The System That Failed Jordan Neely

What a subway killing reveals about New York City’s revolving-door approach to mental illness and homelessness.

“There are more than two hundred thousand residents of New York City living with severe mental illness; roughly five per cent of them are homeless. That’s thirteen thousand people with schizophrenia, major depressive and bipolar disorders, or other significant mental- or behavioral-health diagnoses, all of whom regularly spend the night at a shelter, in the subway, on the street. They’re the ones you recognize—the people whom, for the past fifty years, every mayor has either tried to help, harass, or hide from view. Rudy Giuliani’s cops were known to chase people out of midtown, forcing them into the Bronx and Queens. Michael Bloomberg largely avoided public initiatives that addressed mental illness. Bill de Blasio allocated almost a billion dollars for a mental-health plan, but it was criticized for failing to track outcomes or prioritize treatment for those who needed help the most.

Last November, Adams, citing a “crisis we see all around us,” announced at a press conference that homeless people with mental illness would be removed from the streets and the subways, against their will if necessary, by the police and other city employees. Advocates were outraged. Norman Siegel, the former head of the New York Civil Liberties Union and a longtime friend of the Mayor, said, “Just because someone smells, because they haven’t had a shower for weeks, because they’re mumbling, because their clothes are disheveled, that doesn’t mean they’re a danger to themselves or others.” Rumors spread quickly. Were the police about to start rounding up people who simply appeared to be mentally ill? How many were going to be detained? Two weeks later, lawyers sought to halt the initiative. In a courtroom downtown, an attorney for the city, who was defending the Mayor’s plan, said, “As far as anyone in this room knows, the initiative hasn’t changed anything.” The judge asked, “So the purpose of the press conference was to do what?” [..]

Adams’s policy, in other words, was more of the same.

[..] In the late eighties, following a legal challenge to [New York Mayor in 1987 Ed] Koch’s involuntary-hospitalization initiative, one judge described the city’s approach as “revolving door mental health—that is, forcibly institutionalize, forcibly medicate, stabilize, discharge back into the same environment, and then repeat the cycle.” Thirty-five years later, the vocabulary that’s used to describe the city’s mental-health-care system hasn’t changed. “It’s a revolving door,” a cop who was working an overtime shift on a subway platform in Clinton Hill told me. “We bring them in, and the hospital just discharges them!” She and her partner both had a few streaks of gray in their tidy black hair, and wore matching N.Y.P.D. beanies. The second cop sighed. “In and out,” she said. “I’m not sure anything we do is going to help if the hospitals keep letting them go.” [..]

New York has funded an alphabet soup of outreach groups and teams—M.C.T., B.R.C., S.O.S., ACT, B-HEARD, C.U.C.S., A.O.T., FACT, I.M.T.—each of which is different in origin, scale, and scope. A person with a mental illness is more likely to be the victim of a crime than to commit one, but every so often the script gets flipped. It’s in those moments that local and state politicians feel compelled to talk about change. Assisted Outpatient Treatment was announced, in 1999, after a schizophrenic man, who had been in and out of psychiatric care and had stopped taking his medication, pushed a thirty-two-year-old woman named Kendra Webdale in front of an N train. Webdale died, and that year the state passed Kendra’s Law, which allowed a court to mandate outpatient treatment, including psychotropic medication. (Around three thousand patients are currently under such orders.) City Hall launched I.M.T. teams in 2016, after a person with a mental illness killed a thirty-six-year-old woman named Ana Charle, who ran a homeless shelter in the Bronx. [..]

In 1999, the police responded to some sixty-four thousand calls about Emotionally Disturbed Persons, the official designation for people presenting symptoms of severe mental illness. (Mental-health advocates consider the label demeaning.) By 2022, the number of such calls had almost tripled; the city’s cops responded to nearly five hundred mental-health crises every day. The N.Y.P.D. is, in effect, the largest psychiatric-outreach team in America.”

Full article, A Iscoe, The New Yorker, 2023.5.10