Hospitalization of the Homeless – InNewCL
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In California, Gov. Gavin Newsom recently signed legislation making it easier to force treatment on people with certain mental illnesses. The mayor of Portland, Oregon, said last week he was considering similar action. And in New York City, Mayor Eric Adams’ ongoing push for involuntary hospitalizations has already sparked weeks of public debate.
All three leaders, like others across the country, face the same thorny challenge: how to house and treat severely mentally ill people who live on the streets and on subways and who refuse medication. The group represents one of the most persistent and visible sub-groups of America’s homelessness crisis.
The roots of this crisis can be traced back to the deinstitutionalization movement of the middle of the last century, when struggles for civil rights and hopes for new treatments led to the closure of decades-old public psychiatric hospitals. Many people with schizophrenia and other disorders have been released. Over time, they have struggled, in part due to inadequacies in housing and supportive care services. Across the country, thousands or more were living on the streets or bicycling through shelters, prisons, and emergency rooms; some became a threat to themselves or others.
Her distress has only worsened lately. Disorders related to the Covid pandemic, rapidly rising costs of living and faltering public funding for mental health treatment have exacerbated homelessness in all its forms. And some politicians have blamed mentally unstable people for the rise in some types of crime.
There is no clearer example than New York City, which is the focus of today’s newsletter. It can take years to understand the full impact of Adam’s proposals. But the debate they’ve already sparked — including opposition from unexpected quarters — helps illustrate what’s at stake.
New York plan
The city’s program aims to help a small segment of the total homeless population: a group of at least hundreds of people known to suffer from untreated mental illnesses severe enough to prevent them from meeting their basic needs . (My colleagues have explained it in detail here.) In a speech announcing the postponement, Adams said the city has a “moral obligation” to intervene.
Adams’ critics were quick to point out that he was struggling with concerns about another problem – crime. He said people with “mental health problems” are driving increases in tube crime, although researchers say only a small percentage of serious crime can be traced to mental illness.
The city has long had the option of sending members of this smaller group of severely mentally ill people to hospitals for treatment. Adams has directed police officers and other city employees to do the practice more frequently — not only for people who turn violent, but also for those believed to be in an acute psychiatric crisis that threatens their safety.
The Adams administration hopes its policies will help stabilize those who desperately need them. It also wants hospitals to house these patients pending plans for offsite care.
Broad resistance
Adams’ plan immediately drew a storm of criticism. Some warned that the practice could traumatize already unstable individuals or threaten their civil liberties. Others pointed out that New York has a serious shortage of psychiatric hospital beds and the type of supportive housing needed for treatment plans to last. Even Adams acknowledged that the latest moves were just the beginning of an attempt to fix a complex system.
But almost as notable as the criticism were the critics themselves. Liberal politicians and nonprofit groups that care for the homeless community have sounded the alarm, as has New York’s influential police community, with which the groups often disagree.
Years of meaningful public outcry over the way police treat civilians, inflation and relatively low wages have eroded morale and led to a growing shortage in the ranks of the New York City Police Department. Patrick J. Lynch, the president of New York’s largest police union, said the new policy would “strain our severely understaffed, overworked and underpaid ranks.”
Another pressing question: should police officers be the ones interacting with a seriously mentally ill person on the street? Officials are not trained as health professionals, and encounters with emotionally disturbed people can quickly escalate.
Kim Hopper, a Columbia University professor who has spent decades studying the connection between homelessness and mental illness in New York, voiced additional concerns. He said Adams’ new initiative is a repeat of failed mental health efforts in an earlier generation. He said he was concerned that city policies would simply push people through emergency rooms, shelters and the streets without addressing structural issues such as housing shortages and aid program funding.
“It’s the same trap, but it’s offered as the new compassion,” he told me. “We know, and they know, that’s not going to work.”
See also: Some black leaders in New York compared criticism of Adams to the experience of the city’s first black mayor, David Dinkins.
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ART AND IDEAS
Why hits sound so familiar
A strange phenomenon appeared on the pop music charts that year: many of the catchiest songs were also the catchiest songs of 2007, 1998, or 1987. Artists were increasingly turning to already-famous tunes and samples to spice up their singles, according to the Times Critic Jon Caramanica writes.
He uses the strategy twice on rapper Jack Harlow’s new album: The song “First Class” is based on a sample of Fergie’s “Glamorous,” a Billboard No. 1 from 15 years ago; and “Side Piece” samples Snoop Dogg and Pharrell Williams’ “Beautiful,” a #6 hit of 2003.
“It’s a way of using existing star power or familiarity as a proxy for generating your own,” writes Jon. “A cheat code.”
Hear samples of borrowed pop hits, including three that reached #1 this year.
