Jan 05, 2025
The presence of people struggling with serious mental illness on subway trains and platforms, a festering open wound in city life, may finally get the serious policy response it demands. That’s the hope, anyway, in the wake of Gov. Hochul’s renewed pledge to champion legislation to change New York’s involuntary commitment standards to make it easier to get inpatient mental health care to people in the throes of psychosis. The governor says she’ll put such language in her executive budget — a move that increases the chances that it’ll become law. She must use every lever of power she has to get this done. Of course, getting people from the trains or the streets into treatment and care is only the first step. If there aren’t long term spots for them when their initial intake and evaluation at the hospital ends, they’ll end up right back on the subway and sidewalks. Recent underground horrors remind us of the urgent need for action. There was the arson homicide of a woman at the Coney Island station, and the caught-on-camera shove onto the platform of a man in Chelsea. But those are just two headline-grabbing crimes. Day in and day out, the city has suffered an average of 548 felony assaults in the subway each of the last three years — more than twice the average of the previous 15 years.  While only some of those assaults were committed by people struggling with schizophrenia and other serious psychoses, so-called “emotionally disturbed people” who are addicted, mentally ill or both are a disproportionate share of the problem. They’re also a reason that transit sometimes feels more unsettling and dangerous than it actually is; the proliferation of folks sprawled on benches is a problem in and of itself for a system that, in the wake of a huge pandemic falloff in ridership, is desperate to get paying customers to return. Help is available. There are social workers offering shelter beds. There are cops on platforms and trains. There are newer co-response teams with monikers like SCOUT and PATH. These are made up of mental health professionals and cops who can — if and when they seem to present a danger — forcibly remove unstable persons to take them to the hospital, where, if they’re found to be in the throes of psychotic crisis and deemed at risk of harming themselves or others, they just might wind up committed involuntarily for further treatment. But this happens much too rarely, which means that even when people who might be on the cusp of a meltdown are taken in, they invariably get released and return to the subways, or go to jail. State law is vague; it refers only to danger to oneself or others. Under Mayor Adams, city officials have long understood this to mean that a person thought to be psychotic could hurt himself or someone else — and also that he is unable to take care of himself. The courts back up that interpretation, but not everyone else buys it, so many front-line professionals refuse to  use the tools the law gives them. For years, Adams has been asking Albany to clarify the law to make clear that someone who can’t meet their own basic needs can qualify for involuntary treatment. He also wants New York’s standards to align with those in more than 20 other states to establish that a person’s danger of doing further psychiatric and not just physical harm to himself can trigger involuntary care. Both ideas are part of a bill, the Supportive Interventions Act, introduced in the middle of 2023. Whether Hochul backs that particular bill or another matter less than giving cops, social workers and medical professionals the tools they need to get these suffering people into care and make all New Yorkers safer.
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