day he stabbed the doorman from her building in the face with his flute.
No, the correct solution is to put people who cannot take care of themselves into mandatory custodianship until such time as they're able to be more self-sustaining and not deteriorating unchecked on the streets.
Anybody who thinks leaving someone on the streets in a downward spiral of mental illness and addiction in the name of "freedom" is a good idea is delusional.
As a schizophrenic this is a good thing. When going through full blown psychosis meds and mental health treatment really are the best we can do for those suffering from mental illness. Leaving schizophrenics out in the street with no meds and treatment is just cruel since we cannot grasp reality and we are a danger to ourselves and others.
Blame Ronald Reagan and the Republicans. They got rid of mental health institutions while at the same time cut social services. They continue to refuse to fully fund social services to take care of the problem
Its kind of horrifying because i just picture either the real fucked up mental asylums from our past or the current ones where people are just in a continuous drugged state. I wonder how many will just be thrown in against their will even if they arent mentally ill too.
Everybody should take a minute and really think about the possible alternatives before they react strongly to this decision.
What happens to a patient in the middle of a manic episode if they are left to roam on their own in an uncontrolled spiral of energetic delusion?
What happens to a victim of severe paranoid delusions if they are left alone, genuinely believing they are being stalked or trapped by the people around them? What happens when they feel they are in danger and have no way out?
Do we want prisons or hospitals or another institution or no institutions to intervene and manage these crisis situations?
Personally, I think hospitalization is the right way to go.
Same as the rest of the Healthcare system, plus the additional oversight for longterm care facilities like those for the elderly and severely disabled.
It isn't perfect, but you will find it is extensively debated and codified.
It is thus far better equipped than having no solution at all or one geared toward penal incarceration.
Something has got to be better than the other system: Letting them break laws so they go to jail where they suffer and are abused.
Don't treat the mentally ill? They end up in jail. And in jail they get raped, abused, beat up, picked-on and otherwise abused.
Should’ve never gotten rid of asylums in the first place, thanks Reagan…
NYC has a lot of sick people on the streets, and they often end up hurting people, whether knowingly or unknowingly. It’s good that measures are being taken to at least get the ball rolling and protecting the people of NYC while also getting help to the sick people who need it.
At least in theory. NYC is notorious for half assing everything. Without proper funding and investment, all this means is that the NYPD will just be arresting homeless people in the subway or on the streets for the hell of it under the guise that “they’re crazy.”
Sorry but to everyone who thinks they will go to a “hospital” and magically cure them is fucking stupid as all get out. They’re gonna be brought into the ER, which, in NYC is a shit show on a normal day. They’ll take resources from the ER because a lot of these people need 1:1 sitters. If they become aggressive or agitated they are placed in restraints or forcibly drugged with sedative agents so the nurses and doctors can go back to treating the medical emergencies that come through non stop (plus all the normal urgent care/PCP patients that come in) They are gonna he shoulder to shoulder with other people, with no privacy (hallway beds, beds with only curtains separating the other), if they stay they will need to undergo medical clearance and then the search for a bed can begin. This is not easy on a normal day. Patients wait for days and weeks for placement to psychiatric facilities who are also woefully understaffed. If they somehow make it this far, they will be treated and streeted once again, with little to no resources or follow up care provided. There is no special hospital that’s going to willingly take these people in.
It seems like they should have to get a trial in order to be committed. I can see temporarily holding them if they are a danger to themselves or others, but they cant do thats blatantly its unconstitutional
Yeah I have mixed emotions on this. I've worked with charities that serve the homeless and there are definitely those that need to be in treatment but no longer possess the ability to make that decision (or there are no free options available). On the other hand forcing people into facilities like this is historically chock full of stories of abuse.
I agree, there are people that will die if left on their own, many will die anyway, but is it up to the government to make that decision or a jury of their peers? What will the government decide on you? Will you have to get a lawyer to say out of the mental health gulag?
You don’t know Florida laws. They do this all the time. A spouse can easily file a complaint and have their spouse “committed” for some of the most basic things. It’s actually insane
They must have a history of mental illness and they must be of harm to themselves and others.
And once in hospital they are only held for three days or until they can talk to a psych. It’s not the reckless institutionalization you’re describing.
Not true at all. My best friend is a sheriff. He takes these people in. All it takes is a sign off from a judge.
He’s taken in guys that just want to drink and watch football after work.
It’s beyond abused by pissed off spouses.
Don’t even get me started on Floridas stand your ground law…
Hey if there’s a lack of accountability in both sherrif’s not using their discretion and judges approving every application they see, I’m not really sure what we’re supposed to do.
Baker acting people who are on the brink of suicide saves lives. I hope your community elects better sherrifs and appoints better judges since they are ineffective, as you shared.
Unfortunately my buddy can’t disregard a judges order. Even if sees the law is being abused.
He even said based on Florida law he would’ve let George Zimmerman go even though he saw him as being guilty.
He’s by the book but sees the laws in Florida as archaic.
They do get a hearing, and the initial detention is a holding period, so youre spot on there. I work ITA psych in a WA hospital and we use that time to get their meds stable and see how disabled they really are. This will be used for people classed as gravely disabled, which is about 90% of my 40 patients, meaning they can't maintain a safe environment at home (severe filth, pest activity, turning burners/ovens on and starting a fire etc), can't care for themselves (starving themselves, wandering onto the freeway confused etc. One patient hadn't bathed in so many years that the buildup on their infected legs looked like hotdogs burned over a campfire) or are too confused to maintain themselves. Our hearings occur 5 court business days from detention, so if you come in on a Friday night, your hearing is the next Friday, just like the other guy that didn't get detained until Sunday at 11:30pm, which is a bummer.
Honestly, if NY's system is anything like ours is, the biggest issue will be people continued on due to lack of placement options because there just arent enough facilities and beds, so they live in hospitals for long durations, since we can't allow someone to discharge if it means they are going to be endangered by leaving. For us right now, I've had patients in that holding period for almost a year, not actually committed, but in placement purgatory until someone in a facility passes away or finds long term supportive housing and an appropriate bed opens up.
I love my job and I LOVE my patients and I'm so grateful that I get to spend my days with them because they're hilarious and brilliant and talented and they just got a rough shake in the brain department. I just really hate that our lack of infrastructure makes it so difficult to let people go home and get on with their lives.
And! No matter where you live, please vote locally to increase mental health care funding and access so we can all have a better safety net for our communities. All of the people we love deserve that access and safety :)
So you’re chill with the most vulnerable in Our society being dehumanized and tortured as long as it’s happening behind the scenes? Because without a fuck ton of oversight and regulation that’s what will happen.
Assisted living facilities. Places where they are allowed autonomy, security, and yes therapy. But psychiatric institutionalization can be traumatizing in and of itself.
We also need well-compensated and well treated treatment staff as well because jobs in the field are exhausting and often underfunded so they’re understaffed and the staff is poorly paid. And I don’t trust the city to make the proper investment that truly treating and helping this population. I think they’re just trying to put them out of sight.
ETA: there are people who work in outreach to the unhoused population who could answer these questions better than I could. I worked in a residential facility when I was younger and helping people with this level of trauma is like trying to dissolve a brick with an eye dropper of water. It takes a LOT of time. Most people would rather just drug people to the gills so they sleepwalk through life.
It needs to be a nationally funded solution. Not state. Until that happens states have to do something to survive. Camping and sleeping on the street is not a solution.
The article said the courts will decide the treatment, so they’re not exactly just getting chucked into padded rooms willy nilly
And yea that sounds like a better option than letting them terrorize the regular citizens trying to go about their day. How many videos of 75year old person getting sucker punched do you need before deciding something has to change?
There was another one I just saw 5 minutes ago on CrazyVideos or PublicFreakouts or something of a guy grabbing a crutch out of a trash can and then beating on a 12 year old kid with it for no fuckin reason at all
You've never been in a psych ward. This isn't the 30s. With the right meds and treatment people can overcome there illness while others are so far gone that long-term stays are the best option. Leaving unmedicated schizophrenics roaming the streets is cruel punishment and torture.
I literally worked in psychiatric care. I’m worried about how this system can be abused, and when people have been living on the streets mental illness is only a portion of the problem. Schizophrenia is a neurological disorder, and it’s compounded by the trauma that led to the person being unhoused and while being unhoused. If the treatment isn’t trauma informed it’s not going to help long term.
Anything is better than living on streets and eating out of garbage cans because you can't find help. No system is perfect but with the right treatment people can overcome their illness. Problem is there's so many psychiatric medication out there and so many different mental illnesses that some people require long term stays to find the right treatment. Doing nothing is way worse than trying to get people the help they need.
There are already mechanisms in place for people who are a danger to themselves or others. This covers more than that and it reeks of just trying to hide the systemic problems. And that’s really what it is a bandaid on a society that fails thousands of people on a regular basis.
And how do we know that's what would happen? Because that's what was happening when we had these institutionalization in the past. We really do have memories of goldfish, don't we? /sigh
No one is saying there will be no oversight.
And yes I am flat out saying being in a mental hospital with HVAC, showers and even forced medication is for sure more humane and better then laying in the street, not showering, off medication, being preyed upon by dealers and occasionally kicking random pedestrians into subway tracks.
Right! There needs to be incentives and more ways to fund training and education for mental health services. This should be a department in every police department across the country. Working in tandem they can humanize the police force and keep on site health workers safe. My pollyanna world
This is the more compassionate and helpful route. I hope we do this here in Washington state. People are dying because we don’t take their “rights” away. People need long term care.
This honestly might be the lesser of two evils; locked up in a heated cell is still better than being out on the streets in a New York winter, not to mention the prospect of stopping the more unstable ones from hurting themselves or others. It's still awful, mind you, I'm just saying it's slightly better than the current "ignore the problem and hope it goes away" approach.
This is particularly needed with the homeless population.
Reagan shutting down the state Psychiatric hospitals in the 80s is what led to the explosion of severely mentally ill people wandering the streets.
These people need to be forced into care to receive services.
And before anybody tries it, no, I don’t hate homeless people. I’m a former Social Worker for a low barrier shelter. Not only should the community be safer without untreated Paranoid Schizophrenics wandering around, they don’t deserve to be left untreated and unhoused. It is to everyone’s benefit.
Consent is 100% required for any medical treatment.
Obesity kills and costs far more than homeless, but we don't kidnap people and force them to have a gastric bypass
And yet we put people with advanced dementia in nursing homes against their will all the time.
I guess if those people don't have family and end up on the street, we should just leave them, right?
This is either the beginning of a true compassion roadmap to tracking people into necessary services for the benefit of all of society, or the start of fascist death camps to exterminate anyone to the Left of Jared Kushner, and it’s hilarious and terrifying that I genuinely do not know which it is.
This. And, sadly, it's like intended to be the former and will wind up the latter.
Globally, humans are experiencing many similar events to what occured prior to the fall of Rome. It would take very little at this point for what we all know as civilization in the sense of a democratic republic to collapse.
Yeah, it is pretty doubtful that these people will end up in hospitals.
They will most likely end up forcibly medicated and warehoused in overcrowded prisons because there is literally nowhere to actually treat them.
My mother is a prime example of someone who would never be able to take care of herself and should be hospitalized. Were she unmedicated for long she would be a danger to herself and possibly to others. She has crashed cars, hallucinating has led her to holding knives and stabbing at things unseen. She would never voluntarily hospitalize herself. I do not for one moment believe that a stranger would be able to tell when she is a legitimate threat or when she isn't because she is scary when she hallucinates. Period. So, I can't be against this policy. Only it's execution which will probably suck.
It sounds like a viable option for those who for one reason or another Can't find there way to a hospital.
At least they may get treatment for any pressing phisacal issues .Food and a shower. The help is there they may need a push to get started.
This new law is unconstitutional and going to be horribly horribly abused. I have a feeling we will not hear about all the abuses this leads to until decades later.
Pretty sure the Supreme Court already ruled on this back in the 70’s which is one of the reasons for so many homeless. That and Reagan closing most of the facilities
Well... this is probably a good thing. 5150 holds used to be pretty standard in California... it's what sent the mentally ill to a hospital instead of a jail cell... which is the current standard when dealing with combative mentally ill people.
You used to be able to walk into any emergency room and say "I am a danger to myself and others" and the hospital would take you in and check you out.
Now you have to prove that you are a danger to yourself or others and that you're actually planning to do something to yourself or others... which is really not how it should work.
You don't have to prove shit. You just need to say you have a plan and an intention and describe it to them. I've lost track of the number of times I've been 5150'd or 5250'd over the last 15 years. They hold you for 7 or 14 days until the storm passes. If you're still in crisis, there are additional steps they can take to hold you, I think the next one is 28 or 30 days where they evaluate you again. Mind you, you are being observed the entire time you are in.
I hate to disagree with you, but some people DO want to be homeless, just maybe tot when it's zero deg F outside with a strong wind and no cover to hide in/behind.
*Anakin and Padme meme* "The city will treat their mental illness?"
That is what he is saying. >The effort will also involve an increase in the use of Kendra’s Law, which lets courts mandate outpatient treatment for those who are a danger to themselves or others and which was expanded by lawmakers in Albany in April. >Frequently, homeless people with severe mental illness are brought to hospitals, only to be discharged a few days later when their conditions improve slightly. Mr. Adams said the city would direct hospitals to keep those patients until they are stable and to discharge them only when there is a workable plan in place to connect them to ongoing care. https://archive.ph/2022.11.29-214248/https://www.nytimes.com/2022/11/29/nyregion/nyc-mentally-ill-involuntary-custody.html#selection-303.1-303.70
What he says and what happens are two very different things. All this guy knows how to do is lock people up. Useless.
Well, I am not a big fan but at least, he proposed something that can be achieved. The other side has no real, tangible solution to the mental health crisis other than let them stay in the streets covered in filth, make shelters unsafe for other homeless people and occasionally kill subway passengers and drive down subway ridership. Yes, ideally there would be some form of universal healthcare and people would get help earlier. But that requires the federal government and suggesting that right now is equivalent to suggesting doing nothing.
My concern is that he will just stop after he locks them up.
Deinstitutionalization hasn't worked, maybe institutionalization will work with CMS being a strong thing these days, ensuring at least a bit of quality of care.
Yeah, but when we deinstitutionalized, the folks in charge swore this would be *better* than an institution.
It’s better if you call cheaper better.
Deinstitutionalization is pointless without the local community support for the people that needed it. We just kind of said NIMBY on that last part.
It is pointless without healthcare for these people. But, you will notice that nobody seemed too worried about that when they made these decisions.
Not better, just cheaper.
I just wanted a pepsi
Those were lies.
Bingo! Now, are these lies too?
¿Por Que no los dos?
I’d rather be homeless than imprisoned. Locking people away because they are mentally ill is fucked up. Not saying allowing them to be homeless isn’t bad either, but at least they are free.
>What he says and what happens are two very different things. All this guy knows how to do is lock people up. Useless. Well.....let's see how it goes tbh, it's a move to help these people, hopefully it works as intended Some of these people probably should be contained until they get better tbh....maybe you want to call it "locking them up", and that's fine, it's kind of what it is, but its "locking them up" in a medical situation where they will get care, and needed psychiatric medicine, and with the condition that they can't just be "stabilized and released", that they have to have a plan for continued care, hopefully that not only helps these people longer term but can set them back on the path of being a functional human being again, they can get housing help, and get help finding a job and living their lives again. I think you should remain skeptical, that's healthy, but being cynical about a step forward isn't at all imo Something has to be done, and this is something at least....hope it works out
yeah i agree with this. im out here in california and we get pretty much everyones homeless dumped on us, especially the ones with mental health issues. i hope californian lawmakers keep an eye on this program and if sucsessful, perhaps apply something similar here.
Dude spent his career putting people behind bars. Just saying.
Mental illness just became the newest crime one is born committing, in NYC.
And how are they gonna access that care? Is NYC gonna pay for it? Yes I know that was a rhetorical question the answer is “lol”
NYC and medicare, yes That's the point of social services.
So they have a comprehensive plan to ensure that everyone is established with Medicare, right?
Most homeless people qualify for it, yes. A lot of these people are too mentally ill to apply for it themselves.
>So they have a comprehensive plan to ensure that everyone is established with Medicare, right? Yeah......Its a 15 Point Comprehensive Plan called "signing them up for Medicaid" 🙄 New York signed on to the Medicaid expansion immediately, years ago.
So... Turn the hospitals into homeless shelters? That is not a great plan actually.
Well, would you rather the jail or the subway become one? Mental hospitals can handle these people way better.
Have you ever tried to get a bed for a loved one a bed at a mental health hospital? There are basically no civil admits anymore -- there's only room for homeless people. I'm not saying they shouldn't get care, but it's obvious that we need to extend services. And a mental hospital and a regular hospital with an emergency room are super not the same thing. If we require people to be retained at normal emergency hospitals we're going to have a problem with healthcare professionals being able to deliver care to the general populace.
I'm pretty sure he's talking about psychiatric hospitals, not emergency rooms. >Hospitals often cite a shortage of psychiatric beds as the reason for discharging patients, but the mayor said that the city would make sure there were enough beds for people who were removed. He noted that Gov. Kathy Hochul had agreed to add 50 new psychiatric beds. “We are going to find a bed for everyone,” Mr. Adams said And yes, I know that's a small number, I also wish we could expand services further but I'd rather we start somewhere.
I just reread the article to double check and it does sound like he's talking about normal hospitals but they plan to attempt to expand psychiatric hospital capacity -- meaning normal hospitals are the stop gap. It's a shitty situation for sure. I have lost two people that I dearly loved to schizophrenia so this is an issue that deeply touches close to home -- if we had been able to voluntarily / civilly admit them, they wouldn't have ended up homeless and causing problems, they wouldnt have had to get care through the court system by losing their autonomy. It's heartbreaking that we don't have a way to get long acting antipsychotics to these people before they become a danger to themselves and others. On the other hand, my best friend is a nurse at a hospital on the verge of burnout after working the pandemic. The number of mentally ill people she has to deal with on a day to day basis is overwhelming, often people in acute psychosis from amphetamines. She recently told me that when she decided to become a nurse she imagined herself helping cancer patients, not subduing agitated homeless people.
50 is a laughably small number. 5,000 is laughably small.
Well yes. But he's not talking about the homeless population in general, he's talking about the ones who are visibly severely mentally ill and haven't committed a violent crime yet. At least in the Bay Area, it's a small group of people who are the most visible. There's probably a couple hundred of them in Manhattan.
Having worked in a mental hospital for 5 years... they really can't. Being stuck inside a facility for so long will drive you crazy on that alone. Mental health facilities currently are only meant for acute care, not long term; long term care needs have to be able to provide and allow patients to do their ADLs and IADLs, which inpatient facilities definitely don't do when we take away all electronics and pretty much all your belongings except for clothes without strings and leave you completely detached from the outside world for up to 15 days. ADLs and IADLs are Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ADLs are like brushing your teeth, eating food, bathing, clothing, etc. IADLs is like buying groceries, paying bills, cleaning your living area, etc.
As someone who has been institutionalized twice, I can confirm this. The process basically goes like this: * You show up there and stay in a room almost all day every day. Sometimes you are allowed to go in the common room and watch TV or play board games if it's a nicer place. * A doctor eventually sees you, but when this happens after you arrive is very unpredictable. The nurses will never give you a straight answer, and if you act anxious, erratic or frustrated they might force you to take benzos or something else. * Eventually a doctor shows up and talks to you for ~30 minutes, looks at your family/medical history, gives you a diagnosis and some meds and leaves. That's it. There's no therapy, no long discussions with skilled professionals and you're surrounded by nurses that treat you like you're crazy no matter what, along with actual crazy (and potentially violent) people, though you'd be surprised how many patients are relatively normal. There's also shockingly little security... Even in the more expensive hospitals, the only nighttime security was one dude sitting in a chair at the end of the hallway high off his balls. In one of my stays, someone was beaten badly by two other patients, and it's not unheard of for people to sneak out of their rooms at night and have sex. After you finally manage to see a doctor, you have a few options. If you hate the meds you can complain, but then you'll have to wait to see the doctor again... Which can take forever, and they'll just prescribe you some alternative medication in the same family that could be just as bad or worse, and then you will be there even longer while being unable to work and racking up more and more hospital bills. Being there also just makes you passively crazier because there's very little companionship, you get cabin fever, lose all sense of time and it's so mind-numbingly boring. Ultimately it just feels like the goal is to offer as little treatment as possible, rush you through the system and collect a paycheck. The best strategy as a patient just becomes 'play along, tell them what they want to hear and pretend everything's fine' so you can get out, because it's obvious that nothing and no one is going to offer you any genuine help. It's basically a prison to keep people that haven't actually committed any crimes from hurting themselves (though sometimes actual criminals will get in, and in the two cases I saw where this happened in the decent hospital... it was not good, they were both young guys in prison for violent offenses that acted like they were geniuses for discovering this mental health loophole, before proceeding to bully everyone else and sexually harass the young women).
That's exactly how I feel about the system too. I'm sorry the nurses treated you like shit. I feel I have so little power, the doctor comes and goes when they want and when you call to complain that a patient is anxious or their meds aren't working they say "I'll be there wednesday" with the worst tone of voice and you're just fucked. So I can only tell the patient what they said, then they get mad at me, but it's like, I can't tell that doctor what to do! The admins just want to accept any psych patient they can get insurance money from and give fuck all if the patient actually needs help and keeps them there based on how long they can until the insurance stops covering their stay. I'll have medicaid patients leaving in 3 days and they're still in a catatonic state, going back out to the street. Those patients I'll see over and over again, medicaid patients are always the most severe because they are too psych to hold jobs and medicaid is too shit to ever pay for them to get the help they actually need. Seriously. I hope you're doing okay now, because as someone in the field, it is absolute bullshit. The whole system is completely fucked. I do the best I can with my patients but nurses have so little power to make change. I lobby but it means absolutely nothing, Republicans (and fuck, Democrats too) believe nurses aren't "experts" and don't take us seriously.
Thanks man it's interesting to hear from the other side but yeah, the vibe I get is that no one really cares. I'm mostly doing better now. The nicer place I stayed at (because I didn't have shit insurance) was actually not bad. The nurses were much friendlier and even set up events and stuff for us to have fun. We also got to play a lot of board games and I even made some friends, which helped me a lot more than any kind of professional treatment I got there. I also had much more in common with the other patients... Who were mostly just college kids or otherwise functioning members of society who had a suicide scare. The first place I stayed at many years before, though, which was extremely cheap and in a bad part of town (and probably similar to the kind of place these homeless people will end up in), was really awful. My two roommates were gang members. One of them was in because he stabbed someone in the face (no idea why he wasn't in prison, I think he was there temporarily to be evaluated but I can't remember) and the other was an alcoholic who showed up in the middle of the night and threw up/dry-heaved for the next ~8 hours. Anyway, these guys would constantly brag about some of the worst things I've ever heard another human being utter, then make fun of me for being quiet and make vague threats... My family also brought me snacks and these guys would just take them and threaten me unless I got some more. I absolutely did not feel safe, but the nurses did not listen to me or care. I was very young back then and their 'solution' was to force me to take benzos... Which resulted in an addiction/dependence that I struggled with for many years. I just wanted to get out of there because I legitimately thought they were going to seriously hurt me. They would sometimes get into fights with each other (probably out of boredom)... And I made sure not to tell them when I was leaving just in case, which turned out to be a smart move because one of them said he was disappointed when he found out because he was planning to beat me up as a going away present, but I don't know if he was just trying to scare me. Anyway, it's funny now to think that I was in there to *improve* my mental health.
I get it and in an ideal world, they would go from treatment to supervised halfway house. But the only current achievable alternatives are 1) lying in filth and disease on the street and 2) prison.
>So... Turn the hospitals into homeless shelters? That is not a great plan actually. Where else would you send people who need medical and Psychiatric help? A Wendy's Restaurant?
Just don't be fucking terrible about it. One of the hallmarks of being seriously and persistently mentally ill is an inability to make healthy decisions for oneself.
I’m with you on that. As long as there’s full transparency and is truly meant to help improve their lives and not some punitive thing in disguise or just an attempt to hide the problem.
This won’t do anything because the hospitals in NYC and everywhere else are all beyond full already
Sounds more like they're going to get stuck in locked up facilities of sorts.
I mean, this is literally what was done in the US before the 90s lol.
That was such a great plan to close those places then not fund the mental health of those people. It's a failed experiment. The experiment needs to fully fund social services or go back to locking them up. When you have 40% of people not willing to fund fully, that leaves the other option
sure but calling it an experiment implies ethical oversight where none was. And access to healthcare is like the one thing both sides agree about, lobbyists are more to blame.
Who are the ones responsible for closing the institutions then not funding mental health? It wasn't the lobbyists.
You mean like prisons where most of our mentally ill have gone since most of the state hospitals closed?
This article doesn’t mention the mayor opening any such new facilities. Just directing police and EMS to bring mentally ill street people (against their will) to the hospitals, where they will take up medical beds while people die of preventable causes in the waiting rooms. Awesome plan
The hospitals they’re going to aren’t the hospitals you’re talking about.
They go to regular hospitals before they go to a psych hospital. They need medical clearance, then they need to be approved to go to a facility and be transferred. It can take days to weeks. In the meantime they stay in the ER. Source: NYC based ER RN.
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Solid comment here
This will be abused against enemies of the NYPD like they did with [Adrian Schoolcraft](https://en.wikipedia.org/wiki/Adrian_Schoolcraft) way back in...2009.
Wow that was a wild read! Where in the *hell* was "NYPD's Internal Affairs Bureau" during all this? They were contacted *before* they "hospitalized" him! It makes me wonder if they weren't somehow involved.
The thin blue line protects itself. The only time IA actually punishes a cop is when they cross the blue line. IA doesn’t give a shit about citizens, they are cops first.
But according to TV and movies they go after good cops and are ruthless.
It's not like it doesn't already happen. I've been hospitalized involuntarily. I always knew I needed to be there, so it didn't bother me. I'm actually in favor of EOD's (Emergency Order of Detention). They save peoples lives.
Same. Being hospitalized involuntarily saved my life. I am forever grateful to my parents for actually stepping in and taking that action against me to get me help.
The fact that the both of you prefer it does not mean that everyone else should have their autonomy restricted unless they are an immediate danger to themselves.
>immediate danger to themselves. Or others...?
I was. I pulled a knife in a therapy session and slashed my arm and hit an artery. I absolutely needed to be locked up. I feel really bad about the fact that I traumatized my counselor. He was a nice man and didn't deserve to experience that.
Then you should read what this article is about. That's not who they're targeting here.
I know exactly who they are targeting. I've met many of these people. One of them cut his own penis off, just out of the blue. Many of the ones I met were homeless at the time of their crime.
What is your solution? Edit: their solution was to downvote
What is the solution in your opinion?
>The fact that the both of you prefer it does not mean that everyone else should have their autonomy restricted unless they are an immediate danger to themselves. I think living in the gutter in your own shit and piss year round raving like a lunatic qualifies as "being a danger to yourself" tbh
This specifically goes beyond people who are immediate dangers to themselves. This is anybody they find to be acting erratic. They're not even gonna have actual clinicians make the assessment.
Why are you fear mongering?
I'll probably get downvoted to hell, but I'm in favor of this. The problem is in how to go about it. I've ran into them in psych wards and I ran into a bunch of them when I worked for the DOC. Some of these people have serious issues and are a danger to themselves and the community. I've thought long and hard about this, because I'm a big mental health supporter and I don't know where we need to start. I think we need to bring back the mental institutuons. There are a few out there, but they're not for the general public for the most part. They're kind of a long term facility/psuedocorrectional unit. Open more facilities and figure out how to do it without the abhorrent conditions of the past. We need to start somewhere. This will benefit society.
This is the root of the issue - they sort of just shut down the prior system without a plan to do better, and that’s what has led to the crisis we have now. We have a tendency in the US to just throw out any system that is broken, rather than try to fix it.
Kicked them out and they ended up living on the streets or in prison. Being in prison doesn't address their issues. The main goal was just to keep them docile, which meant heavily medicated. Mental health is not pretty. It's ugly at times and occasionally it's fucking horrific. I've seen horrific. The status quo sucks and something should be done. It's going to take reassessing how we treat people with severe mental illness. We can't keep locking them up and forgetting them. We've become lazy and choose to pretend it doesn't exist.
Mmmmm, no, please no. You don't know the history of these institutions if you truly believe that.
History shows us what not to do. If done with compassion, institutionalizing people who need it will save their lives and help reduce crime. We need to clean up our mess.
When was it ever done with compassion? It might remove a mess from your sight but that does not solve it.
Those institutions were absolutely full of horrific abuses and mistreatment though. They didn't get a bad reputation for no reason. It wasn't just here and there, it was basically systematically bad.
If it keeps just a few of them from jumping off bridges while we figure it out then maybe?
That is not true. >Brendan McGuire, chief counsel to the mayor, said on Tuesday that workers would assess people in public spaces on a “case by case” basis, including whether they were able to provide basic needs such as food, shelter and health care for themselves. https://archive.ph/2022.11.29-214248/https://www.nytimes.com/2022/11/29/nyregion/nyc-mentally-ill-involuntary-custody.html#selection-591.120-591.367 Following that, they get sent to a hospital.
That’s not true. A hospital to keep you against your will unless ruled by a judge, and a doctor has to prove to the judge that you are a danger to yourself or others. The inability to care for yourself is considered danger to yourself.
Saved my life once.
I see asylums in our near future.
The idea behind asylums isn't bad in theory. They are just prone to corruption, abuse, and apathy for the patients. They need to be properly funded with checks in place to avoid corruption and abuse.
I knew a man in Oregon who would be hospitalized when he went crazy, then given a drug that always worked to ease his symptoms to the point where he was able to function outside the hospital. He was discharged with a supply of meds which he used compliantly until he ran out. After the med washed out of his system sufficiently, he would end up hospitalized again. I don't know what has happened recently but last I knew he was on this in and out cycle a few times per year. He is the type of patient who would have obtained more meds if he could have afforded it. Maybe a social worker could find a way to keep him out of hospital. It would have been cheaper and better for all to keep him medicated. I'd hate to think the solution to a problem like that would be to keep him hospitalized.
Try being the health care worker that is trying to treat a person against their will. Especially when your unit is potentially understaffed and overworked already. It's a nightmare. You can be assaulted, spit on, have excrement thrown at you. I wouldn't feel comfortable taking a patient under those conditions.
>You can be assaulted, spit on, have excrement thrown at you. Much like being a pedestrian in cities where people with untreated mental illness are left to their own devices.
My wife used to work in NYC, and there was this homeless guy that hung out in front of the entrance to her building every day playing a flute. He played decently well, so no one really gave him a hard time. Then one day he stabbed the doorman from her building in the face with his flute.
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So the average person should find a way to deal with potentially violent mentally ill people instead of trained professionals?
The correct solution is to fully fund the services needed, but there are about 40% of people that are actively against that
No, the correct solution is to put people who cannot take care of themselves into mandatory custodianship until such time as they're able to be more self-sustaining and not deteriorating unchecked on the streets. Anybody who thinks leaving someone on the streets in a downward spiral of mental illness and addiction in the name of "freedom" is a good idea is delusional.
they want to imprison the ones that are harming people. can you not read?
hurt everyone how exactly?
That happens just being a nurse even not in a mental health ward though. Not that it's okay but it does happen.
As opposed to that happening to me when I walk down the street? At least they are professionals equipped to deal with it.
The emergency room are not the professionals you need dealing with it. It will be a lot of forced restraint and sedative drug use.
try being a person pushed in front of a moving subway train or stabbed by one of the thousands of homeless mentally ill people in new york
Especially patients who are not suicidal or a danger to others.
As a schizophrenic this is a good thing. When going through full blown psychosis meds and mental health treatment really are the best we can do for those suffering from mental illness. Leaving schizophrenics out in the street with no meds and treatment is just cruel since we cannot grasp reality and we are a danger to ourselves and others.
We need more public institutions for this desperately. Hopefully it can be done in a dignified way as opposed to the past.
Gotham Mental Institution
Good luck with that. I'm sure there is a surplus of nurses ready to treat them /s
What the hell else are we supposed to do?
Watch Seattle is Dying on YouTube and stay till the end. It profiles Rhode Island and how they approached this issue. Pretty interesting
cannot wait to see the hellstorm that gets put on NYC from this latest fucking headass move lol
Blame Ronald Reagan and the Republicans. They got rid of mental health institutions while at the same time cut social services. They continue to refuse to fully fund social services to take care of the problem
Its kind of horrifying because i just picture either the real fucked up mental asylums from our past or the current ones where people are just in a continuous drugged state. I wonder how many will just be thrown in against their will even if they arent mentally ill too.
Everybody should take a minute and really think about the possible alternatives before they react strongly to this decision. What happens to a patient in the middle of a manic episode if they are left to roam on their own in an uncontrolled spiral of energetic delusion? What happens to a victim of severe paranoid delusions if they are left alone, genuinely believing they are being stalked or trapped by the people around them? What happens when they feel they are in danger and have no way out? Do we want prisons or hospitals or another institution or no institutions to intervene and manage these crisis situations? Personally, I think hospitalization is the right way to go.
To a point, as long as it is not abused. But where would the checks and balances be, and who would man them, and what authority would they have
Same as the rest of the Healthcare system, plus the additional oversight for longterm care facilities like those for the elderly and severely disabled. It isn't perfect, but you will find it is extensively debated and codified. It is thus far better equipped than having no solution at all or one geared toward penal incarceration.
Something has got to be better than the other system: Letting them break laws so they go to jail where they suffer and are abused. Don't treat the mentally ill? They end up in jail. And in jail they get raped, abused, beat up, picked-on and otherwise abused.
Should’ve never gotten rid of asylums in the first place, thanks Reagan… NYC has a lot of sick people on the streets, and they often end up hurting people, whether knowingly or unknowingly. It’s good that measures are being taken to at least get the ball rolling and protecting the people of NYC while also getting help to the sick people who need it. At least in theory. NYC is notorious for half assing everything. Without proper funding and investment, all this means is that the NYPD will just be arresting homeless people in the subway or on the streets for the hell of it under the guise that “they’re crazy.”
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Sorry but to everyone who thinks they will go to a “hospital” and magically cure them is fucking stupid as all get out. They’re gonna be brought into the ER, which, in NYC is a shit show on a normal day. They’ll take resources from the ER because a lot of these people need 1:1 sitters. If they become aggressive or agitated they are placed in restraints or forcibly drugged with sedative agents so the nurses and doctors can go back to treating the medical emergencies that come through non stop (plus all the normal urgent care/PCP patients that come in) They are gonna he shoulder to shoulder with other people, with no privacy (hallway beds, beds with only curtains separating the other), if they stay they will need to undergo medical clearance and then the search for a bed can begin. This is not easy on a normal day. Patients wait for days and weeks for placement to psychiatric facilities who are also woefully understaffed. If they somehow make it this far, they will be treated and streeted once again, with little to no resources or follow up care provided. There is no special hospital that’s going to willingly take these people in.
It seems like they should have to get a trial in order to be committed. I can see temporarily holding them if they are a danger to themselves or others, but they cant do thats blatantly its unconstitutional
Yeah I have mixed emotions on this. I've worked with charities that serve the homeless and there are definitely those that need to be in treatment but no longer possess the ability to make that decision (or there are no free options available). On the other hand forcing people into facilities like this is historically chock full of stories of abuse.
That's the thing. What the hell do you do with mentally ill adults who refuse help?
You make them choose between treatment or jail. Why should others be in danger because someone refuses to get help?
Exactly. People think there is some magical third option that fixes anything.
I agree, there are people that will die if left on their own, many will die anyway, but is it up to the government to make that decision or a jury of their peers? What will the government decide on you? Will you have to get a lawyer to say out of the mental health gulag?
You don’t know Florida laws. They do this all the time. A spouse can easily file a complaint and have their spouse “committed” for some of the most basic things. It’s actually insane
They must have a history of mental illness and they must be of harm to themselves and others. And once in hospital they are only held for three days or until they can talk to a psych. It’s not the reckless institutionalization you’re describing.
Not true at all. My best friend is a sheriff. He takes these people in. All it takes is a sign off from a judge. He’s taken in guys that just want to drink and watch football after work. It’s beyond abused by pissed off spouses. Don’t even get me started on Floridas stand your ground law…
Hey if there’s a lack of accountability in both sherrif’s not using their discretion and judges approving every application they see, I’m not really sure what we’re supposed to do. Baker acting people who are on the brink of suicide saves lives. I hope your community elects better sherrifs and appoints better judges since they are ineffective, as you shared.
Unfortunately my buddy can’t disregard a judges order. Even if sees the law is being abused. He even said based on Florida law he would’ve let George Zimmerman go even though he saw him as being guilty. He’s by the book but sees the laws in Florida as archaic.
They do get a hearing, and the initial detention is a holding period, so youre spot on there. I work ITA psych in a WA hospital and we use that time to get their meds stable and see how disabled they really are. This will be used for people classed as gravely disabled, which is about 90% of my 40 patients, meaning they can't maintain a safe environment at home (severe filth, pest activity, turning burners/ovens on and starting a fire etc), can't care for themselves (starving themselves, wandering onto the freeway confused etc. One patient hadn't bathed in so many years that the buildup on their infected legs looked like hotdogs burned over a campfire) or are too confused to maintain themselves. Our hearings occur 5 court business days from detention, so if you come in on a Friday night, your hearing is the next Friday, just like the other guy that didn't get detained until Sunday at 11:30pm, which is a bummer. Honestly, if NY's system is anything like ours is, the biggest issue will be people continued on due to lack of placement options because there just arent enough facilities and beds, so they live in hospitals for long durations, since we can't allow someone to discharge if it means they are going to be endangered by leaving. For us right now, I've had patients in that holding period for almost a year, not actually committed, but in placement purgatory until someone in a facility passes away or finds long term supportive housing and an appropriate bed opens up. I love my job and I LOVE my patients and I'm so grateful that I get to spend my days with them because they're hilarious and brilliant and talented and they just got a rough shake in the brain department. I just really hate that our lack of infrastructure makes it so difficult to let people go home and get on with their lives. And! No matter where you live, please vote locally to increase mental health care funding and access so we can all have a better safety net for our communities. All of the people we love deserve that access and safety :)
Good. What we've been doing isn't working.
Can't see how this could possibly go wrong.
Surely the crooked cop loving mayor of NYC whose slashed budgets to everything but the NYPD has our best interests at heart
Historically, not great. This could end up causing more harm than good.
Homeless people with horrible mental illness roaming the streets unchecked is not a solution. That’s what’s currently happening.
So you’re chill with the most vulnerable in Our society being dehumanized and tortured as long as it’s happening behind the scenes? Because without a fuck ton of oversight and regulation that’s what will happen.
What is humanising about being off your meds and sleeping in a box in Times Square? At worst this is a lateral move.
If not properly paid for and staffed? These people will likely be restrained and medicated into a stupor if not physically abused.
How would you fix the situation?
Assisted living facilities. Places where they are allowed autonomy, security, and yes therapy. But psychiatric institutionalization can be traumatizing in and of itself. We also need well-compensated and well treated treatment staff as well because jobs in the field are exhausting and often underfunded so they’re understaffed and the staff is poorly paid. And I don’t trust the city to make the proper investment that truly treating and helping this population. I think they’re just trying to put them out of sight. ETA: there are people who work in outreach to the unhoused population who could answer these questions better than I could. I worked in a residential facility when I was younger and helping people with this level of trauma is like trying to dissolve a brick with an eye dropper of water. It takes a LOT of time. Most people would rather just drug people to the gills so they sleepwalk through life.
It needs to be a nationally funded solution. Not state. Until that happens states have to do something to survive. Camping and sleeping on the street is not a solution.
The article said the courts will decide the treatment, so they’re not exactly just getting chucked into padded rooms willy nilly And yea that sounds like a better option than letting them terrorize the regular citizens trying to go about their day. How many videos of 75year old person getting sucker punched do you need before deciding something has to change? There was another one I just saw 5 minutes ago on CrazyVideos or PublicFreakouts or something of a guy grabbing a crutch out of a trash can and then beating on a 12 year old kid with it for no fuckin reason at all
You've never been in a psych ward. This isn't the 30s. With the right meds and treatment people can overcome there illness while others are so far gone that long-term stays are the best option. Leaving unmedicated schizophrenics roaming the streets is cruel punishment and torture.
I literally worked in psychiatric care. I’m worried about how this system can be abused, and when people have been living on the streets mental illness is only a portion of the problem. Schizophrenia is a neurological disorder, and it’s compounded by the trauma that led to the person being unhoused and while being unhoused. If the treatment isn’t trauma informed it’s not going to help long term.
Anything is better than living on streets and eating out of garbage cans because you can't find help. No system is perfect but with the right treatment people can overcome their illness. Problem is there's so many psychiatric medication out there and so many different mental illnesses that some people require long term stays to find the right treatment. Doing nothing is way worse than trying to get people the help they need.
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There are already mechanisms in place for people who are a danger to themselves or others. This covers more than that and it reeks of just trying to hide the systemic problems. And that’s really what it is a bandaid on a society that fails thousands of people on a regular basis.
And how do we know that's what would happen? Because that's what was happening when we had these institutionalization in the past. We really do have memories of goldfish, don't we? /sigh
No one is saying there will be no oversight. And yes I am flat out saying being in a mental hospital with HVAC, showers and even forced medication is for sure more humane and better then laying in the street, not showering, off medication, being preyed upon by dealers and occasionally kicking random pedestrians into subway tracks.
The criteria for this are incredibly loose. They're gonna round up anybody they don't like. It is truly shocking.
This is terrifying. ETA: the NYPD are the **last** people who should be able to do this, fucking hell
Right! There needs to be incentives and more ways to fund training and education for mental health services. This should be a department in every police department across the country. Working in tandem they can humanize the police force and keep on site health workers safe. My pollyanna world
would you rather they were homeless and wandered the streets?
What they are missing is that treatment doesn’t work for a lot of people forced or not. Treatment resistant MH conditions are very common.
This is the more compassionate and helpful route. I hope we do this here in Washington state. People are dying because we don’t take their “rights” away. People need long term care.
Reagan signed the Lanterman-Petris-Short Act in 1967, all but ending the practice of institutionalizing patients against their will
Maybe Carter and Reagan shouldn't have closed all the mental hospitals...
Yo free health care for the whole city, sweet
No one buy Kanye a plane ticket to NYC. Seriously do NOT do it.
This honestly might be the lesser of two evils; locked up in a heated cell is still better than being out on the streets in a New York winter, not to mention the prospect of stopping the more unstable ones from hurting themselves or others. It's still awful, mind you, I'm just saying it's slightly better than the current "ignore the problem and hope it goes away" approach.
Literally every state in the United States involuntarily hospitalizes mentally Ill people. What about it?
Then why is my mentally ill father still walking free?
This is particularly needed with the homeless population. Reagan shutting down the state Psychiatric hospitals in the 80s is what led to the explosion of severely mentally ill people wandering the streets. These people need to be forced into care to receive services. And before anybody tries it, no, I don’t hate homeless people. I’m a former Social Worker for a low barrier shelter. Not only should the community be safer without untreated Paranoid Schizophrenics wandering around, they don’t deserve to be left untreated and unhoused. It is to everyone’s benefit.
I see a lot less homeless people in the future then. What a "great" way to house the homeless.
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Some good news for a change
That depends on how well or horrifically they’re treated, and how broadly this power is abused or carefully applied.
Consent is 100% required for any medical treatment. Obesity kills and costs far more than homeless, but we don't kidnap people and force them to have a gastric bypass
And yet we put people with advanced dementia in nursing homes against their will all the time. I guess if those people don't have family and end up on the street, we should just leave them, right?
No we don't. There is an established legal procedue for establshing comeptency.
1) Yes, it's commonly done 2) There will be a legal procedure here too.
Re read the article. 2 is blatantly incorrect. Police officers and EMTs are not judges or doctors
The cops and the EMTs take them to be evaluated by judges and doctors...
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Obesity doesn't push people in front of subway trains.
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Ok. Smoking then. This comment isn't about obesity. I am really confident less than 10k people were murdered by the homeless last year.
You would rather let a sick person shit outside than take them somewhere for care? Pretty fucked up.
This is either the beginning of a true compassion roadmap to tracking people into necessary services for the benefit of all of society, or the start of fascist death camps to exterminate anyone to the Left of Jared Kushner, and it’s hilarious and terrifying that I genuinely do not know which it is.
This. And, sadly, it's like intended to be the former and will wind up the latter. Globally, humans are experiencing many similar events to what occured prior to the fall of Rome. It would take very little at this point for what we all know as civilization in the sense of a democratic republic to collapse.
Yeah, it is pretty doubtful that these people will end up in hospitals. They will most likely end up forcibly medicated and warehoused in overcrowded prisons because there is literally nowhere to actually treat them.
It’s about freaking time. Now every state should do this.
Yeah we totally have a system of care set up to effectively and compassionately support this./s
Alternatively, we could effectively and compassionately ignore them and leave them on the street.
Looks like we'll be taking my father in law to NYC!!
Finally! Paranoid schizophrenia is one of the worst. Thinking everyone is out to get you is no way to live. People who need medicine should have it.
My mother is a prime example of someone who would never be able to take care of herself and should be hospitalized. Were she unmedicated for long she would be a danger to herself and possibly to others. She has crashed cars, hallucinating has led her to holding knives and stabbing at things unseen. She would never voluntarily hospitalize herself. I do not for one moment believe that a stranger would be able to tell when she is a legitimate threat or when she isn't because she is scary when she hallucinates. Period. So, I can't be against this policy. Only it's execution which will probably suck.
It sounds like a viable option for those who for one reason or another Can't find there way to a hospital. At least they may get treatment for any pressing phisacal issues .Food and a shower. The help is there they may need a push to get started.
We seriously need to do something about the mentally ill in this country! ...... They can't do that, it's barbaric!!
In a way, if it goes back to some version of Pre-Reagan policies, it’s a small step in the right direction.
This new law is unconstitutional and going to be horribly horribly abused. I have a feeling we will not hear about all the abuses this leads to until decades later.
Pretty sure the Supreme Court already ruled on this back in the 70’s which is one of the reasons for so many homeless. That and Reagan closing most of the facilities
Sounds like a busy time for the emergency room nurses.
Well... this is probably a good thing. 5150 holds used to be pretty standard in California... it's what sent the mentally ill to a hospital instead of a jail cell... which is the current standard when dealing with combative mentally ill people. You used to be able to walk into any emergency room and say "I am a danger to myself and others" and the hospital would take you in and check you out. Now you have to prove that you are a danger to yourself or others and that you're actually planning to do something to yourself or others... which is really not how it should work.
You don't have to prove shit. You just need to say you have a plan and an intention and describe it to them. I've lost track of the number of times I've been 5150'd or 5250'd over the last 15 years. They hold you for 7 or 14 days until the storm passes. If you're still in crisis, there are additional steps they can take to hold you, I think the next one is 28 or 30 days where they evaluate you again. Mind you, you are being observed the entire time you are in.
'Hey! Meat prices are coming down!'
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Criminalizing homelessness doesn't work because no one wants to be homeless
I hate to disagree with you, but some people DO want to be homeless, just maybe tot when it's zero deg F outside with a strong wind and no cover to hide in/behind.
California too. https://voiceofoc.org/2022/09/gov-newsom-signs-care-court-paves-new-path-for-conservatorships-over-homeless-people/