I have heard all the objections raised by critics of Mayor Eric Adams’ initiative to get those living on our streets due to untreated severe mental illness into hospitals or treatment settings. The infrastructure can’t handle it. There are not enough beds. We should invest in services for those who want treatment.
What I don’t hear from these critics, however, is agreement that the way things are now is unacceptable. Inadequate infrastructure? No beds? I don’t see the people raising these arguments marching to Albany to ask for more hospitals to treat those in need of the most acute care. Invest only in voluntary services? Who then will find and engage those suffering from SMI (serious mental illness) who don’t know where or how to get help, or more likely whose psychosis prevents them from even ever seeking it? Critics of Mayor Adams’ plan certainly won’t be leading that or any other efforts to get help to those in the most dire need.
The fact is that the most vocal critics of the mayor’s initiative offer only straw arguments. What it all comes down to is opposition to involuntary treatment of any kind, and a cold-hearted decision to treat as a choice what is actually a symptom of psychosis. I understand the civil rights concerns. Like most Americans, I believe we must conscientiously safeguard our civil rights and liberties. But in our zeal to uphold those, we must not forget about fundamental human rights – like the right of an ill person who relies on society’s conscience and protection to survive a treatable illness.
We must conscientiously safeguard our civil rights and liberties. But in our zeal to uphold those, we must not forget about fundamental human rights – like the right of an ill person who relies on society’s conscience and protection to survive a treatable illness.
There comes a point when we must recognize that criticizing all proposals with no alternative plan or solution is really just an argument for letting things remain as they are. I believe that those in charge of governing are reaching the point where inaction is not an option. Public opinion is robustly behind finding a way to compassionately intervene and help people who are too ill to seek treatment to recover their lives and identities. The number of people who oppose any form of involuntary intervention is actually comparatively small, though you would not know it from the alarmist headlines.
Many people have misstated Mayor Adams’ policy, characterizing it as an expansion of the law. It is not. The law in New York, as in all states, already allows for intervention when a person poses a danger to self or others. What Adam’s policy is really saying is that we should reconsider our tacit choice to intervene only with those who pose an immediate risk to others or when harm to self escalates to imminent suicidality. His policy says that we must also reach those who have become invisible within our system of care, and who are quietly dying on our streets from things like sepsis, overdose, pneumonia, or exposure.
No one is saying that it will be easy to do what Mayor Adams is proposing. Other leaders proposing intervention to address those who are homeless due to untreated psychosis, such as Governor Gavin Newsom in California, have also faced stiff opposition from civil rights groups. True leadership, however, requires the strength to decide what is needed and walk bravely in that direction.
[Mayor Adams’] policy says that we must also reach those who have become invisible within our system of care, and who are quietly dying on our streets from things like sepsis, overdose, pneumonia, or exposure.
If New York City invests in training and hospital beds and care coordination (which does indeed seem to be happening) some extremely vulnerable people’s lives will be saved. If it bows, however, to the critics who have proposed nothing other than more of what is not working now, those lives will be lost.
While the enormity of the job of addressing our broken mental health system can sometimes seem overwhelming, we must never lose sight of the fact that effective treatment does exist; recovery is possible; and we owe our loved ones and fellow humans the chance to achieve it. Every single individual suffering on our streets, trapped by psychosis, is deserving of that chance.
Lisa Dailey is the Executive Director of Treatment Advocacy Center in Arlington, Virginia, a national nonprofit dedicated to eliminating barriers to the timely and effective treatment of severe mental illness.