New York mayor orders some homeless people involuntarily hospitalized for mental illness

The rise in homelessness is a source of major tension around the country, including in New York City, which has a larger homeless population than any other city in the U.S. This week, Mayor Eric Adams announced a new policy to try to curb the trend, but as William Brangham reports, it has also drawn criticism.

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  • Judy Woodruff:

    The rise in homelessness as a source of major tension around the United States, including in New York City, which has a larger homeless population than any other city in the U.S.

    This week, Mayor Eric Adams announced a new policy to try to curb homelessness. But, as William Brangham tells us, it's also drawn criticism.

  • William Brangham:

    Judy, the new policy gives police and other first responders the authority to forcibly hospitalize anyone living on the streets who, because of their mental illness, are believed to be a danger to themselves, and not just a threat to others.

    Announcing the plan on Tuesday, Mayor Adams said he wanted to address what he called a crisis that we see all around us.

    Eric Adams (D), Mayor of New York: If severe mental illness is causing someone to be unsheltered and a danger to themselves, we have a moral obligation to help them get the treatment and care they need.

  • William Brangham:

    The mayor said city hospitals would also be required to develop ongoing treatment options for those that were admitted.

    For more on the challenges and questions surrounding this plan, I'm joined by Sam Tsemberis. He's the founder of Pathways to Housing, which is a national homeless advocacy organization that started in New York City.

    Sam Tsemberis, very good to have you on the "NewsHour."

    I know that you have worked for years trying to help people who don't have a home, who are struggling with mental illness and substance abuse disorders, to try to help those people.

    So, from your perspective, what do you make of the mayor's plan?

    Sam Tsemberis, Founder and CEO, Pathways to Housing: Well, thanks for having me on, William, and it's good to be back with you.

    The mayor's plan came as a bit of a surprise to me, a very disappointing surprise, because I have been working in this field for decades, as you say. And another well-intentioned mayor almost 35 years ago in New York City by the name of Ed Koch had a similar, had exactly the same, actually, proposal to take people who were apparently a danger to themselves or gravely disabled off the streets involuntarily, bring them to the hospital for treatment.

    And this was an idea of a compassionate approach, as Mayor Adams just said, a moral obligation to do something about homelessness. Yes, we do have a moral obligation to do something about homelessness, but that something has to be informed by evidence and experience.

    We already know that involuntary treatment in a psychiatric hospital is not a solution to homelessness. Housing is a solution to homelessness, and follow-up mental health support services are what helps people with mental illness do better.

  • William Brangham:

    I want to ask you about that, the coercive, involuntary nature of this, because this is something that the critics have really jumped on, that, if you're asking police to take people against their will, that that may be illegal, and they argue it is certainly unethical.

    Do you think it is humane and/or effective to press people who might be resisting treatment into treatment?

  • Sam Tsemberis:

    I don't think treatment actually works in a coercive manner.

    It works much better when the person is offered options. When we started the Housing First program, it was exactly after five years of this coercive taking people to the hospital, they stay a month, and then they're discharged back to the street with no housing.

    And these repeated failures led us to do something different which is much more effective. We do need to intervene when someone is actually a danger to themselves, if they're coughing up blood or they have wounds. There are emergency situations.

    But we already have mental health laws that address these quite adequately. And they're often enacted by a psychiatrist or a social worker or a nurse. Police officers are about enforcement and public safety. They're not clinicians. And it's really a questionable practice to put that kind of decision-making authority into the hands of the police.

  • William Brangham:

    I mean, one of the problems, as I think you know, is that New York City has suffered several terrible violent attacks by people who are mentally ill and living on the streets.

    And, again, we should caveat this by saying that mentally ill people are much more likely to be the victims of violence than the perpetrators of it. But many people argue that they feel terrorized and the city has to do something.

    The remedies that you're talking about have been very difficult to fund and to implement. So, what would you like to see. If you were counseling the mayor of New York City or the mayor of any big city, what would you be counseling them to be doing?

  • Sam Tsemberis:

    I would be counseling them to take an evidence-based approach.

    I think caution and public safety are a huge issue. They are random acts of violence, as you say. So that's not really our big problem or frequently occurring problem. The most frequently occurring problem is that we have people roaming the streets who are clearly disabled, clearly need assistance, and clearly need housing.

    So, the focus has to be on addressing the homelessness first, for all of our sakes, not just for the folks that are homeless, for all of our sakes. It would — we would have a safer, healthier, better environment.

    We actually did this during the pandemic. At the height of the pandemic, before the vaccine, we would put people into the empty hotels, because we knew that a safe space is exactly what people who are homeless needed to stay safe themselves, keep the rest of us safe. And people did much better.

    Now that the emergency funding has gone, people are back on the street in larger numbers than before. We need to do an emergency program. But the emergency is about homelessness, not about mental illness. Mental illness takes a while to cure. Homelessness can be cured immediately by the offer of an affordable place to live, and for these people with severe mental illness, robust follow-up support services. That's what the evidence shows to be effective.

  • William Brangham:

    Well, I guess we're going to have to wait to see.

    There is reporting that that is possibly what is coming down the line subsequently in New York City's plan, which we also know may suffer quite a few legal challenges as well.

    Sam Tsemberis, Pathways to Housing, always good to see you. Thank you very much.

  • Sam Tsemberis:

    Thank you.

  • Judy Woodruff:

    And we thank you, William.

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