New York City Will Hospitalize More Mentally Ill People Involuntarily
nytimes.com
nytimes.com
Fast forward 30 years, and all the state hospitals are closed. Mentally sick people are left to live on the streets. Meanwhile our culture gets sicker and sicker. Thank you for invoking God.
During this limbo, people are at great risk for exploitation as well as avoidable catastrophes due to simply being invisible during their decline. Rather than willful neglect, there is simply nobody there with assigned duty to steer folks on the least unhappy path.
Ironically, people with mental illnesses appear to be much more likely to develop dementia too. So they can experience multiple flavors of this tragedy.
Sane or not a person is a person and not a property. Others shouldn't decide your fate without your consent unless your fate affects others. Cruelty disguised as charity is not right. But by default opt-in seems reasonable. If even euthanasia is popular, I hope my comment isn't too extreme or controversial.
He was allowed to go on like this for years because his brother was very wealthy and was generous with the school administrators.
My last year there, the dorm was slated to be torn down and replaced with a much larger one. His brother had to come and take him away.
A few months later I saw him sitting on a bench and he looked like a completely different person. Clean shaven, put together. He told me the time he spent living in the storage closet was horrible and he wished his brother had forced him into treatment years earlier.
I find myself utterly incompatible in living in such a society and I've spent much of my life seeking other people and locations that eschew such violence
Also If we're going by someone with compromised mental faculties, I would say an organization (state of New York) who physically and/or sexually abuses the disabled* is not fit to make these decisions. The New York State government has proven themselves to have compromised mental faculties and thus unable to make these decisions to violently/forcibly institutionalize the portion of 'mentally ill' adults who don't aggress upon others. In part New York paired down their institutions because they were such terrible places for these people to be, often worse than in the gutter with teeth rotting.
IMO even the disabled, especially if they are not acting in a criminal capacity, should be asked for their consent before violently being forced into institutions of physical and sexual abuse for which New York is known.
*grep for my below comment about Willowbrook State School where we discover the (mentally disabled) children you worry so much about are actually abused by New York when institutionalized.
You don't draw child's line at merely being to express their desires, why would you do so for an adult?
If I were a child of sufficient age to express desires I would rather beg in the streets in a state of psychosis than be in the institutions such as New York's Willowbrook State School.
In any case, it's shifting the goalposts. Now we are talking about particular states depriving people from agency, in the previous comment you were talking about a mentally unwell person being categorically entitled to their agency...
I personally think it's a two way street, with 2 inflection points. If someone depends on welfare state in any significant degree, it should be valid to deprive them of a little bit of agency, since it's sorta indicative of them not being capable of good decisions. Kinda like teenagers in the child analogy. If someone depends on welfare state to a large degree and also STILL cannot keep it together in terms of committing crimes / being an active menace to others, it should be valid to deprive them of a lot of agency. Kinda like 3 year olds.
At any rate in context of the article, I think agency should be proportional to responsibility. NYC should just be tough on crime in this case, and any mental health defense should be conditional on losing agency. If you are mentally healthy enough to refuse to be committed, you are mentally healthy enough to be held responsible and go to jail.
IMO, what you're saying is analogous to "if someone suffering from clinical depression wants to kill themselves, let them." I vote no. Please think about it a bit.
Personally I find your stance far more judgmental than mine; no one needs to 'justify' to someone else why they will or will not commit suicide. It's not even for me to justify or not when someone else does that and I reject your allegation I've done so.
I can't honestly say I know that living in a psychosis (medicated or not) is always better than dying. I defer that judgement to the owner of the body contemplating suicide. Personally no I would not stop the bleeding if asked not to, whether their choice was rational or not. I believe consent and personal choices trump my feelings or trauma from past experiences, even if it turns out the choice of others may be misplaced.
It would be odd indeed if it was OK to stop the dying only if they intentionally performed the action that led to their (imminent) death, but not OK to stop the dying if it was caused by something like a disease.
I do not think the alternative society that say maximizes certain utilities at the cost of consent is wrong per se as long as it's possible to freely enter/exit such a society, I just find it incompatible with my values. While I disagree with the notion of stopping someone who has asked his/her respects to be honored in regard to suicide, I don't think it's some moral failing if a private individual makes an in-the-moment reaction to stop them. It's pretty much human instinct to try to preserve innocent life of those around us, so hopefully it hasn't been read that I think you're a bad person or something if you see someone cutting themselves and you stop them.
What is this theoretical individual losing if we help them? What is the society losing if we act to help?
Sadly that is not the reality we live in. The dictator, in this case is New York and various government entities. A government notorious for putting mentally ill in wards where people are "living in filth and dirt, their clothing in rags, in rooms less comfortable and cheerful than the cages in which we put animals in a zoo." [0] Without magic wands, the doctors are not always returning them to neurotypical condition, but rather often some other, perhaps clinically more palatable often drug-induced different mental state. There is often no neurotypical state the wand can be waved to, and often the decision for suicide overlaps between "ill" ad not ill persons particularly when they're subjected to indefinite stays in facilities under conditions of sexual abuse such as historically found in New York mental wards. Hell I might argue it may be cruel to stop someone from committing suicide to avoid being "helped" by New York.
That is, we are dealing with gritty, dirty reality where the mentally ill entity that is the state of New York, itself unqualified in its mental facilities, has a history of sexually and physically abusing people [0, but that's not all] to "protect" them from their own mental illness/suicide etc. Even if the consent argument fails on merits (I disagree), I argue the decision cannot and should not rest on the state in non-criminal concerns of imposing force on the ill (and notwithstanding the dystopic notion of government entities choosing who meets often poorly defined mental diseases).
With the state totally unqualified, and the individual on his own on the street often with family far removed, I defer to his perhaps ill consent. Notwithstanding, of course all help that can be offered should be.
You have already heard all the unsolicited opinions and suggestions from people who have no fucking clue what you're going through or what 6oige been through. You have been told "just do X, Y, Z" and have been given countless resources both local and national that others think would help you. You tried contacting a few and they were too demanding, demeaning, or discriminating.
You spent a lot of time learning helplessness even as you became self sufficient to the best of your ability. It wasn't enough either way. Nobody wanted to help you, they just wanted to tell you that they want to, and you discovered that you don't even want their help anyway because it comes with caveats and requirements that you simply cannot tolerate or meet.
You found a way to stay connected and survive despite all this. You know you can take care of yourself. You know you are worth someone's effort and time, but you can't find that someone. Every time you think you do, they fuck you over in some way.
The tiny things added up. A broken this, a missed that, a forgotten something by someone. Dominoes fell. There are plenty of individuals at fault but it's mostly the systems, or The System. The World Should Be Better, but it's not. People are assholes, churches and charities are grifters, there's no hope for those who proffer hope. You're right.
You're right. You're on your own. You're better than all of them.
Prove it.
Workin' on it to the best of my ability. 'Tis taking far longer than I'd hoped, and all the while the pain and lack of sleep drives me slowly insane… It's a race against time, and so far time is winning. Ah well… Live alone, die alone, even surrounded by 8 billion others… C'est la vie…
Senator Robert F. Kennedy toured the institution in 1965 and proclaimed that individuals in the overcrowded facility were "living in filth and dirt, their clothing in rags, in rooms less comfortable and cheerful than the cages in which we put animals in a zoo" and offered a series of recommendations for improving conditions.
Shortly thereafter, in early 1972, Geraldo Rivera, then an investigative reporter for WABC-TV in New York, conducted a series of investigations at Willowbrook uncovering a host of deplorable conditions, including overcrowding, inadequate sanitary facilities, and physical and sexual abuse of residents by members of the school's staff.
>“The common misunderstanding persists that we cannot provide involuntary assistance unless the person is violent,” Mr. Adams said. “This myth must be put to rest. Going forward, we will make every effort to assist those who are suffering from mental illness and whose illness is endangering them by preventing them from meeting their basic human needs.”
How does this work with federal US Supreme Court rulings such Connor Donaldson and Addington Texas:
https://en.wikipedia.org/wiki/O%27Connor_v._Donaldson
https://en.wikipedia.org/wiki/Addington_v._Texas
Some more cases:
https://en.wikipedia.org/wiki/List_of_United_States_Supreme_...
NYC especially is pretty good at this: they make a law, it works through the system and gets struck down by SCOTUS, then they immediately make a slightly different law which has to work through the system and be struck down.
It’s way quicker to make a law than it is to strike it down. Ultimately, if the people of a region keep electing lawmakers who make unconstitutional laws, that region will have unconstitutional law most of the time.
Wouldn’t it be more reasonable to view this phenomenon within the context of the balanced powers of government? The Supreme Court has the final say in the constitutionality of a certain law, but that doesn’t make them the most powerful branch of government. They lack the power to try again, and the legislature and the executive have that power.
To me, the system is working as intended when the people elect representatives who repeatedly force the judicial branch to strike down laws the people want. This seems to be a way to redirect this type of question into a political solution, i.e., a way to force people to recognize that what they really want is not a particular law, but a better judiciary or a center Constitution.
After all, the chain of events you’re describing is one that never departs from the mechanisms considered by the Constitution (and the Marbury court, of course, but that ship has sailed).
Ideally you would have lawmakers incentivized to produce laws, that upon review, are constitutional, but it remains the supreme court’s jurisdiction to determine that constitutionality.
Like try spamming the FDA drugs unlikely to pass scrutiny — they’ll just shut you out — so you’re incentivized to try to submit something reasonably likely to pass.
I agree that there is no disincentive to passing laws that the judiciary will nullify (other than the fact they get nullified and have to be replaced). The “malicious actor” of whom you speak appears to me to be the representative of the populace, from whom all power derives, and accordingly I see this as a feature, not a bug. The only incentive they should need to pass useful laws is re-election.
My ideal would be that the courts would interpret and make law, but that political questions like “what comports with the Constitution” would be solved at the ballot box, in the legislature, or with the veto pen, as was intended.
The idea that the judicial branch could be made “impotent” via repeated passing through the duly empowered legislature of bills signed by the duly empowered executive seems like exactly the right amount of power for what was considered by Article III. The courts are, after all, currently the strongest part of our constitutional system.
All boils down to “government is doing something with force of law” and is reviewable by SCOTUS.
> ruling that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom by themselves or with the help of willing and responsible family members or friends.
The non-paywalled portion of the article
> Mayor Eric Adams directed the police and emergency medical workers to hospitalize people they deemed too mentally ill to care for themselves, even if they posed no threat to others.
These seem to be the same standard, they are confining people who incapable of caring for themselves, which O'Connor v. Donaldson apparently allowed.
On an aggregate level, I would say two things: 1) I assume most people who are homeless did not choose to be homeless with sound mind and free will. If I am right, then we should do what we can to get them off the streets if they are sane and willing, and take them off the streets involuntarily if they are in decrepit health or are in any way violent.
2) Let's say most of the homeless were living the vagabond life. I asserr there exists a limit on the sustainable homeless population in any community or city. At some point, when do cities say "no you can't shit in the bushes in the park, no you can't have entire parks taken over as makeshift campsites, no we will not tolerate IV drug use which litters our streets"?
More needs done, out of compassion and out of necessity for the housed community.
They only get involved when those family members and friends call them directly, or the person is found wandering around.
The "public medical facilities" were terrible, underfunded and everybody shut most of them down.
Of course, nobody actually set up anything to take their place because that would be expensive.
And here we are.
It's unsurprising. NYC elected a cop as mayor, and his only idea for solving the city's problems is more policing. It hasn't worked in the past, and it won't work now, but the media and real estate classes here keep demanding it anyway.
Why not just give these people free housing with assisted care on location? If we can survive on the street we can surly survive in a residential setting.
What will happen is they they will pump us full of drugs to sedate us and just keep sucking money out of the state and federal government so that these hospital owners can buy another house in Bermuda.
https://slate.com/news-and-politics/2018/07/tent-fires-are-o...
For these people who have severe mental illness, free housing with assisted care on location looks a lot like a mental institution. Without oversight they are liable to walk out of care and be back on the street. For some homeless, that's how they are on the street today. They might have gotten a delusion that leads them from disappearing from their families, and sometimes they find them years later living on the streets in a state of complete dissociation with reality, other times they never find them.
The agony induced by haloperidol was used by the Soviets to help their dissidents realize the gulags were much better places than the psycho prisons.
surely giving anti-psychotic drugs isn't tantamount to abuse in severe cases.
Houses.
> many homeless (not all) that menace pedestrians and businesses on a daily basis?
Houses.
You see, the answer is simple but there is just no will to do it because people do not care about the mentally ill. We scare people for no reason but their own ignorance. I would say 90% of the mentally ill would have a great remission of their symptoms if they had stable housing.
I am homeless, all I need is a simple fcking studio but even making a lot of money from disability I cannot afford one anymore and I get shut down by people who do not want to rent to me because I am on diability.
Can we agree that different people have different urgent needs? I agree with you that you need a house. A mentally unstable person who can’t take care of themselves needs mental help. A person with hard drug addiction destroying them needs physical and mental help. Not all problems can be solved with free housing, just like not all problems can be solved with involuntary hospitalization.
That is unfair, as it implying that throwing houses at the problem will magically fix it. Houses would help, for some (many) cases, but it's a lot more complicated than that. Nor is it simple to supply those houses, and lack of doing so isn't just "not caring". It's hard. It's really hard.
Poor people who are not mentally ill often do exactly that. Even some drug addicts can sometimes get together to rent a place to crash. But we're talking about the severely mentally ill here. They are unable to band together. I imagine that this is sort of by definition... those who's mental illness illness is mild enough that they can help themselves by working together... just do it. The remaining are on the streets.
The trope about "the Mayor is a former cop" makes for good political talking points but it's meaningless otherwise. In what way has NYC become any different since Adams took the helm?
We could force the state to put these people in front of a judge or jury if you prefer. California does--and my experience is that these people seem to get reasonable aggressive representation from the state.
It unfortunately won't change much.
There aren't enough beds--that's the simple truth. So, this isn't going to put even a dent into the situation.
Same with healthcare or housing or any other population wide benefit policy where benefit recipients can migrate in and net payers into the system can migrate out.
This is begging the question. You have to explain why you think that's bad, not merely describe what's happening.
Obviously you're assuming a shared sense that it's illegitimate to intern someone without a trial, but the whole point here is that some people think an exception should be made in this particular case. You're just reiterating the controversy.
I don't notice much difference with him compared to de Blasio, except de Blasio was universally not liked. Adams is better but surprisingly by not much.
> It hasn't worked in the past
Considering the 70s were a complete mess & a generation afterwards it didn't feel like that, whatever happened in-between seems to have improved things. And that improvement definitely did come from police to some degree.
Crime was at a historic low until recently with the advent of "defund."
By the way, "defund" was also about using some paramilitary police funding to fund social services and mental health calls like the ones that may be dealing with the people in this discussion.
Finally, recall that "defund" kicked off at the same time as a global pandemic and major economic shock, an affordable housing shortage, a wage shortage and a drug epidemic.
so are you pro-worker or not (I suspect you are pro-worker), cause it sounds like you're hashing out anti-worker rhetoric against your enemies
I hear this all the time from ppl, it's this automatic talking point that cops don't do their job, so we should just push dangerous slogans like defund - when cops are desperately needed in actually dangerous neighborhoods. It's a very privileged sentiment.
If the rail workers threatening a strike had a history of disabling crossing guards on railroad crossings to hit cars without warning, and their union didn't want conductors to get fired for that, I'd be against the railroad union, too.
Again, "defund", this scary slogan, attempted to wrap a lot of ideas up, most of which did not directly mean "eliminate the role of law enforcement". And, like I said and you failed to refute, substantial police budget cuts are quite sparse. So what's dangerous besides something that hasn't happened? What's dangerous other than cops quiet quitting to protest things that haven't happened?
Public sector employees are represented by the public in voting. The idea that they should bargain with the public is ridiculous when they are the public elected by the public. Any additional "protection" will dangerously insulate them from reform & accountability to the will of the public.
Public sector unions are fundamentally anti-democratic.
With a union, they're able to hold other citizens hostage. It's disgraceful and exactly why they're able to get humongous budgets for doing nothing, as you seem to admit.
Mind you this happens with teachers and other public sector employees. Pretty much inevitably.
Of course, the people who get up-in-arms about police never extend their logic to their own sacred cows.
We should probably nationalize our railroads, too, but that's a different discussion.
We've gone off the rails (!) but we might agree more than disagree. My stances:
Homelessness: housing needs to be more affordable, income inequality should be reduced through progressively higher taxes, and funding for mental healthcare and public safety should be increased.
Cops: major reforms required but they are a necessity in society.
Unions: reasonable for private sector, debatable for public sector, dangerous in the case of law enforcement.
Oh, and the root of our failures in government is the two party system which lowers morale for the public, promotes political extremism and encourages fear-based politicking instead of solution -based politicking.
50 more psych beds won’t cut it.
The solution is easy bu they truth is no one cares. No one cares about the mentally ill homeless. No one. I know this because I ma mentally ill and homeless now for four years. People would rather make bank off an AirBnB than rent it to me for half the price and still make it so I am paying of f half their mortgage. It is just greed, simple greed, with everyone.
I am not even asking for much, a simple studio, but no one cares, so I get worse and worse and then you will all pay SO MUCH MORE when I am in the hospital and medicare has to pay for my $10,000 a week hospitalization.
It is all so idiotic.
Huh? I would have expected you would need at least thousands of new psychiatric beds to meet the need in a city as large as New York City.
There's also a WP page on the history of deinstitutionalization world-wide [1]. It starts from the 19th century, talking about sanitariums and what happened with them.
[0] https://en.wikipedia.org/wiki/Deinstitutionalization_in_the_...
If only we had a test for strength of free will…
Yes. Thats how it worked for over 100 years in the US, until the 1980s. I remember being shocked to learn this too, being too young to remember such a time. The “funny farm” was a real place.
But the alternative is what we have now. Where every major city in the country has thousands of deranged psychotic people roaming the streets, completely unmedicated or cared for, until they inevitably cause harm to themselves or someone else.
Huh. Every now and again, I'll think that I basically understand the broad strokes of the US political system reasonably well for someone who doesn't live there.
Then I learn that mayors can section people, which surely takes time away from core mayoral duties like opening supermarkets.
If that last sentence caused you to pause a bit, fair enough, I paused when I read it in the Chronicle as well. Those aren't my words, that's a quote from someone involved in the program. Thing is, I actually do agree with the statement. But it does astound me how determined we are to use only the language of compassion, even when describing a drug addicted man who is roaming the halls of the housing of last resort for homeless people in a pandemic, slashing faces with a knife. Our language around this does hint at the source of our profound paralysis.
As for mental institutions, they have a bad rep for a good reason. But consider the depths we have plumbed in street conditions, tent camps, drug scenes, fentanyl overdoses, meth-induced violence, and somehow using a single term, "homelessness", to encompass this and people who are having trouble affording housing, blurring the distinction. I know it's always risky to take the perspective of the future as if it will prove one right, but... maybe we will look back on our treatment of the mentally ill as simply another installment in the cruelty of our mental institution, just that we sent it from the institutions to the streets for a while, but that those looking back will not see an appreciable difference. That last sentence is optimistic, because it at least leaves open the possibility that we will someday look back on this from a better place.
[1] https://www.sfchronicle.com/projects/2022/san-francisco-sros
The easiest thing to do is to say "it's their own choice".
A violent knife slasher belongs in prison. Help he needs? What does that mean?
However, I ultimately have the same reaction you do to this sentence. The pure language of compassion shows no compassion for the victims of this crime, or the horrifying and brutal nature of this crime. It really does pinpoint the source of paralysis in a very progressive city like San Francisco. I have trouble believing that we won't reach some kind of turning point, mainly because the failure is just so spectacularly and overwhelmingly undeniable.
I want you to say this after you stayed a week in one of these hospitals. You do not care about us, you care about seeing us.
You want us to be forced to take medications? Which ones? The ones that don't work of the one that give us heart diseases, tardive dyskinesia, and also do not work?
It disgusting? You know what is disgusting? The way people make the mentally ill homeless because they want to rent an AirBnB or have two or threee houses or got house rich with 2% mortgages and created the homelessness problem.
We cannot say housing/Airbnb is not an issue entirely. On most nights, I have three houses within 100ft of me that are empty because they are short rentals near the city center. I wonder if there are a few people who would like to live in those homes if they could?
But yes too, many are mentally ill and some need more than just a bed.
I didn't suggest squatting is a solution. You punched your own straw man.
Phase II was to let them out of asylums, and then sending them to prison after they committed crimes (the 90's, 2000's)
Phase III was to let them out of prison, because we are over-incarcerating, studies show that recidivism is worse when people are imprisoned [1]
Phase IV - send them back to the asylum
We're currently flirting with phase IV.
1- Blah blah blah John Jay School of Criminal Justice Blah blah blah Social Science Blah Blah Blah The Carceral System [tm]