NYC's Involuntary Hospitalization Plan Can Proceed, A Judge Rules

[fooferdoggie]

You know what's goignto happen with this.
A judge ruled that New York City’s controversial plan to allow first responders to involuntarily hospitalize homeless people with mental illnesses can proceed, according to CNN.
Under Mayor Eric Adams’ plan, which faced backlash and legal challenges shortly after it was introduced in November, first responders would have the authority to remove and involuntarily hospitalize anyone on the streets who “appears to be mentally ill” or “displays an inability to meet basic living needs.” Removal would be allowed even if the person doesn’t appear to be a danger to themselves or others.

NYC's Involuntary Hospitalization Plan Can Proceed, A Judge Rules

The decision comes a few months after the controversial plan was introduced by Mayor Eric Adams.

www.huffpost.com

 

[Alli]

What’s their backup plan? Cause it won’t take long for the hospitals to fill up this way.

 

[fooferdoggie]

What’s their backup plan? Cause it won’t take long for the hospitals to fill up this way.

exactly it will be abused big time.

 

[Chew Toy McCoy]

“displays an inability to meet basic living needs.”

So basically anybody who is homeless.

 

[AG_PhamD]

As someone who works in psychiatric medicine, I am not opposed to this in theory, so long as cases are handled appropriately. I have strong doubts this will be successful given the current and intended resources.

Most homeless people on the street are indeed severely mentally ill and are not receiving treatment. They are not in the state of mind to make reasonable decisions. In a place like NY, especially in the winter, living on the street dose poses significant risks to self. On average homeless people live almost TWENTY years less. Many suffer from severe substance use disorders which is also a form danger to self in some jurisdictions. And while many of these individuals are not violent, there some that are.

I think people assume involuntarily institutionalizing someone is inhumane, but I would argue the opposite is true. The goal is to get them into treatment, get them to a point of stability, provide them the resources to allow them opportunity to have a better life with as much independence as possible.

Unfortunately with mental illness, people are so sick that they cannot see a way out.

But for this system to work, there must be enough public resources to support this population. And the quality of care must be appropriate for individual needs, not a one size fits all model.

ER’s are already overcrowded with psych patients. Some ER’s might as well be psych units. I suspect what we will see though is a system with no continuity. People will be dropped off at the hospital, admitted for a few days and given antipsychotics, and as soon as the person starts to stabilize the hospital will have to discharge them as they no longer meet the necessary criteria to hold them. Longer term psych programs or housing support will not have beds available and these people will be discharged back onto the street or a shelter. Having no support, these people’s conditions will relapse and the cycle will begin again. That’s how the system operates as it is even with those who do pose an explicit danger.

Another problem is that it’s just not mental illnesses like psychotic disorders that requires treatment. More often than not, there is concurrent severe addiction and trauma involved, which are very difficult conditions to treat independently. Combine all of these and its exponentially more difficult and a lot of programs are not adequately equipped to handle such cases. Addiction treatment in particular is very resource intensive and accessibility has long been a problem, let alone dual-diagnosis programs that handle the more complex problems.

Thanks to media, many people have very interesting conceptions of mental health hospitalizations- like 1950’s asylums with people being given ECT against their will and being abused by staff. That’s not the case. It is true there are some pretty awful psych programs, but a lot of that has to do with funding.

The civil liberties issue is not that people are being involuntarily committed, it’s that they’re not being committed. I would much rather these people have every opportunity to get help, live in a safe environment, and hopefully achieve successful management of their condition and independent living than see them sleeping over a subway grate to keep warm in freezing weather while strung out on drugs next to the garbage can they eat out of- at risk of being beat up by some delinquent kids or robbed of the little they have by another homeless person.

Ideally involuntarily commitment would not be necessary, but that’s not the nature of the diseases involved. But in what world is alternative considered humane?

Honestly, the belief of “caring” by not caring is ridiculous and is used by politicians to underfund and excuse themselves of the failures of the social systems.

Here’s a good article to read: https://news.harvard.edu/gazette/st...entally-ill-homeless-not-entirely-outrageous/

 

[Chew Toy McCoy]

As someone who works in psychiatric medicine, I am not opposed to this in theory, so long as cases are handled appropriately. I have strong doubts this will be successful given the current and intended resources.

Most homeless people on the street are indeed severely mentally ill and are not receiving treatment. They are not in the state of mind to make reasonable decisions. In a place like NY, especially in the winter, living on the street dose poses significant risks to self. On average homeless people live almost TWENTY years less. Many suffer from severe substance use disorders which is also a form danger to self in some jurisdictions. And while many of these individuals are not violent, there some that are.

I think people assume involuntarily institutionalizing someone is inhumane, but I would argue the opposite is true. The goal is to get them into treatment, get them to a point of stability, provide them the resources to allow them opportunity to have a better life with as much independence as possible.

Unfortunately with mental illness, people are so sick that they cannot see a way out.

But for this system to work, there must be enough public resources to support this population. And the quality of care must be appropriate for individual needs, not a one size fits all model.

ER’s are already overcrowded with psych patients. Some ER’s might as well be psych units. I suspect what we will see though is a system with no continuity. People will be dropped off at the hospital, admitted for a few days and given antipsychotics, and as soon as the person starts to stabilize the hospital will have to discharge them as they no longer meet the necessary criteria to hold them. Longer term psych programs or housing support will not have beds available and these people will be discharged back onto the street or a shelter. Having no support, these people’s conditions will relapse and the cycle will begin again. That’s how the system operates as it is even with those who do pose an explicit danger.

Another problem is that it’s just not mental illnesses like psychotic disorders that requires treatment. More often than not, there is concurrent severe addiction and trauma involved, which are very difficult conditions to treat independently. Combine all of these and its exponentially more difficult and a lot of programs are not adequately equipped to handle such cases. Addiction treatment in particular is very resource intensive and accessibility has long been a problem, let alone dual-diagnosis programs that handle the more complex problems.

Thanks to media, many people have very interesting conceptions of mental health hospitalizations- like 1950’s asylums with people being given ECT against their will and being abused by staff. That’s not the case. It is true there are some pretty awful psych programs, but a lot of that has to do with funding.

The civil liberties issue is not that people are being involuntarily committed, it’s that they’re not being committed. I would much rather these people have every opportunity to get help, live in a safe environment, and hopefully achieve successful management of their condition and independent living than see them sleeping over a subway grate to keep warm in freezing weather while strung out on drugs next to the garbage can they eat out of- at risk of being beat up by some delinquent kids or robbed of the little they have by another homeless person.

Ideally involuntarily commitment would not be necessary, but that’s not the nature of the diseases involved. But in what world is alternative considered humane?

Honestly, the belief of “caring” by not caring is ridiculous and is used by politicians to underfund and excuse themselves of the failures of the social systems.

Here’s a good article to read: https://news.harvard.edu/gazette/st...entally-ill-homeless-not-entirely-outrageous/

The short version is the only people they are really looking to help is "hard working" tax payers who don't want to view or be harressed by homeless people.

 

[Herdfan]

This seems like one of those situations where the pendulum swings back and forth and never reaches equilibrium.

Starts out as a homeless problem, so someone is elected who promises to "fix" it. They do so by rounding them up and keeping them away from where people see them. Then someone gets elected who thinks this is cruel, but instead of looking for a real solution, just lets them go back to doing what they want. They end up back in the public eye harassing people and hurting business. So someone gets elected to fix it. And again, instead of finding a real solution, just moves them somewhere else. Rinse, repeat.

So as this pendulum swings violently back and forth, it never seems to reach an equilibrium. Or anywhere close to it.

We have lost sight that most real solutions make neither side 100% happy.

 

[AG_PhamD]

The short version is the only people they are really looking to help is "hard working" tax payers who don't want to view or be harressed by homeless people.

I don’t think that’s at all what I said.

It is the governments job to help the people that pay taxes… and those who cannot. But let’s not pretend that most people “care” much for helping the severely mentally ill homeless either. Given the choice between tax dollars to support education or repave a road with potholes and funding mental health programs or homeless services, guess what they’re going to pick?

And I don’t think there is anything wrong with people not wanting to be harassed by homeless people (or anyone for that matter) or to have homeless people sleeping on their doorstep (or accumulating junk, relieving themselves, or doing drugs). There’s a reasonable expectation of cleanliness and order in any city. People are not supposed to be homeless.

The argument that people are somehow the bad guys for being disgusted by homeless people living, sleeping, and shitting on their streets is simply absurd. I really don’t understand the idea of normalizing homelessness.

If your non-homeless neighbor was throwing his trash, empty bottles of alcohol, and syringes on the sidewalk, leaving bodily waste on your front step, screaming at everyone that walked by, I’m pretty sure this would not deemed acceptable.

I can’t say what the intentions behind this bill are. If they actually want to support this population, I’m guessing they are rather misinformed about how the mental health system functions or expect it do accomplish something it cannot given the present resources. And adding 50 beds to NYC’s psych infrastructure is nowhere near what’s necessary and only addresses one small part of the system.

What I foresee happening, to expand on my previous post that mentions the already revolving door of hospitals stabilizing psych patients for a few days and letting them out, only for them to come back shorty thereafter- that’s already how it operates. Police will get tired of this and will stop bringing them in. Otherwise, the homeless people will adapt and find areas that aren’t as well policed or where the police don’t care or move to another city.