The Mentally Ill and Their So-Called Advocates

By Noah Rothman

Friday, November 30, 2022

 

The New York Times headline blares: “New York City to Remove Mentally Ill People From Streets Against Their Will.” The reality of Mayor Eric Adams’s proposal is vastly more complicated.

 

Citing existing state law and court precedent, Adams revealed on Tuesday that the city’s social workers, first responders, and city-run hospitals will be allowed to commit the violently disturbed predicated on a clinical assessment of the danger they pose to themselves and others. This initiative is coupled with the development of a “tele-consult line” to provide police with instant access to clinicians who can, for example, help distinguish mental illness from the symptoms of drug abuse. The city has also drawn up an 11-point legislative plan aimed at augmenting facilities, closing administrative gaps, and amending applicable statutes.

 

The literature around the mayor’s initiative is littered with explicit caveats designed to mollify the squeamish. The screening requirements, mandatory psychological evaluations, and layers of legal authority and input from “community providers” are designed to ensure that, human error notwithstanding, this authority will not be abused. Its foremost purpose is to ditch the standard that once rendered psychiatric commitment entirely punitive—a response only to an “overt act” of violence. But to hear advocates of “unhoused people” tell it, Adams is wielding authoritarian powers to cleanse the city of its most vulnerable population. And for little more than the cosmetic effects.

 

“Let’s get to the heart of the problem,” said Legal Aid Society attorney Jeffrey Berman, the only source New12 New Jersey quoted in its reaction to Adams’s initiative. “Let’s avoid psychiatric hospitalizations and the revolving door of jail,” he said. “Let’s get people the robust community treatment they need.” But how, you ask? Who knows! All we can be certain of, according to a Coalition for the Homeless statement, is that “surveillance, policing, and involuntary transport” don’t work.

 

CBS News New York seemingly couldn’t find anyone who found more to praise than criticize in the mayor’s plan. “The city really needs to address this more from a health and housing lens, rather than focusing on involuntary removals and policing,” said Coalition for the Homeless’s Jacquelyn Simone. The problem presented by housing shortages everywhere notwithstanding, when it comes to the segment of the homeless population suffering with debilitating mental illness, long-term housing is more a problem of demand than supply.

 

The report goes on from there. Vocal-NY calls the mayor’s plan “draconian.” The organization’s leader, Milton Perez, fears that the effort to drive the dangerously mentally ill into shelters could force the homeless population “deeper underground.” The New York Civil Liberties Union’s leadership indicted the program by invoking the legacy of Rudy Giuliani, which is accurate only insofar as the program is designed to interdict violence rather than merely respond to it. “It doesn’t provide the treatment necessary for [a] long-term solution,” NYACLU Executive Director Donna Lieberman asserted, “and it causes great harm to individuals who are, themselves, hurting quite a bit.”

 

It’s hard to avoid the impression that the New York Times set out on a similar mission when the outlet dispatched reporter Sarah Maslin Nir to survey the homeless after dark in places such as Penn Station and Washington Square Park. But readers of her dispatch emerge with a distinctly different impression. Malsin Nir peppers her report with color that conveys her own sense of peril; she notes the shadows “gesticulating wildly” that flash across her peripheral vision and the eerie unresponsiveness of subjects given only to silently rocking themselves. But those who would speak with her, even those who self-identify as mentally ill, were not as dyspeptic about the program as their so-called advocates.

 

One woman dismissed the “stigma” around “psych wards,” which conflicts with her experiences in those facilities. “They care,” she said. There are “violent people out here,” said another. “If people need that kind of support,” he added of the mayor’s plan, “it would be creative.” A third homeless individual agreed that the proposal is “pretty warranted.” He continued: “All the mental facilities seem to have been closed, and a lot of the mentally ill seem to be displaced within the homeless society.”

 

There was dissent. Malsin Nir noted the degree to which the disproportionately black homeless population does—and, a conscientious reader concludes, should—fear a violent outcome resulting from police interactions, though the chronically homeless interact with police quite often. One unnamed homeless person provided to the Times via the Coalition for the Homeless fretted that the city would “sic more police” on the mentally unwell. “No one can take my spirit and joy and pride,” said one defiant homeless individual.

 

The relative experience of joy and the indomitable spirit notwithstanding, the notion that there is “pride” to be found in street life has been promoted by the advocacy class for generations. In the 1990s, when countless business-improvement districts committed to rejuvenation, quality of life, and generous rehabilitative programs for the homeless, advocates for their condition made essentially the same arguments. There but for the grace of God go you, they claimed. But a scratch at the surface of that argument exposes something far more solipsistic. The homeless themselves are soon rendered abstract objects in a quest to indict the callousness of the society into which they could or would not fit. This population rejects the modern world, and there is something noble in the savagery to which they are subjected daily.

 

The arguments haven’t changed much over the last 30 years. Today’s homeless advocates warn only of the potential harm that may inadvertently result from a policy designed to mitigate the active, ongoing harm being visited upon the city’s people—commuters and residents, the housed and “unhoused” alike. The deliberate conflation of those without housing and those in psychological crisis is a misdirection tactic, as Loren Barcenas, a public health doctoral student at the University of North Carolina, revealed when she declared mental impairment “a side effect of housing insecurity and being put on the margins of society.”

 

How this mental exercise relates to the dangerously mentally ill, for whom homelessness is not a choice, is a mystery. Nor do homeless advocates deign to address the scourge of violence that has been the direct result of experimentations with their policy preferences. New York City tried for years to combat the problem of the violently homeless by deemphasizing shelters, scaling back quality-of-life policing, and going to war against “sadness.” It’s time for something different.